Dental treatment costs here vs the North

ballsymchugh

the waiting lists in DDH are closed for a year unless you're in serious pain. even at that, you'll just be sorted and sent back to your own dentist.

Cato78

From an American perspective, it seems so strange that you'd have to drive to the UK for anything. I live in Florida and can't imagine having to drive to Georgia to buy something or get medical care. Are there many demonstrations there over things like this? I can't imagine most people are happy with the government.

greenie

stepbar wrote: »

Well I've had the full works done in my mouth. So far I've had....

3 root canals
2 gold crowns
1 cap
1 porcelain tooth and removal of bone (associated with same)

All done thank god. I guesstimate that I've spend no more than c2k to get this all done.

I am really really really shocked that you only paid 2k for all that work here in Dublin. Considering finding someone to do a crown alone for under 1k is near impossible. Wow!

greenie

Anthony16 wrote: »

That dentist put years of hard work into becoming the dentist he/she is today.If he/she deemed the x ray was needed then it was needed.Dentists deserve a good salary because they provide a great service.I hate the way people always undermine the decision of health professionals.and no, i dont have any friends or relations who are dentists,i just dont like the jealousy people have towards healthcare professionals who have big salaries.They try their best and shouldnt be down graded

I don't think the question is whether Dentists deserve a good salary..people aren't refusing to stay in Dublin for dentist work simply because they're misers, that's very unfair. A lot of people are struggling these days and simply cannot afford some of these outrageous prices. Granted Dentists here claim to use better quality materials (which I don't refute in any way) leading to increased prices however when it comes down to less extensive/non cosmetic work then of course people are going to get the work done for half the price whether it be outside Dublin or in the North. I think you'll find that people who can afford treatment here will stay here and others who just can't afford it will shop around.

Cerocco

Last year I had a tooth that needed looking at. It had gone blackish in colour after a previous root canal done here in Dublin. That set me back €500. A friend recommended a dentist in Downpatrick. She had a look and recommended a plan of action. I had my teeth whitened, new crown, had to have another root canal ( just bad luck) 2 veneers numerous x-rays. The total cost was £1200. Priced the work down here and it would have set me back over 2 and a half grand. Have a perfect smile now and found a really nice dentist aswell. If only I could get a GP up there as well I would be sorted:D

stepbar

Anon47 wrote: »

Thats interesting Stepbar how long did u have to wait?

Were you a Dental Student?

Had to wait about a year and yes I was a dental student. Realistically, it's not for the faint hearted. Each root canals took 3 sessions and each session was 3 hours long!

BostonB

I assume that an ordinary punter wouldn't get those prices

stepbar

BostonB wrote: »

I assume that an ordinary punter wouldn't get those prices

And why do you assume that?

I waited in line like everyone else.

BostonB

I was under the impression that Dental Students get a discount at Dublin Dental Hospital. Perhaps even all Trinity students. I was told that before by a student who got some work done there. Maybe thats not the case anymore? Or maybe your not aware of it?

stepbar

BostonB wrote: »

I was under the impression that Dental Students get a discount at Dublin Dental Hospital. Perhaps even all Trinity students. I was told that before by a student who got some work done there. Maybe thats not the case anymore? Or maybe your not aware of it?

I'm not a dental student; I misread the post a few up. I'm an ordinary punter.

buswankers

Had a similar experience last year as some of the other posters..... Tooth giving me gib visited dentist in Dublin who took an x-ray put in a temporary filling & told me to come back couple of weeks later. Went back, was told i needed root canal & a crown...tidy sum of €1,500.

Am from Galway so next time i was down home visited a dentist who priced the treatment at €1,300 - he also took an x-ray.

No way i could afford that at the time so I decided to price the treatment up North...found a dentist in Newry that would do both for £550. Took a trip up for an intial consultation, she took an x-ray, had a look at the tooth & said we should be able to get away with a filling no bother.....Total cost: £50. That's nearly a year ago now & the tooth hasnt given me any trouble since!

