Crossing that (dental) bridge.

thAt the end of April I got some unpleasant news concerning my teeth, news so unpleasant that it made me want to go out and waste money. Regular readers know that would indicate some serious upset.

As I explained in “How to avoid takeout,” the Maryland dental bridge I’ve had for 31 years needs replacing due to a cavity underneath it. The first stage — cutting apart the bridge, fixing the cavity and crowning the tooth — would cost approximately $1,222.

Today I had the first part done and the appointment revealed both very good and very bad news. Typical.

The good news: My initial impression, as it were, was that crowns weren’t covered by my mediocre insurance. Last night I read my policy and learned that an in-network discount exists but that Alaska is a state in which providers aren’t required to offer it.

Mint Dental offered it anyway. That plus the 5 percent discount for paying for cash brought today’s cost down to $846 and change. Huzzah!

The bad news was probably there all along, subliminally speaking: If I can’t afford two implants then I need to get a partial denture.


Replacing what’s been lost

Due to a long period with no dental care two molars are missing from my lower left jaw. Without implants or a partial to make up for the now-vanished bridge my upper molars will start erupting downward in search of their “partners,” according to the dentist.

In addition, chewing mostly on the other side of the mouth would place undue stress on those teeth. It’s clear that I need to replace the left-hand chompers.

However, it isn’t as simple as just financing the implants: Because those molars have been gone for more than 30 years the bone has eroded significantly. That means it must be built up surgically.

The graft probably wouldn’t come from me. “You can use pig bone,” the dentist explained.

Gee, can I? Thanks!

Major expense, major discomfort, the chance of infection and a pork-and-porcelain combo. Eeesh.


An embarrassing mouth

Here’s the real issue, though: the very idea of a denture. Dentures are a bad punch line. Dentures are what I’ve fought to avoid after years of little to no care.

And, yeah: Dentures are for old people. Specifically, for old people who didn’t do right by their own teeth.

My dad used to chant a jokey refrain: “Her eyes were like pools. (Cesspools!) Her cheeks were like petals. (Bicycle pedals!) Her teeth were like stars. (They came out every night!)” That made us laugh when we were young, but the idea of taking my teeth out…brrrrrr.

My grandmother sometimes thrust her upper denture out to startle us kids. That made us laugh, too. It also frightened me to think of having to take your teeth out and put them in a glass every night.

What also frightened me was how odd it looked when Mom-Mom or any of my other dentured relatives weren’t wearing their teeth. Their faces looked caved-in and gaunt.

Apparently those fears stuck with me, because I thought about them off and on all day.


Attitude (reluctantly) adjusted

Now I’m thinking along different lines:

  • That I’m being silly. Something must be done. I can’t put this off or wish it away. The dentist said that a partial will work just fine if I can’t afford the implants.
  • That I’m letting anxiety run amok. Yes, the partial will be expensive but I have money in my emergency fund to cover it. Do I want to take that money out? Of course not. But that’s why it’s there: to take care of unforeseen issues.
  • That I’m actually lucky. Rather than have my teeth continue to go wonky I can get this fixed. Besides, it’s just a partial plate.

Compare my situation to my son-in-law’s. An inherited calcium deficiency plus extreme over-prescription of corticosteroids during his childhood meant that Tim’s teeth were crumbling when he met my daughter. He’s had full dentures for several years and they’re saving up to pay for implants before the bone in his jaws erodes any further.

Naturally I don’t like the idea of taking out a partial every day, or paying another $2,200 or so for the second crown and the partial. Already at work on ways I can shave money here and there from my current budget to make the cost less disruptive to my EF. (First up: Since my friend and I take turns buying lunch out each week, I’ll sign up for more restaurant reviews and get paid to treat her to meals.)

But the fact is that I’m twice blessed: I have access to good care and I don’t have to go into debt to receive it. Attitude adjusted. Now all I have to do is remember to be thankful once some of my teeth are like stars.

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  1. Holly S

    I KNOW where you are coming from. Six weeks ago I fractured a lower molar. May 1 I had that surgically removed AND I had to have 2 previously root canaled teeth (front, lower) also were removed. I also needed grafts which were done during the extractions. Surgery/grafting + implant for the molar is $5000 and needed or I will lose the tooth above. Extraction + grafts + bridge for the front teeth is $1800. The bridge is a permanent one so no taking my teeth out at night. I do NOT have dental insurance & my medicare does NOT cover any of this.

    Hello EF. With my normal savings rate this money will be replaced in 20-24 months. However, with no vacation and hoping no close relative marries in the next 10 months I should be able to cut that in about half. Also, I swept my checking account so an extra $250 already repaid and there is the possibility of even more next month.

