4 ms·

"Even with insurance, the co-pay on wisdom tooth extraction is typically 50%, because such procedures are typically (not always) preventable by proper dental ca

by bgruber 15y ago

"Even with insurance, the co-pay on wisdom tooth extraction is typically 50%, because such procedures are typically (not always) preventable by proper dental care." Wait, what? It's true that under most dental coverage you pay a percentage (and not a flat co-pay) on oral surgery, but for the life of me, I don't understand the idea that the need for wisdom tooth extraction is ever preventable by proper dental care. No amount of brushing and flossing is going to prevent your body from throwing extra teeth in your mouth in your late 20s. If anything, proper dental care means none of your teeth will have fallen out, so when your wisdom teeth come in they have nowhere to go and get impacted and then decayed and then infected.

rkischuk 15y ago
I said "not always". Although it seems possible that scheduled wisdom tooth extraction may have been possible with proper care, regular x-rays, etc, that's not really the point. In my recollection, scheduled wisdom tooth extraction has usually been on the same 50% co-pay as emergency wisdom tooth extraction. And I don't think the "emergency" part has the cost implications in dental that it does in other medical realms. Neither is pleasant, but the cost would probably be the same either way. I don't try to justify the tiering of the co-pay, but recognize that moving it down to the 20% co-pay range just means the actuaries factor that change into everyone's premium.
- bgruber 15y ago
  I said "not always". You said "typically (not always)" and I say pretty close to never. I don't try to justify the tiering of the co-pay You said the co-pay was tiered "because such procedures are typically (not always) preventable" (emphasis mine). (i'm note 100% sure that by 'tiered' you mean that you pay 50% for this instead of the flat or 0 co-pay most dental coverage has for checkups and the like)
  - rkischuk 15y ago
    Sure, you can micro-parse the language, and yes, I mean it's at the 50% co-pay or whatever. If I were trying to explain the rationale in this case, I'd theorize it's because this is typically something that happens once in a lifetime (if at all). I'd expect once one wisdom tooth gets cranky, they'd yank the rest at the same time. So, in this case, the thought would be that people partially pay for it when it happens rather than making everyone in the insurance pool pay for that risk every month, especially people with no wisdom teeth. But I am not an actuary or insurer, so I don't know for sure.
    - dedward 15y ago
      some people dont have space for wisdom teeth, and in such cases they need to be removed - whether it can bedone simply with some freezing or some more complex surgery depends..... but uf you dont haveenoughspace, as many dont, they gotta come out.
    - zopa 15y ago
      I'd go with a business rational over the theory of distributive just over lifespans. It's an adverse-selection problem. Wisdom-tooth extraction is usually not an emergency (Nick's case excepted!)-- they have to come out sooner or later, but often you've got some time. And it's a big cost compared to most dental work. If the insurer covered all or most of it, you'd have people signing up for dental coverage, getting their teeth pulled, and dropping out.
    - Duff 15y ago
      It's not always a 50% co-pay. That will vary by state and by plan. I have pretty cheap & awful dental insurance, but wisdom teeth extraction was 100% covered. I think my only cost was the copay for anesthesia. Dental insurance is pretty cheap -- there are a limited number of high-dollar procedures that happen infrequently. Plus, major costs like anesthesia are usually part of medical coverage. So while the insurance pool is more likely to pay for a wisdom extraction for many folks between 18 and 30, that's a one time event. Medical insurance, on the other hand, needs to cover a broad array of overpriced procedures with nearly unlimited liability. I had a back surgery that cost my insurance company about $75k. The recent birth of my child cost nearly $25k!
skimbrel 15y ago
My wisdom teeth actually fit in my mouth. Because I took care of them (and the rest of my teeth) as they started growing out, I get to keep them. Dentists far too often recommend extraction for wisdom teeth when it's unnecessary, probably because they can charge a hefty fee for it.
- marvin 15y ago
  Very commonly, a person's jaw/mouth is too small for the wistom teeth to fit. Case in point, I (25-year old guy) had a wisdom tooth which grew sideways (into the next tooth) and _would_ have destroyed the next tooth and caused an infection like the one linked in the article. I have a second one which might do the same. These things are not preventable, you were just born lucky. Remember, humans didn't usually live to become 50 years old.
  - Zancarius 15y ago
    > Very commonly, a person's jaw/mouth is too small for the wistom teeth to fit. Exactly this. I had something similar (identical?): A horizontal impaction of my bottom right molar. Had I left it longer, it would've destroyed the roots to the molar in front of it, and I would've lost that tooth, too. I suspect it's largely genetic. My mum has all her wisdom teeth, and she's never had an issue; my father had all of his removed because they didn't come in straight. My situation played out identically to his. Hence, I don't believe that simply taking pristine care of the teeth will magically help--if they don't erupt from the gums properly or come in crooked, there isn't much else that can be done save an extraction if they're problematic. In many cases, you're better off having them removed to prevent issues precisely like this one.
    - andrewem 15y ago
      I'm missing two upper teeth [0], which resulted in my having enough room in my mouth for my upper wisdom teeth to fit comfortably. It's evidently of genetic origin in my case, as I have relatives who are missing the same teeth, which I think from that source are called the upper lateral incisors. Were I not missing those teeth I expect I'd have needed the upper wisdom teeth removed to make room. (On a tangent, there's a great article [1] about how bulldogs have been bread to have massive jaws and a very short face and that results in all kinds of breathing difficulties.) [0] http://en.wikipedia.org/wiki/Hypodontia http://en.wikipedia.org/wiki/Hypodontia [1] http://www.nytimes.com/2011/11/27/magazine/can-the-bulldog-be-saved.html?pagewanted=all http://www.nytimes.com/2011/11/27/magazine/can-the-bulldog-b...

