Does Trusted Dental Care Have A Value?




Dental care is not a commodity.  It’s not laundry detergent or breakfast cereal or wireless minutes.  Dentistry is a professional service that’s both art and a science.  Yes, there are excellent dentists and not-so-great dentists.  Often, you get what you pay for.  Teeth are a crucial part of health and appearance.  Untreated gum disease, for instance, is linked to heart disease.  (Would you choose a cardiologist based on price?) Over time, most will come to realize that shopping price is a minor concern when in comes to their health.  Any minor cost differences amortized out over a lifetime will become insignificant.  The results and the most long-term satisfaction come from getting care from someone you trust. 

Dental insurance is nothing like health insurance or auto insurance.  It is a maintenance plan that will cover cleanings and x rays and maybe half the cost of a crown.  It will not protect you if you need a lot of work done.  The maximum annual benefits, $1000 to $1500, have not changed in the 50 years since dental insurance became available.  It is a minor cost assistance and there is a widening divide between what patients expect and what is actually provided by their coverage. 

Anywhere from 60% to 80% of what a patient pays goes toward the expense of running a modern dental practice.  Dentists pay rent or mortgage payments on their office space, payroll for hygienists, assistants, office managers and receptionists, taxes, supplies, business insurance, malpractice insurance, and technology—just to name a few.  A lot of people would be surprised at how tight the profit margins are, and may dentists are still paying student loans from dental school.

Dentists cannot afford to reduce their fees by 50% or more, and stay in business.  However, this is what is expected by many dental insurance companies, especially HMO’s and DMO’s .  Despite any noble intent, many find they could not stay in business if they actually charged the plan fees.  They would literally lose money.  So, the dentists who sign on with these plans learn to work the system.  They often have to learn to add on fees that are not covered by the plan.  They also “unbundled” procedures and itemize “extras” that are not really “extras” such as local anesthesia.  In a normal dental office, these extras are included as part of the procedure or service.  By the time the “plan recommended” dentist is done adding on extra charges, the final fee is often MORE than it would have been at a private dentist.  Patients who sign up for HMO/DMO plans, under the expectation that they will be saving money, may actually end up spending more.

 So why would a dentist agree to such an arrangement with an insurance company? By signing on as a contracted provider, the dentist gets a lot of patients referred to him or her by the insurance company.  It’s a promise to keep the dentist “busy”.  They think they will make up losses with volume.  Of course, it does not work out that way.  Other corners must be cut to accept these low fees. 

Lab fees also play a roll in the cost of dental care.  Different labs vary in the quality of the products they produce.  We all want our dentist to be using high-quality labs for things like crowns, bridges, veneers and dentures.  Should we have to ask about the lab? No.  We should trust our dentist to select a good one.   Discounted dentistry does not allow for your dentist to choose the best materials or the best lab, and chances are they are being made by the cheapest available.

You should choose and receive your dental care with your eyes wide open.  You should not be surprised with unexpected costs.  Also, when in doubt, get a second opinion. 

For more information, please visit Dr. Michael Miller at or call the office at 706-454-3040.

Can Bad Breath Be A Serious Condition?

If you’re experiencing chronic halitosis (bad breath), it could be a sign of oral disease (as well as a systemic condition or treatment). In fact, it’s quite possible to visit our office about bad breath and find the cause is actually tooth decay, gum disease or some other oral condition.

In those cases treating the more serious condition might also result in a reduction in bad breath. Here are a few scenarios where such treatment could result in both better health and fresher breath.

Repairing decayed teeth. Repairing teeth damaged by decay — removing diseased tissue, filling cavities or repairing defective fillings — will also reduce the level of decay-causing bacteria. Such bacteria are often responsible for bad breath since they also release volatile sulphur compounds (VSCs), characterized by a foul “rotten eggs” odor. After treatment, these odors can diminish significantly.

Treating gum disease. Periodontal gum disease is a progressive infection caused by bacterial plaque. The basic treatment is to remove as much offending plaque and tartar (hard deposits) as possible. This may require extensive cleaning techniques (like root planing) to remove plaque from tooth root surfaces beneath the gum line, as well as antibiotic therapy. Periodontal therapy not only restores health to gum tissues, it may also alleviate bad breath caused by bacteria.

Extracting third molars (wisdom teeth). The opercula (flaps of gum tissue) around wisdom teeth have a tendency to trap food debris, which fosters bacterial growth. If this leads to chronic infection we may recommend removing the wisdom teeth. This not only reduces the chances of infection but may also alleviate bad breath caused by the bacterial growth.

Treating candidiasis. This is a yeast infection arising as a result of antibiotic use that suppresses normal oral flora. It’s also a source of bad breath. Treating the infection and restoring normal balance in the mouth may help alleviate bad breath as well as prevent disease.

You may see a pattern here: many of these conditions that simultaneously contribute to bad breath stem from high levels of bacteria, which flourish in plaque built up on tooth surfaces due to inadequate oral hygiene. Effective daily brushing and flossing (along with semi-annual office cleanings) removes much of the offending bacterial plaque. As a result you’ll experience better oral health — and maybe fresher breath too.

If you would like more information on controlling chronic bad breath, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bad Breath.”