    • Donna Freedman

      The bridge they’re replacing was a permanent one — sort of, since cantilevered bridges aren’t truly permanent. But 31 years is pretty good.
      I’m grateful to have any care, and to be able to replenish my own savings over time. Just workin’ it through. Sorry to hear about your pain and suffering, both physical and fiscal.
      Thanks for being such a consistent reader and commenter.

  2. jestjack

    MAN….Sorry for the dental problems. Aaaand I got a feeling that I’m right behind you. My bridge is feeling “wonky” and I dread it physically and financially. BUT as crazy as it sounds I feel blessed. My folks had dentures relatively early in life. My Mom in her 20’s and my Dad in his early 40’s. Boy, dentistry is a lot more complicated today. So if you get the “pig bone graft” does that mean you have to steer clear of bacon?

    • Jack,
      “Steer clear of bacon”, funniest thing I’ve heard all day. 😀

    • Donna Freedman

      It might mean I’d want more bacon — pigs are cannibalistic omnivores.
      My dad’s dentist told him something like, “In your parents’ day it was accepted that they’d have dentures. In your day it was accepted that you’d have root canals and crowns. In your children’s day it is accepted that they won’t necessarily need any of those things.”
      Dentistry is more complicated now but I’m really glad I have access. My sister, a dental hygienist, says that keeping your own teeth (or as many as possible) has a lot to do with nutrition and overall health. I believe it.

  3. Sandy

    I can sympathize with everything you are saying. A few weeks ago I broke a tooth and had to have it crowned. Making a long story short, the crown ended up as a root canal. I do have dental insurance, but it ended up costing me almost $500 out of my FSA…which was earmarked for new glasses. Oh well, at least the money was there! I also have a fear of dentures, remembering well some years ago when my Dad handed me his dentures in a little cup when he went to surgery. But, this is preventative care that will all be worth it for you in the end. Good luck!

  4. Sympathy. My teeth have been causing trouble since I was a child. In the process of replacing crowns that are 25 years old. I’m with you on fearing the implants. Using tissue not my own, and having metal that my body does not like in my mouth might further push my autoimmune thyroid troubles. And if I already have an autoimmune issue could lead to others. Not to mention the infection risk. The partial is probably way less invasive as a health threat even tho that it a big disappointment. And even with dental insurance, the amount I pay could fund some really nice week-long trips…Hang in there.

  5. Kathryn

    hey, at least we WISH upon stars!! 😀

  6. Robin

    I was raised by my grandmother and never went to a dentist till I was 16 and half my teeth were bad. No one ever talked about my irregular bite until about 10 years ago. I don’t know how many teeth I have have missing. I recently had to have two more pulled that came loose and got infected. I have been going to the dentist regularly for about 42 years now. Thank god all the pulled teeth are towards the back where you can’t see unless I open my mouth wide. One dentist wanted 5,000 to fix partials. Money I don’t have and can’t afford to take out a loan for. My teeth are a little yellowed from taking tetracycline all throughout childhood. I tried every whitener and toothpaste out there, but to no avail. Now they are starting to get brittle. I am allergic to so many things, that I will not attempt implants. I will be one of those people who will probably end up with false teeth one of these days. At least I would have the white teeth I always dreamed of.

  7. Catseye

    I can empathize with you on this, although my teeth issues aren’t as serious. I estimate that I’ve spent close to $10,000 on my teeth over three decades. I have six or seven crowns, I’ve lost count.
    I realized in my early twenties that I was going to have to take better care of my teeth if I did not want to wind up like mom who had her remaining teeth removed at age 50 and wore dentures after that. She hated them and hardly ever wore them after she retired.
    I’m glad that you have the money in your emergency fund. I currently don’t have an EF or dental insurance, but I still get teeth cleanings twice a year. I’m a big advocate of regular dental care.

    • Donna Freedman

      What I didn’t realize is that dentures affect the way food tastes and also the way you chew, e.g., you might not be chewing food enough (which is hard on your stomach) or you may avoid certain foods because they’re tough on your teeth (which deprives you of some forms of nutrition).
      It’s just all-around better to keep your teeth, no matter what the price.

  8. Betty

    I have had a number of implants over the last 12 years. They are expensive but they do feel like real teeth. I have had to have bone surgically attached, but I am not sure of the source. My dental insurance did not cover implants until just recently with a max of $2,000 per year.

    In the past, my dental office had some sort of a loan program from an outside company that charged little or no interest (hard to believe). You might want to check around to see if there is anything like that still available.

    Good luck with everything.

