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Special Report

New Age of Dentistry

Choices, Costs & Cautions

Going to the dentist today means that you might encounter services that are suspicious or surprising, such as high-tech oral-cancer screening, Botox injections and collagen implants. And at a time when many consumers don’t have dental insurance, new alternatives, such as seeking less expensive treatment in other countries, has its problems, too.

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Joyce Lacovra hid her grin. Because of gum disease and oral infections, she lost one-third of her teeth by the time that she was 52. She had no dental insurance, was bankrupt from oral-surgery bills and needed permanent teeth implants, which, one U.S. dentist told her, would cost $100,000. When she discovered 3 years ago that she could get her teeth fixed in India for just $22,000, she hopped on an 8,000-mile flight to Mumbai, where a U.S.-trained dentist pulled and replaced every one of her remaining teeth.

Today, Lacovra has a full set of gleaming white implants, and she is delighted that she paid about one-fifth of the expected price for her dental surgery. “I thought I would have to spend the rest of my life paying off dental bills, or spend the rest of my career as a singer hoping that my ill-fitting bridges didn’t fly out of my mouth onstage,” says Lacovra, who lives in Washington.

ROOT ISSUES. Lacovra’s experience represents one of the many significant changes in dental care in the past 5 years. At a time when a growing number of Americans are losing dental insurance, consumers have new ways to save on dental care—either by seeking treatment in other countries or by visiting newly available midlevel practitioners who are called dental therapists. At the same time, some U.S. dentists whose profits have been squeezed by the recession are working to polish their own bottom lines by introducing services, such as Botox injections for cosmetic purposes, oral-cancer-screening tests that use light and special rinses, and cutting-edge laser tools, for which they can charge customers more money.

But each of these new developments in dental care presents potential problems for consumers. For instance, there’s little evidence to suggest that the latest cancer-screening tools are more effective than are traditional exams. In addition, the newest cancer-screening techniques and the increased use of Botox injections will increase your out-of-pocket dental expenses, because these types of procedures typically aren’t covered by insurance. And if you’re desperate enough to get dental care in other countries, it can create a financial mess if you have to get a U.S. dentist to fix the botched work of an incompetent dentist who’s outside of the United States.

It isn’t a coincidence that all of these potential problems exist as more Americans struggle to find low-cost dental care than ever before. An estimated 46 million U.S. citizens who are under the age of 65 have no health insurance, and nearly double that number—90 million—have no dental coverage. Arizona, California, Hawaii, Idaho, Kansas, Massachusetts, Minnesota, Ohio and Washington slashed Medicaid dental services for needy adults in 2010 and 2011 by reducing the number of dentists who serve Medicaid patients and eliminating coverage for routine checkups—a short-sighted decision that could result in an increase in more-costly health problems later. Among Americans who are fortunate enough to have private health insurance, 27 percent must pay for their own dental coverage.

What’s more, private insurers for years have capped their dental coverage at around $1,500 to $2,000 per year—less than what you might have to pay for a single crown or a root canal. At the same time, the cost of dental-health premiums is rising faster than inflation is, and it’s forcing many consumers to go without coverage during these lean times, according to The New York State Dental Journal. It’s no wonder that the percentage of people who see a dentist every 6 months as recommended by American Dental Association (ADA) has declined to just 42 percent (127 million patients). And it’s no wonder that Department of Health and Human Services reports that 53 million U.S. children and adults have untreated decay in their permanent teeth.

In short, the new age of dentistry means that now, more than ever, if you’re determined to protect your wallet and your health, you really need to know the drill.

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