My advice: unless u know the dentist very well I would always go for a 2n opinion (in my case i needed a third!)

BostonB

Getting away with it fine. The temp fix might last your lifetime, or not. But it isn't fixing the underlying problem. So its not directly comparable in terms of price. The 500 vs 1500 is comparable. I'd like to understand why theres such a big disparity.

Anon47

BostonB wrote: »

Getting away with it fine. The temp fix might last your lifetime, or not. But it isn't fixing the underlying problem. So its not directly comparable in terms of price. The 500 vs 1500 is comparable. I'd like to understand why theres such a big disparity.

I would accept up to a 25% uplift in costs here compared with the North given the tax and business cost regime, but 200-300% smacks of getting away with it during the Celtic Tiger and not adjusting to reality now that the Tiger is a rug on the floor!

davo10

Guys, I don't really want to delve too much into this discussion but I'll give you a little backround.

a)In general things cost more in Dublin compared to the rest of Ireland, just as things cost more in Belfast compared to small towns in the North and in London etc. The cost of buildings/rent/rates/wages/living/homes/insurance/water etc is higher, so there is no great surprise that virtually everything costs more in Dublin than in Newry.
b) The exchange rate is excellent at tha moment for purchasing anything in the North be it wine or dental treatment. Consider this, if a filling costs €100 today in Dublin and €70 (£63)in Newry, 2 years ago when the exchange rate was 66p to the Euro, the cost of the filling would have been almost the same north and south, in other words currency changes have effected the price difference between all consumer items. This used to work to our favour a few years ago when Northerners used to come down here for cheaper shopping/hotel breaks etc.
c) Dentists in the north get large grants from NHS for practice building/refurbishments etc and for years got "capitation" and "continuing care" payments from NHS for every patient registered at their clinic, this used to range from £1-£3 per month per patient depending on age and was not dependent on the patient having treatment, just registering at the clinic, now the clinic I worked at in the North had approx 10,000 NHS patients so about £20,000.00 came into the clinic each month even if the dentists there never saw a patient. This scheme I believe has changed in recent years so I'm not sure what payments the clinics in the North now recieve from the NHS.
d) Why do people think that the most of the fees they pay is profit for the dentist and why do people think dental treatment should be cheap. The cost of running a clinic is enormous. In particular root treatments and crowns are at the top end of fees. Root treatments are difficult to do, time consuming and if the dentist is up to date the rotary machines and instruments are very costly. A set of titanium rotary files costs about €70 and are recommended to be single use, for a molar rct I book off about 2 1/2 hours which costs me €300 in clinical running costs (total monthly expenditure devided by number of appointments), for the price I charge patients for RCT, I would be better off doing 10 scale and polishes in the same time. Crowns are a little more emotive, a good lava/procera ceramic crown will cost €300-€350 in lab costs, they look incredible right down to the finest detail and come with a 5 year gaurantee, an NHS PJC crown costs about €70 but they do not reflect/refract light well and are brittle. But they can look nice.
e) if profits are so great why do Northern/Hungarian/Bulgarian dentists not open clinics here to do all their treatments (I know some to exams/pre treatment here), the reason is that if they charged their fees here they would go out of business very quickly.
f) Lastly consider this, virtually every profession is paid less in the North than here, the difference is exaggerated due to the exchange rate but right now public sector workers are up in arms over an 8% wage reduction which still leaves them considerably better off than their Northern counterparts. In the South we want everything to be as cheap as in the North but at the same time keep the wages we have been used to.

I expect a barage of insults for this post but I wanted to give you the broad strokes of what the differences are.