    • Donna Freedman

      The dentist has the no-interest loan program, but I’d rather just pay it all upfront. I have a horror of debt and besides, I do have the money. Now all I’ll have to do is replenish that emergency fund to the tune of however much it winds up costing.
      Glad your dental work turned out well. That’s good to know, since my son-in-law is having that same surgery in January.

  9. Amber

    Donna, I’m sorry for the tooth trouble. Will they give you anything to put under your pillow for the tooth fairy?

    My grandfather lost his teeth (born 1901) but his gums would not allow him to wear dentures, so he had to literally gum his food. No more steak, lots of mashed vegetables and biscuits with gravy. I felt for him. Imagine going through life with no teeth! We are lucky, even with all our root canals, crowns, and partials.

    I told my dentist earlier this year that I am really putting my money where my mouth is.

    • Donna Freedman

      Ha! In fact, the dentist did ask if I wanted the fake tooth from the part of the bridge she sawed off. I should have taken her up on it. 🙂

  10. Lots of people I know have had implants some with bone grafts with no problems as far as I know. Also dental techniques are continuing to advance so possibly in the not so distant future it will be a relatively simple operation. It is very common for Irish people to go to some of the cheaper European countries(ie.Poland, Hungary) for implants and other expensive dental work with seemingly very successful results.

    • Donna Freedman

      I might yet choose to do implants. A friend just told me that hers weren’t so bad. For now, though, a plate will have to do.

  11. teinegurl

    Can I say that I relate? I’m only 28 but after 10 years of no dental insurance since I was a kid ( quest only covers emergencies extractions in my state) I’m finally able to get teeth cleanings. I have 4 wisdom teeth that needs to be removed one is sideways. Luckily I don’t have pain which surprised my dentist but I’m worried about paying $200 co pay. I know its a necessity but when your single mom something always come up. Just try to cushion my e fund before making the jump.

    • Donna Freedman

      One of my wisdom teeth had a root that grew underneath like a letter J. The dentist had to break it and take it out in pieces. Eeeww. Fortunately I had insurance.
      I think that cushioning your EF is a great idea and I wish you luck in doing it quickly.

  12. Maureen

    Just a reminder, that if you have an HSA account, you can use some of the funds from there — as long as it’s not considered cosmetic. We didn’t have much in there last year when my husband had his 2 implants done, but he loves that he finally did it. He says his mouth feels brand new again!

  13. I grew up with a somewhat similar fear, though more drastic scenario. One of my grandparent sets lived in a rural area, dental care simply didn’t exist. They did the best they could, brushing every day, but fluoride wasn’t available and annual cleanings were unheard of. So by the time I met them, they didn’t have but a few teeth of their own left. That always stuck in my mind: losing your teeth would be hard. Losing them and not having any option to replace them would be worse.

    In her last years, Mom suffered severe dental trauma and degradation thanks to terrible dental care provided through Medicaid. If I had known those dentists were ruining her teeth at the time, I would have paid out of pocket for her to see a private practitioner much sooner and hang the cost.

    All that to say: I’m so glad you are having this taken care of now. Even if it’s a pretty penny now, your quality of life is just priceless.

    • Donna Freedman

      Absolutely. I missed having dental care during a couple of periods in my life and am now paying the price, as it were. I will do what it takes to stay healthy.
      Sorry your mom suffered so.

  14. Cathy in NJ

    I have so many thoughts on this subject I don’t know where to begin. First, sorry you are having these dental issues. Hope your problems get fixed pain free.

    Secondly, why is dental insurance not part of normal health insurance. It is treated like a rich man’s luxury, “I have a BMW, yacht and dental insurance.” Don’t get me started.

    Thirdly, I always do the least invasive procedure.

    Consider the 0% loan because if you spend a chunk of the EF no one else will give you a 0% loan if you have a two-fer, another expensive problem on the heels of this one. I open a separate account and set aside the money for the 0% loan that way I don’t think it is available for other issues.

    • Punkin Pye

      Cathy, the reason that dental insurance probably is so expensive is that almost everyone will need teeth filled, crowned, or replaced during their life, and not just when they are older. Insurance companies make their money by collecting premiums for events they know probably won’t happen.

  15. Punkin Pye

    Having grown up poor, to uneducated parents, I had never even heard of having regular dental checkups or cleanings until I was 18 and needed a root canal. My dentist had to perform a very expensive deep cleaning with anesthetic. Starting in my late twenties, I would break a tooth at least once a year until all of my molars were crowned by the time I hit my early forties. This was probably a result of all the steroids I had to have throughout my life.

    Ever since I was able to get good dental insurance through my employer, I have been religious about cleanings and check ups. Expensive to be sure, but I have also always viewed the idea of dentures with horror. I have always joked that, if a fire broke out in the middle of the night, I might have to run out of the house naked, but by God, I’m going to have teeth, LOL.

