• Dental Phobia Support

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Need to find a sensitive dentist fast. Some questions.

C

c247

Junior member
Joined
Dec 26, 2016
Messages
6
Hi, everyone. I just posted this topic in the "Find a Dentist" section:

[out-of-date link removed]

I didn't find much in the way of recommendations for my area, which seems odd since it's Los Angeles. Just one recommendation for an expensive guy out in Santa Monica. There must be more around here, no? I was hoping to find a "special needs" dentist who works with disabled and severely phobic people. This is for my wife who hasn't seen a dentist for 27 years. She's 39 now and terrified about having to do this.

She hasn't had any major dental pain in the past 27 years but I'm sure she has a number of cavities. Just the other day, she bit into something hard and it made a small crack/hole in one of her molars. The grooves in her molars are dark brown/black in some spots. This hole isn't really causing any pain unless she bites down on it. But I imagine it is collecting food and needs to be taken care of as soon as possible. This is obviously going to be a huge scary thing after so many years of neglect. She has wisdom teeth that need to be taken care of as well. Depending on how bad things are, we could be in for a very extensive and pricey treatment.

One thing I really don't want to happen is for the dentist to make some kind of comment while examining her teeth that will upset her. I'd really prefer it if he didn't say anything about what kind of problems he sees until after the exam. And I'd prefer he tell ME what the situation is privately and then I can tell my wife about it and explain her options. The idea of a stranger telling her upsetting things just makes the situation worse. I need to be able to sit down with her and tell her what's going on. Is an arrangement like this unheard of? I imagine if a kid goes to the dentist, they will talk to the parent and leave the kid out of it so as not to upset them. That's the kind of situation I'd really prefer.

I'm also very confused about insurance. She has a regular PPO healthcare plan that does not include dental coverage. That can be added for just $30 or so a month, but it appears they only cover part of the expenses up to $1000 and after that, you pay full price for everything. This doesn't seem very good for someone who will probably have to have a lot of work done. I've seen other plans like Delta Dental that have various options but it's really confusing to me.

This may be a stupid question but do you have to have insurance before your initial exam or can you get it afterward? What is the best strategy insurance-wise for someone in her position? I really have no idea how extensive her treatment will be and how much it could possibly cost. Is it too late to get insurance at this point? Although this isn't an emergency (yet), I want her to see someone ASAP. But I want to find someone who caters to phobic patients. I've been searching around the internet and keep running into conflicting information that has me very worried.

Take this example. This dentist claims to "cater to cowards," i.e. phobic patients. Perhaps the attempt at humor should be a warning sign, but her Yelp reviews are mostly positive. But the negative ones always scare me. Take a look at the second and third one-star reviews here:

[out-of-date link removed]

The idea of someone ordering unnecessarily complicated procedures involving extractions is really not something a phobic patient who has avoided the dentist for nearly 30 years needs to be worrying about. How could any person in a trusted authority position whose job it is to care for desperately scared people be so soulless as to pull something like that? And non-disclosure agreements? WTF? The problem is I seem to find something like this for just about everyone I look up. Like this guy:

[out-of-date link removed]

Special needs dentist? So far, so good. And from the website:

Call Now...You're conversation will always be with Dr. Minsky!! The phone call with Dr. Minsky is free...Each patients needs are important. That's why Dr. Minsky is the only person you will speak with. When you call, Dr. Minsky can answer your questions about insurance, treatment, and cost. You won't be frustrated, angry, or wasting your time calling the office!

Dr. Minsky listens to his patients and knows how frustrating it can be making endless calls hoping to find a dentist who will treat someone with special needs.


Wow, sounds like a lock. Let's check out his Yelp reviews:

[out-of-date link removed]

Not many reviews, but all five-star. This could be the one. Let's just do a final Google search... Uh-oh:

[out-of-date link removed]
[out-of-date link removed]
[out-of-date link removed]


So what the heck am I supposed to believe? How can I possibly trust anyone enough to put my severely phobic wife's mouth in their hands? I knew this was going to be difficult but there seems to be a lot more to worry about than I imagined. :confused:
 
I suggest calling dental practices in your area, asking if they have any dentists that are very good with phobic patients, then explaining your requirements to them beforehand. A really good dentist (and they do exist) should be willing to go the extra length to take care of a patient's needs, including a chat beforehand etc.

