More Dentistry

....But not for me.

Wife was involved in a car crash ( sometime before I knew of her presence on earth ) and as result had some
superficial facial injuries and, at the time, not so apparent dental injuries that resulted in very fine cracks in some
front teeth.

The problems with front teeth have only become apparent over the last 10 years or so.
About 8-9 years ago a front tooth needed work so our dentist put in a temporary crown that lasted until just recently.

When the crown came adrift we decided to seek treatment here in Hervey Bay but a neighbour advised us of a good
dentist in Maryborough, so off we went. Turns out she was a good dentist and nowhere near as costly (greedy? )
as the locals here. Trouble was the job needed to be done by an orthodontist somewhere up in the mountains.
On ringing him we found the cost was to be $3500!! So, we rang our dentist in Ipswich who quoted us $2000.

As we know the quality of our own dentists work we felt it was worth the extra hassle of driving to Ipswich and back to have
the work done there.

WHY is there such a difference between dentists for EXACTLY the same work???

They operate a collusive cartel of price maintenance.

Dentists, according to the ATOs list of tax returns by profession, have the highest margins of all occupations and businesses.

I would post the link, but it appears the ATO website is offline this weekend....again....

Although it shouldn't happen, people value their time differently. Depending on their workloads, they can value their time higher or lower to either maintain constant work or get paid a premium when there is too much work. I personally think that people should never devalue themselves just because "they need the work", because not only does it screw themselves over, it also screws over the entire industry that they are apart of. It happens a lot in woodworking with the retirees and hobbyists looking to make an extra buck by selling some crap they made over the course of 20 hours for 100bux...but if you ask them if they would accept a job which pays 5bux/hour without sick pay, holidays, long service or superannuation, they scoff in disgust at the thought. And then of course you need to trust your dentist not to drill through the side of your cheek, and so once that trust has been gained it is difficult for the consumer to go elsewhere to the "unknown" dentist which may or may not be a total hack. And with that trust, the work keeps coming in at premium prices. Tis good business.

All orthodontists are dentists but not all dentists are orthodontists.

Hence the price difference. Orthodontists are specialists in their fields. Its kind of like going to a GP vs going to a surgeon.

What you say is true Kuffy but surely there must be a standard price for a particular treatment.

What you say is also True Tonzeyd, but when the job can be done by any dentist why would you go to an orthodontist?

Certain things are best left to an orthodonist eg braces jaw surgery etc. Also their knowledge and experience comes into play when complications arises. Plus the cost also depends on the method and materials used in the replacement, as not all crowns are the same and the ortho may call in an external anesthetist which will also add to the overall cost.

Then opportunity cost comes into play obviously an orthodondists bread and butter is "cosmetic stuff" they'll tend to charge slightly more for the more simple stuff than a dentist would.

However if your dentist recommended you go to an orthodontist i'd ask why as I would have thought crown replacement would be a fairly routine task for a dentist.

Exactly my thoughts Tonzeyd!!

I know there are things best left to an orthodontist but a simple croown replacement?

I had (here in the states) a dentist as a child who charged as much as he could to insurance, and then would buy equipment (that was not yet insurance approved) and insist his patients used it. Some of that equipment is routine now, but he was just trying to make money back then, not help anyone. He also wanted to "seal" all teeth on every kid (again, income related). We eventually stopped going to him, because he'd bought an expensive xray machine that wasn't insurance covered and threatened all of the patients (or his receptionist did) that "Dr. Zero doesn't think he can be your dentist if you don't opt to have panoramic xrays performed". My dad had enough and said, "we'll get a new dentist then".

The second dentist was miles more honest, and told me the first, "Dr. Zero" regularly sends me overflow patients and I have to charge his rates when his patients come to me (apparently, Dr. Zero was good at marketing and guilting people). His rates are three times as high as mine for non-routine services". (When dr. Null doesn't have the capacity, dentist B keeps the entire fee, too - even though it makes him feel guilty).

Dr. Zero also hosted the local dentists in semi-rural Pennsylvania where I grew up (had them over for dinner to "talk shop") and told them that they all needed to raise their prices to bring the area up to market. Practically all of the dentists came from UPENN where I grew up, so the last one out of dental school had suburban and urban philadelphia pricing strategy.

Point being, unless the dentist is regulated or has their rates set by an insurance company, they can pretty much charge whatever they want - and they can suggest all kinds of crap that you don't need but make it sound like it's necessary as long as they don't state that it is absolutely necessary. Some dentists are nice people. Quite a few of them are outright greedy pigs, and some around here post on facebook what their financial goals are, and when you go to their clinics, they will try to sell you everything they can, and you'll see them for about a minute at each visit unless you're doing something very costly.

Before you have work done next time, ask a dentist what insurances they take. Then check the price of those insurances. Here's a real life scenario that happened to another woodworker a few years ago. They had gone to their dentist and were told that they needed dental surgery or something similar. The dentist told them the price would be 7k (I think it was more than one area of the mouth, so it might've been several). Insurances (even the garbage ones) have negotiated rates with dentists, so even if the insurance doesn't cover the surgery, the dentist is obligated to charge only the negotiated rate for an insured participant. In this case, the dental coverage was $50 a month and the negotiated rate for the surgery was $2500 - something like that. I told the person mentioning this that they needed to purchase insurance and then have the work done, even if insurance didn't cover it. The net difference was about $4K, and they were irate that the dentist didn't tip them off to this.

In the US, insurers often have agreements with dentists that all work of each class will be at a percentage of stated rates. For a root canal and crown, that might be 40% of a dentist's customary cash rates. The dentist won't tell you that, they'd rather get cash, and then they have an excuse that they can't offer you a price concession, because it would violate their agreements with insurers (which is true). if you have dental insurance in Australia, I'm sure the issue is similar. The insurer will negotiate to get the best rate that they can, because it helps them be more competitive when they set a premium (and you're probably going to buy similar coverage at the lowest price you can).

(the issue of implying that you're obligated to do something also is used by scummy attorney's here. My mother's mother died about 10 years ago and had a $2M estate to settle. The family attorney wanted $80K or something like that to settle it. The settlement work is about 20 hours at most, and most of it is done by paralegal staff. The attorney just thinks they're entitled to it. My mother's brother doesn't pay for anything he doesn't have to, so he contacted a CPA friend and the CPA friend told him that if he did all of the work, the CPA friend would help with tax form preparation for $3k. The attorney called several times stating "I wasn't aware that you could settle an estate without an attorney, and you're asking for trouble if you don't follow the rules". What he didn't say was "it requires a legal opinion by an attorney". He weaseled words together to make it sound like an attorney is required, because he wanted easy money. I suggested to my mother and her brother that she inform the attorney next time that all of their conversations would be recorded, and when he did that, they attorney stopped calling).

Ask around a little bit on all of this stuff, do a little bit of leg work. If you have a dentist that is shelling you because they're guessing whatever they can get out of you is a high number, find a different dentist. Most of these folks are in business to make money as fast as they can, not to be honest - their friendliness, or pretended friendliness is a business act.