  16. Insurance Gal

    Donna, I also am missing all molars on the lower left. Last year I was fitted with a removable partial. All procedures, including the partial, were paid for with Care Credit. If one is approved, Care Credit is interest free for a year. I was able to pay it off early.

    Cost aside, not sure about the implant route. That being said, I despise the partial with a passion, and feel like I am not old enough to have to have one. However, as I said to my dental assistant, “It’s better than being a toothless monster.” Being in sales, I’ve got to look presentable. I’m in my late 40s, and as time progresses, more dental issues are cropping up. This whole aging process is difficult and upsetting, IMO.

  17. I feel for you. I’m 28 years old with a myriad of dental issues.. thank you genetics *sigh* – I’ll spare you the gory details (and yes, it’ll make you cringe). I’m currently “down” to $1200 left in dental debt I hope to have paid off by July. Unfortunately, there’s lots more dental pain & costs in my future 🙁 I’m currently wearing a flipper for a missing tooth & will eventually need a partial (bridge or implant isn’t an option). I am completely mortified to have such awful dental issues at such a young age, so I’m constantly having to remind myself there could be worse issues (my personal frame of reference: Mom died, or my grandpa has had dentures since he was 15). Might sound morbid, but helps put things into perspective. As for the money, there’s not much I can do but pray & save. Dental insurance doesn’t cover much, i.e. a bone graft was deemed “cosmetic” – are you kidding me?!

    FYI: your comment that says ‘upper molars will start erupting downward in search of their partners’ might apply to some people, but I lost a molar in 2010 & haven’t had any issues. But yes, chewing primarily on one side is a pain.

  18. Yipes! You’re scarin’ me!

    I also will need to get some dental work in the future. Don’t know what it will be because I haven’t told the dentist how much the upper left jaw hurts, nor does he know about the crack I suspect in a lower left tooth. But I’m afraid it will be extravagantly expensive. Mine’s from bruxism: I clench my jaws unconsciously all the time, which eventually will crack and break your teeth. If a dentist tells you that you’ve got that habit, be sure and ask him to make a mouth guard — they’re not cheap, but they’re sure less than the cost of crowns and other exotica.

    TLC is right about the dental insurance. I also found the policies you can buy as an individual (as opposed to those available through an employer) cover almost nothing. It’s such a rip I no longer carry it at all.

    But…if it makes you feel any better, my mother lost the last of her teeth at about the age of 47. Dentists thought it was because of malnutrition growing up (she actually had rickets as a child!), but I expect her heavy smoking didn’t help. At any rate, the dentures looked GREAT — much better than the last remnants of her real teeth had.

  19. I actually have good teeth, which are a rarity in my family, but did lose an upper left molar because our small town dentist didn’t have a good x-ray machine and couldn’t see some damage under a large filling there.

    Our new dentist said I’d be a great candidate for an implant (healthy bones, not a smoker, great oral hygiene), so I went for it. It worked out that we could split the costs over three calendar years by starting with the extraction late in one year, then doing the bone graft and sinus lift, setting the implant pin, and the last tiny surgery to put on the healing cap on the pin in the second year. (The extraction was bit complicated by the molar had an extra root.) The crown was made and installed in January of the third year. Actual time involved was 15 months, so we were able to spread out paying for sections of the procedures so that it didn’t hurt financially too much.

  20. You poor, poor kid. Aging is the worst disease ever or so my great-grandma would say.

  21. Sue Braun

    I loved this article. I am 63 and have worn an upper partial (first front teeth you see) since I was 16. It is a combination of a partial and retainer since I also had braces. I was in a car accident and lost two upper front, had one jammed in to the roof of my mouth and broke a small tip off of another that could be filed. On the bottom, I lost 1/2 of one that the braces filled in as my teeth were crowded. Lot’s of blood and drama. That being said, my partial is a part of me. It is metal with white teeth in the front and the roof of my mouth has a large hole so it does not change the way I taste. All of this originally was paid for by the insurance company and I have replaced it only once. My dentist would love to see me get implants, but I am not about to mess with what has worked most of my life. My teeth actually look nicer now than they did before. I was told as a young person that partials only cause the teeth they hold on to to go bad, but I have only had two pin head size cavities in my life. You will get used to partials quickly and no one has to see you take them out. I clean mine and brush 3 times a day and sleep in them without any problems. They do remind you to brush more often and that is a good thing. I also floss every day. Thanks for such a wonderful web site to go to and read about issues and ideas that I care about and can relate to.


  1. Just a little link love: Hey Linda edition | A Gai Shan Life - […] Dental repair is scarily expensive, take care of your teeth! […]

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