Remember that the first appointment will not involve any procedures, just an examination and x-rays and a discussion about what needs to be done. As it's your wife in the chair, it's up to her if the dentist she sees makes her feel better or worse.

Lots of phobic patients will be scared out of their wits, crying and shaking in the chair etc. It just happens. A good dentist will help reassure them and not be impatient. If you get a bad dentist, you don't have to see them again.

If you call beforehand, you can also ask if the dentist takes your insurance, and what payment plans they offer.
 
Sevena is right! I just went through this last week. That Tuesday, I called the dental office i had been eyeballing for over 3 years. I hadnt been to a dentist in about 10 years! I checked yelp reviews and google reviews! Only one bad review and it was only about selling a product at the end of that persons treatment. I didnt mind seeing that at all. I explained my panic, phobia, and anxiety situation and told them I was in excruciating pain. They saw me two hours later and i cant tell you how glad I am that I made that call. I saw the dentist (she was super nice and kept reassuring me as she just looked in my mouth). she made a emergency plan for me. That same Friday I saw the main Dentist and he was AMAZING!!! They put a special dental assistant with me that only works with phobic patients and she too was just amazing! So they are out there, just call around and go meet with them. Good luck and keep is posted! Im actually happy to go back and let them do my crown and my full exam. Im sure i will need more work but I will feel VERY comfortable returning there. As a matter of fact, im taking my son there in a few weeks for his 6 month checkup/cleaning. My husband will become a patient there as well. Please dont give up and just support her as it seems you are already doing.
 
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Thanks, guys. I'm trying. I'm really confused about the whole dental insurance thing. Since I have no idea how much work will need to be done, it's difficult to know what to do. I just read this article that suggested dental savings plans over insurance:

[out-of-date link removed]

I'm wondering it that might be a better option for someone in my wife's position. It all depends on the results of the initial exam. Is it possible to get an exam first and then purchase a savings plan before the recommended treatment? Getting through that first visit is going to be difficult.
 
You shouldn't have to agree to any dental treatment plan during the initial evaluation. Many people get a check-up done in one place, then have some treatment done in another, for instance. Some people will also only get what's most "urgent" treated first, then delay later treatments if they need to save money or sort out insurance, etc.

You can ask dentists about savings plans too.
 
I'm unsure if a Dentist will agree to leave your wife out of a conversation about her dental health. Maybe if she agrees and signs a waiver? I know Dentist are still subject to HIPAA laws (privacy) but I'm unsure to what extent. If she doesn't want the Dentist talking discussing his findings mid exam, he may be able to agree to this, but most Dentists still talk to their Assistants while they're performing an exam. She might heart technical phrases but it won't mean much to her until or unless he explains his findings with her.

Whatever happens, she should be reassured that this is her mouth and her teeth - she has full control over the visit, any visit to her provider! It may be helpful if she or you could get her records from any previous provider for the Dentist to review prior to the appointment. If that's not possible, maybe she'd feel comfortable making some notes about prior treatments she remembers, how she tolerated treatment in the past, document what she's nervous about (he may be able to make her more comfortable if he knows exactly what worries her), etc. Also, notes about what is urgent (her pain, location of pain, level of pain, what sets it off and what helps if anything, how the pain is felt, etc).

Remember, if Dentist refuses to give you treatment plan privately but wants your wife present to discuss, remember to tell her that she doesn't *HAVE TO* agree to have any treatment done. A treatment plan is not a contract. At any time during her treatment, she may refuse further treatment. Also, it may help her to know that dentistry has come a LOOOOOOONG way in just the last 10-20 years. certainly it's a much different world today at the Dental clinic than it was the last time your spouse was in. They have much more precise equipment, dramatically improved imaging equipment (OMG the Imaging they do now is incredible!!), their techniques and practices are much improved and overall, it's just a much better experience. The drugs they use for anesthesia is also dramatically improved. If you're seeing a good dentist for treatment, you may expect to feel one short poke and then nothing more -- if you're seeing an excellent practitioner. you won't feel a darn thing during the anesthesia process, much less even see it coming! She'll feel vibration and hear noises during treatment, but she should at no time experience pain (and if she does, always always encourage her to take charge of the situation and raise her hand if she's ever uncomfortable!). There are always sedation options, too. She may prefer that route.