Anon47

Thanks Davo, that's the best informed explanation I have had since starting the thread. The differences in operating costs and other expenses you outlined suggest to me that costs in Dublin will be higher, but not perhaps by a factor of three for a root & crown. My experience up North to date has been excellent and inexpensive. I think that Dublin dentists may have to respond in time to market competition with the likes of Newry and Budapest but I dont intend to wait around paying a lot of money until they do so.
Thanks again...:)

davo10

Anon, the problem is how to achieve the desired responce without closing your business. All the costs in my clinic are fixed bar the purchase of materiels which accounts for about €2000 per month of expenditure. I have no control over mortgage rates, leasing payments, bord gais elec, water, rates, indemnity insurance,etc. I could use cheaper labs but it has taken me 10 years to find the right combination for crown/implant/denture work labs that provide top quaility work. I agree abourt price disparity, fees in Dublin are higher than elsewhere, my fees would be closer to the North than to Dublin but I do not have the rent/rate/property price/living costs that a Dublin practice owner would have.

Regarding Crowns: There are three tiers of crownwork in the North, NHS, Independent and Private. If comparing prices it should be private with private, the next time you have a crown fitted in the North, ask to see the Lab ticket just before cementation, the dentist ticks which type of crown they want lab to make so you will be able to see what you are getting. There is a difference in materials used and the ceramist who makes them. When i worked in North 12 years ago my boss made sure that every crown was NHS regardless if patient was NHS, independent or private.

Anon, something very important happened last Thursday which is far more important to dental patients in Ireland. In December the government scrapped the PRSI dental scheme which allowed workers to get free/subsidized treatment, last Thursday the Medical card scheme was abolished. From last Friday med card holders can only get emergency dental treatment for pain and sepsis, this is limited to 2 fillings per year. The big kicker is that this applies not just to dentists on high street but ALSO to Health Board clinic dentists. Put simply if an elderly person falls and breaks front teeth, they cannot now obtain treatment even from the health board. Now thats a rip off.

Anon47

Thanks Davo, I have been offered a choice of two crowns - one with a metal frame costing £250 (fitted) and a poly-carbon/zirconium something (cant remember the actual name sorry) for £400 fitted. I will take your advice about the lab ticket thanks to ensure i'm getting the right one. By NHS I presume you mean the cheapest?
On the issue of your costs I appreciate that any business has a combination of fixed and variable overheads but you dont mention what margin you are operating at. (For instance I recently got a prescription in a Chemist costing €7.80 and when I asked how much it cost them I was told €2.30 - there was a 100% markup followed by a dispensing cost). You need to make a profit but would it be fair to say that prices were excessive during the Celtic Tiger and they have not changed to reflect more straitened economic times. I was slagged in this thread for saying that I would prefer to support a local dentist if the price difference was less than 25%.
As I write there is a discussion on Newstalk about Dental costs and it would appear that prices are not commonly displayed contrary to the guidelines.

davo10

Anon the best cosmetic crowns today are Procera and Lava provided your bite permits their use, £ 400 seems low for this type of crown with zirconium substructure, lab fees on these can be over €300 and when you take into account the other materials used and clinical time, something doesn't sound right. Make sure you are not getting a standard porcelain jacket crown and being charged for the more expensive one, again this info is on the lab ticket, a procera crown will always be marked private and comes with a gaurentee card from the manufacturer Nobel Biocare,the dentist is supposed to show the patient. A bonded or porcelain jacket crown can be NHS.

NHS lab work is much cheaper and can look good initially, but they tend to fracture more easily, cosmetics deterioate over time and particularly with the bonded crowns (metal inside) the gum tends to receed. When I worked there we were paid £110 by NHS per crown so labs had to make them for £30-£40 at the time. They had to have the cheapest ceramics and metals so clinics could make a profit, also we were allowed to book off only 30 minutes for whole procedure, anaesthetic, impressions for temporary crown, bite registration, tooth preperation, temporary crown production and fit. Then a 15min appointment 2 weeks later for fit. I book off 90-120 mins now for crown preperations.

