This past week Jim reached out to me regarding dental treatment for his daughter, Michelle. Michelle is 4 and was just diagnosed with 3 cavities. The dentist recommended drilling and filling all three and since Michelle has anxiety at the dentist office, they also recommended general anesthesia. Her appointment is scheduled in two weeks and Jim wanted to make sure everything would be covered.
Wow. My own son just turned four. We haven’t taken him to his first dentist appointment yet, COVID got in the way of that, but it’s difficult to imagine the thought of my son undergoing general anesthesia for his baby teeth.
Before I responded to Jim about coverage, I asked if his dentist had discussed alternative treatment for the cavities. “Well, no” he said. I asked if he’d heard of SDF or silver diamine fluoride which is an FDA approved therapy that is safe and pain-free. It’s a liquid substance that gets painted onto the tooth to stop cavity development and kill bacteria from spreading to other teeth.
SDF therapy was approved by the FDA in 2014 and is widely accepted as a safer and effective alternative than drilling yet most dental practices don’t discuss this with their patients.
I asked Jim if he would mind if I contacted his pediatric dentist to inquire about this alternative therapy. After his approval, I phoned the office.
The response was profound…”Yes, our office does perform SDF therapy but we generally don’t discuss this alternative with our patients because insurance doesn’t cover it.”
Let us pause here and inform the readers that the material cost of SDF is about $0.91 per patient and most dentists will charge about $20-$25 per tooth.
Compare this with drilling and fillings which can run hundreds of dollars plus general anesthesia which was quoted in this case to be $2,500. But hey – it’s covered by insurance! The problem here is that Michelle’s full $2,500 deductible would apply, and fillings are only covered at 80%.
There’s no question that SDF without insurance coverage is more affordable.
The next statement from the dentist’s office was classic: “We would be happy to discuss SDF therapy with the patient’s family. They would need to come in for an emergency visit so we can do a consult and discuss the treatment plan.”
So because the dentist failed to advise of safe and possible therapy alternatives, the patient is now dinged for another copay and time wasted.
Cost however, is only one part of the equation. Weighing the risk factors is also important.
From Kidshealth.org: In very rare cases, anesthesia can cause complications in children (such as strange heart rhythms, breathing problems, allergic reactions to medications, and even death).
Drilling is also painful and can leave emotional trauma.
SDF has zero health risks aside from possible staining of the decayed area of the tooth. But we’re talking about primary teeth which will eventually fall out, so I put the risk factors for SDF at zero. It’s safe, pain-free, and quick.
Another lesson in health insurance: Just because something is covered, doesn’t mean it’s good for you.
*Note: the story above depicts actual events. The names have been changed to protect identities. For more info regarding SDF check out Quizzify.com