Just some notes about Individual and Group Dental Insurance in America:

Sadly, the majority of individual and group Dental insurers require the patient satisfy wait periods before they'll pay for any treatment. The majority of insurers will only pay for immediate cleanings and exams at 100% (generally), and that 100% is only 100% of their allowed amount and/or only with their In Network providers. Unless you've had consistent coverage with no lapses, it's important to note that most (all possibly) insurers will subject you to wait periods for any treatments beyond the cleanings and exams. And they likely will not cover any pre-existing (pre-diagnosed) conditions at any time.

In the case of your wife, if she's in pain, she likely won't benefit from having insurance policy underwritten tomorrow...however, if you keep a policy active, she will get coverage later down the line.

Most American Dental insurers have wait periods for treatment. Common wait periods are usually something like this:

Cleaning, xrays, Exam = 0 months
Dental fillings = 6 months
Endo (RCT), Denture, etc = 6-12 months
Crowns, Bridges, et = 12-18+ months

Dental insurance isn't truly "insurance"- it's more of a supplement to offset your costs as a patient. It's nothing like Medical insurance and doesn't work even remotely the same way.

Also, some insurance pays some treatments at higher allowed percentages than others. One plan, for example, may pay 80% of their allowed amount for a Root Canal while other plans will only pay 50% of their allowed amount for a Root Canal. And there are treatments that aren't covered at all under many plans.

If you do sign her up for insurance and can't get immediate coverage for pre-existing conditions, you may still save if you go to a Dentist that is In Network with your insurance plan. That's because In Network Dentists have agreed to only charge the patients in that plan X dollars for each treatment. And some of these Dentists will still agree to only charge you that agreed upon rate even if you have not satisfied the wait period. In which case, you'll pay 100% of the treatment but at least it will be at the reduced amount.

You can buy private/individual plans at any time but the majority of individual dental insurers in America will only provide up to $1,500.00 USD of coverage and at that, they'll only pay up to XX% of an allowed amount for any given procedure.

SCENARIO A

For example, say you have dental insurance, and your max annual benefit dollars = $1,500.00. In this scenario, you've satisfied all of your wait periods AND you've paid your annual deductible. You suddenly find you need a RCT and a Crown but you're seeing a Dentist that is *OUT* of Network for your plan:

Dentist quoted $1,200.00 for the RCT. Insurance max allowed charge for this treatment is $900.00 for the RCT of which insurance will pay 50% of their allowed amount. Which means insurance will pay $900.00 (max allowed charge) X 50% = $450.00 The balance is paid by the Patient...so, you'll pay $1,200.00 (total charge) - $450.00 (Insurance co-pay) = $750.00 total out of pocket from Patient for RCT.

You still have $1,050.00 in available benefit dollars.

Dentist quoted $1,300.00 for Crown. Insurance max allowed charge is $800.00 for the crown, of which they'll pay at 50%. Which means insurance will pay $800 (max allowed charge) X 50% = $400. The balance is paid by the patient...so you'll pay $1,300 (total charge)- $400.00 (Insurance co-pay) = $900.00 total due out of pocket from patient for Crown.

Total Due from Patient for RCT/Crown for Out of Network Dentist - Scenario A = $1,650.00

And you still have $650.00 in available benefit dollars for the benefit year/toward future treatment that year.



SCENARIO B

So let's say now you're seeing an In Network Dentist for the same treatment. In this scenario, you've satisfied all wait periods and deductible.

Dentist quoted $1,200.00 for the RCT. Insurance max allowed charge for RCT is $900.00 and they'll only pay 50% of their allowed amount. Dentist agrees to waive balance between his rates and the max allowed charge by insurer. Which means insurance will pay $900.00 X .50% = $450.00 The balance (50% of the allowed charge) is paid by the Patient = $450.00 total out of pocket for the patient for RCT In Network Dentist.

So you still have $1,050.00 in available benefit dollars.

Dentist quoted $1,300.00 for Crown. Insurance max allowed charge for Crown is $800.00 and they'll pay 50% of their allowed amount. Dentist agrees to waive balance between his rates and the max allowed charge by insurer. Which means insurance will pay $800 X .50% = $400. The balance (50% of the allowed charge) is paid by the Patient = $400.00 total out of pocket for Crown for the patient Out of Network Dentist.