You cannot really compare the cost and provision of dentistry with other retail markets but I'll have a go at it. The example you gave is in essence a retail transaction, the medication is counted out and dispenced (I am sure there is a lot more to pharmacy than this so forgive my ignorance), dentistry involves not just the dispencement of goods but also a clinical/surgical procedure that is required along with it, so where it may cost X to provide the treatment, the clinician must then put a price on their operatory skill, if there was no value to be assigned to the procedure, the dentist may as well just hand you the filling, show you to the chair and then say you have 20mins to put the filling in yourself. If I assign a value of €12.50 to the procedure of giving an injection in a way that is as comfortable as can be, excavating all decayed tissue from a tooth, preparing the cavity so that it provides suitiable retention for the filling, placing a calcium lining and then a quality filling, then the "markup" is of the order of 15%, hardly a ripoff. Now this is assuming that every patient turns up fo every appointment each month, if there is a reduction in clinical turnover because a number of patients fail to attend/cancel, I am absent due to illness etc or if interest rates/costs etc increase then the clinical costs per appointment go up and the percentage profit goes down.

I would agree some prices are over the top but a dentist in Blackrock who charges €1000 for a crown is making far less profit than a dentist in Kells who charges €1000, the reasons should be obvious.

Now to the price list, they are guidelines not requirements so dentists do not have to display them but in my opinion should. Mary Harney had a go at making this a requirement by law but stopped short, do you know why?, it's because prices would go up not down.

Example of transparent price list for a silver filling:

Local anaesthetic: €7.
Single surface excavation: € 50.
Each additional surface: €5 per surface.
Lining: €5.
Matrix band application: €5.
Steel/titanium pin if necessary: €15.00.


Total cost of a 3 surface silver filling with a pin: nearly €100 and the patient would have to pay every cent because it would all be there in the telephone sized book of prices it would take to have a transparent pricing index for every possible combination of treatment.

Prices have come down considerably but cannot go below operatory costs, incidently I heard recently that 8 clinics have closed in Dublin due to downturn and a high profile chain is on the brink so we are no different to any other business.

Anon, a new independent report by Prof Ciarin O'Neill NUI Galway on oral health of irish people found that each dentist in the North recieved an average of €37,000 per year in state grants from the NHS and that this gives dentists there a competitive edge.
http://www.dentist.ie/resources/news/showarticle.jsp?id=962

Anon47

Headed back to Warrenpoint yesterday, tooth prepared and a temporary crown fitted. Final crown will be LAVA type. One hour in the chair, no charge for this visit. Total final charge for crown and fitting £400. The nice thing was having everything explained as we went along. One more visit on the 4/6 and i'm done.

davo10

£400 = €500, at least one half day off work for to go up for tooth prep and one half for fit (€700 weekly wage equates to €140 in lost earnings at a minimum or of one day from holiday allocation), 4 hour round trip on a Friday to warrenpoint each visit with travelling expenses plus a couple of pounds for something to eat. Total cost around €750.00?.

Anon47

£400 = €460.72 (xe.com) plus €30 for petrol, tolls and a coffee/sandwich

BostonB

Anon47 wrote: »

£400 = €460.72 (xe.com) plus €30 for petrol, tolls and a coffee/sandwich

+ loss of wages or holiday's which is the same thing.

If it works out cheaper and a good job then why not. I'd struggle to find the time myself. I usually fit the dentist around work so I don't lose any time for it.

davo10

Tourist rate plus commission, £400 = €489, and rate may be even worse on credit card. Sorry I took journey to start in Dublin as a reference, Dublin to Warrenpoint is 117km multiplied by 4 = 568km, you have a great car if you can do this for €30 particularly as fuel prices are almost at their highest ever. I'm not sure about toll prices as I do not live in Leinster but whatever they are, you have to pay them 4 times (if you live on southside of Dublin, the number of toll charges goes up to 8). I also assume that you arranged an appointment for 4pm on the Friday afternoon so you only had to take a half day off work each time, if you had to take a full day each time the treatment has cost you more than if you had it in Dublin. You left out the loss of earnings in your post.