by bgruber 15y ago

rkischuk 15y ago

I said "not always". Although it seems possible that scheduled wisdom tooth extraction may have been possible with proper care, regular x-rays, etc, that's not really the point. In my recollection, scheduled wisdom tooth extraction has usually been on the same 50% co-pay as emergency wisdom tooth extraction. And I don't think the "emergency" part has the cost implications in dental that it does in other medical realms. Neither is pleasant, but the cost would probably be the same either way. I don't try to justify the tiering of the co-pay, but recognize that moving it down to the 20% co-pay range just means the actuaries factor that change into everyone's premium.

bgruber 15y ago
I said "not always". You said "typically (not always)" and I say pretty close to never. I don't try to justify the tiering of the co-pay You said the co-pay was tiered "because such procedures are typically (not always) preventable" (emphasis mine). (i'm note 100% sure that by 'tiered' you mean that you pay 50% for this instead of the flat or 0 co-pay most dental coverage has for checkups and the like)
- rkischuk 15y ago
  Sure, you can micro-parse the language, and yes, I mean it's at the 50% co-pay or whatever. If I were trying to explain the rationale in this case, I'd theorize it's because this is typically something that happens once in a lifetime (if at all). I'd expect once one wisdom tooth gets cranky, they'd yank the rest at the same time. So, in this case, the thought would be that people partially pay for it when it happens rather than making everyone in the insurance pool pay for that risk every month, especially people with no wisdom teeth. But I am not an actuary or insurer, so I don't know for sure.
  - dedward 15y ago
    some people dont have space for wisdom teeth, and in such cases they need to be removed - whether it can bedone simply with some freezing or some more complex surgery depends..... but uf you dont haveenoughspace, as many dont, they gotta come out.
  - zopa 15y ago
    I'd go with a business rational over the theory of distributive just over lifespans. It's an adverse-selection problem. Wisdom-tooth extraction is usually not an emergency (Nick's case excepted!)-- they have to come out sooner or later, but often you've got some time. And it's a big cost compared to most dental work. If the insurer covered all or most of it, you'd have people signing up for dental coverage, getting their teeth pulled, and dropping out.
  - Duff 15y ago
    It's not always a 50% co-pay. That will vary by state and by plan. I have pretty cheap & awful dental insurance, but wisdom teeth extraction was 100% covered. I think my only cost was the copay for anesthesia. Dental insurance is pretty cheap -- there are a limited number of high-dollar procedures that happen infrequently. Plus, major costs like anesthesia are usually part of medical coverage. So while the insurance pool is more likely to pay for a wisdom extraction for many folks between 18 and 30, that's a one time event. Medical insurance, on the other hand, needs to cover a broad array of overpriced procedures with nearly unlimited liability. I had a back surgery that cost my insurance company about $75k. The recent birth of my child cost nearly $25k!

skimbrel 15y ago

My wisdom teeth actually fit in my mouth. Because I took care of them (and the rest of my teeth) as they started growing out, I get to keep them. Dentists far too often recommend extraction for wisdom teeth when it's unnecessary, probably because they can charge a hefty fee for it.

marvin 15y ago
Very commonly, a person's jaw/mouth is too small for the wistom teeth to fit. Case in point, I (25-year old guy) had a wisdom tooth which grew sideways (into the next tooth) and _would_ have destroyed the next tooth and caused an infection like the one linked in the article. I have a second one which might do the same. These things are not preventable, you were just born lucky. Remember, humans didn't usually live to become 50 years old.
- Zancarius 15y ago
  > Very commonly, a person's jaw/mouth is too small for the wistom teeth to fit. Exactly this. I had something similar (identical?): A horizontal impaction of my bottom right molar. Had I left it longer, it would've destroyed the roots to the molar in front of it, and I would've lost that tooth, too. I suspect it's largely genetic. My mum has all her wisdom teeth, and she's never had an issue; my father had all of his removed because they didn't come in straight. My situation played out identically to his. Hence, I don't believe that simply taking pristine care of the teeth will magically help--if they don't erupt from the gums properly or come in crooked, there isn't much else that can be done save an extraction if they're problematic. In many cases, you're better off having them removed to prevent issues precisely like this one.
  - andrewem 15y ago
    I'm missing two upper teeth [0], which resulted in my having enough room in my mouth for my upper wisdom teeth to fit comfortably. It's evidently of genetic origin in my case, as I have relatives who are missing the same teeth, which I think from that source are called the upper lateral incisors. Were I not missing those teeth I expect I'd have needed the upper wisdom teeth removed to make room. (On a tangent, there's a great article [1] about how bulldogs have been bread to have massive jaws and a very short face and that results in all kinds of breathing difficulties.) [0] http://en.wikipedia.org/wiki/Hypodontia http://en.wikipedia.org/wiki/Hypodontia [1] http://www.nytimes.com/2011/11/27/magazine/can-the-bulldog-be-saved.html?pagewanted=all http://www.nytimes.com/2011/11/27/magazine/can-the-bulldog-b...