Total Due from Patient for RCT/Crown In Network Dentist - Scenario B = $850.00

And you still have $650.00 in available benefit dollars for the benefit year/toward future treatment that year.

So you save $800 having the same two treatments just by seeing an In Network Dentist. And if that Dentist agrees to bill you the In Network rate if you've not satisfied wait periods, you'll still save a chunk of change!

My recommend would be to insure her now to save you some cash down the line after she's satisfied wait periods. However, be prepared for sticker shock at the Dentist if you haven't been in a long time yourself. If she has a group plan at work, there is a slim chance that she may NOT be subject to wait periods for treatment...check with her HR or Benefits department or have her bring the home the literature. Note that you often can't add coverage unless you have a qualifying event or it's open enrollment period. Again, consult with her HR department for clarity on this.

(These are all just sample numbers that have no bearing on what any given Dentist may charge.)

Confused yet? I learned very quickly how Dental insurance actually works in America and how almost pointless it can be if you need any extensive work done, however, finding a Dentist willing to charge In Network rates even after I exhaust all of my benefits has saved me some money. The bottom line is that once you've exhausted your benefit dollars for the benefit year, you have to wait until the next benefit year to have any work done that is covered (at whatever % they will cover).

As far as finding a good dentist, I'd suggest you ask friends/family/co-workers for recommendations, then research those providers and see how comfortable you (your wife) feels about seeing that Dentist over the next one. She may want to see several before feeling comfortable or she may have a good feeling about the first Dentist she sees. I wish you and her nothing but the best of luck, I hope you find an amazing Dentist that performs her craft well and I hope your wife is out of pain as soon as possible!!

I've heard mixed reviews about "Dental Savings Plans" that rely on recruiting several patients to make up the cost (theoretically speaking) -- and I've never actually bought a savings plan. I found my Dentist first and then worked backward to find insurance that she was in network with. It worked well for me.

Good luck.
 
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I just saw this, so I don't know if you've already gone to a dentist with your wife. I recently saw Rachel Fine in Glendale. She is incredibly sensitive, gentle and kind, and her whole office is. They are so helpful in finding a plan that works for you. I went with a dental discount plan (Vital savings with Aetna) and like that there is no maximum. I have already saved over $500.

I don't know if she will just tell you what needs to be done, but she will be gentle and kind. Everyone I've interacted with at this office is wonderful. Again, they accept the aetna vital savings, Quality Dental Plan which is another discount plan, Delta and Aetna PPO and Care Credit - the credit card for healthcare.

I'm terrified to have my first full exam in 6 years - I've only had an emergency exam regarding excruciating pain - but Dr. Fine was wonderful. Knowing that I have found a good dentist makes the thought of a full exam and whatever follows a little more bearable. Good luck and let us know how it goes.
 
Hi, guys. I haven't checked back here for a while. First, I just want to thank Deck2015 for your tremendously helpful and detailed reply! That post needs to be pinned for anyone else confused by dental insurance.

I decided to go with Aetna's Vital Savings plan that meesapanda mentioned. Looks like we'll be able to get the work done in Northern California and I think I may have found the perfect dentist (who also takes Vital Savings). His name is Samer Itani and he sounds like the best possible person for my wife's particular needs. The appointment isn't until next month and I'll let you all know how it goes. Here's his site if you're interested:

[out-of-date link removed]

Nearly perfect Yelp reviews:

[out-of-date link removed]

And a YouTube channel with videos that look very promising:

[out-of-date link removed]
 
Also, I'm not sure if this has been been mentioned before but I found an awesome site for finding "special needs"/"special care" dentists. The Special Care Dentistry Association. They have a referral page where you can search for special care dentists in your area.
 
Yelp is NOT a good source to check on dentists. They have had a long history of disfavoring dentists who don't pay them and other non-ethical behaviors.
Reliable source is Angie's List as best. Google reviews are only verified that they actually came from someone so are useful if you take them time to read the details.
 
Yelp is NOT a good source to check on dentists. They have had a long history of disfavoring dentists who don't pay them and other non-ethical behaviors.
Reliable source is Angie's List as best. Google reviews are only verified that they actually came from someone so are useful if you take them time to read the details.

Thanks for the info. I was not aware of that.
 
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