dr.fuzzenstein

escobar wrote: »

thanks captain ,you're ever vigilant....:D

though I was talking about the money you can claim back on your own personal tax on your wages....

because the budapest dentist was an irish registered company you can claim back your tax unlike n. Ireland..

making it even cheaper again

link and quote below...


http://www.citizensinformation.iDentistse/categories/health/dental-aural-and-optical-services/dental_services

''If you do not have a medical card and have to pay for dental services from a private practitioner, you may claim tax relief for certain specialised dental treatments. ''

Link does not come up with results, only says "The item you requested does not exist on this server or cannot be served."

Bob Z

Anthony16 wrote: »

Just pay the money and be loyal to your dentist.He/she has to make a living too,so dont be a miser

Why don't you give him the extra if you yourself are so 'generous'

Anon47

davo10 wrote: »

Tourist rate plus commission, £400 = €489, and rate may be even worse on credit card. Sorry I took journey to start in Dublin as a reference, Dublin to Warrenpoint is 117km multiplied by 4 = 568km, you have a great car if you can do this for €30 particularly as fuel prices are almost at their highest ever. I'm not sure about toll prices as I do not live in Leinster but whatever they are, you have to pay them 4 times (if you live on southside of Dublin, the number of toll charges goes up to 8). I also assume that you arranged an appointment for 4pm on the Friday afternoon so you only had to take a half day off work each time, if you had to take a full day each time the treatment has cost you more than if you had it in Dublin. You left out the loss of earnings in your post.

Davo, I do have a great car thanks but not that great, the 30 euro is per trip for a total of €120. I paid £200 towards the final bill which translated to €234 on my credit card bill. I take your point about loss of earnings but as I am not self employed I took 2 days leave to cover the four visits and did not count this as an additional cost because I would have had to take leave anyway to visit the local dentist. So my total cash outlay will be about €600 vs €1400 euro quoted by my local dentist (or higher for a Lava crown I think). The Dublin dentist quote included a root canal which, on examination, wasnt needed so the difference between Dublin and Warrenpoint would be smaller then. Im heading back up this friday for the final fitting and will post after.

the groutch

what are the dentists up like north
most of the ones I've been to down here are very condescending and very "rough" in carrying out their job

Anon47

the groutch wrote: »

what are the dentists up like north
most of the ones I've been to are very condescending and very "rough" in carrying out their job

Hi, I cant answer your question fully as I have only seen one dentist - in the Gentle Dental clinic in Warrenpoint. He has been very professional and, unlike my previous experience with other dentists, tends to explain what he is doing before he sets to work. He is open to questions and has answered all mine patiently. There have been no issues to date with pain or other care and I havent seen any condescencion at all. All in all I am very happy with the experience to date and the savings in cost have been spectacular. You just have to allow for the inconvenience of the time to travel North with the associated costs for petrol/tolls and maybe food.

davo10

Anon, regardless of whether you count the days as leave or not, they are two of your holidays or if you were self employed would be two days of lost earnings, either way the actual costs are far greater than simply paying £400 for a crown. Whether the root canal is necessary will become relavant in the fullness of time, if it was an elective treatment prior to crowning, there is a good possibility that it may need to be done in future through the back of your new crown which will compromise it.
If the cash outlay is as high as €600 I stand by my estimate that the actual costs taking into consideration 2 days off work would be in the order of approximately €850.00, and even higher if you were self employed.

I only visited a dentist recently after 18 years of not going
- initial consultation and clean up, dressing and temporary filling in cavitied molar €80
- next visit, two fillings €120
- then one more filling and clean & polish (18 years of plaque buildup in them ) €115
- Root canal on the molar will be €600 approx

All done in the evening after work so no need for me to take time off (handy as I am self employed) and the dentist is only 100 yards from home. Trip to the UK for dental work, no thanks.