Austin Smile Creations – Austin Dentist Blog

A blog about implant dentistry, cosmetic dentistry, general and family dentistry and a healthy living.

Archive for comparing dental practices

Cosmetic dentistry – do you need a specialist?

Angy’s List posted a good article recently touching on a subject of cosmetic dentistry. This is a good article emphasizing in a way the importance of patient education in order to make informed decisions about their care.  It is not very in-depth and it does not answer some of the questions it poses, but it at least raises a little bit of awareness that not all dentists are created equal.

While some lives are being drastically improved by quality dentistry using a comprehensive approach and individually tailored modern treatment options, some lives will be changed in the opposite direction over time, if some existing conditions are not diagnosed and taken into consideration while treatment planning. It is a sad fact of life, as many people do not perceive their teeth as an integral part of their body, a live organ that if not treated or treated improperly – can turn your health upside down and even have fatal effect on your body.

When you are looking for cosmetic dentistry, do not look for the cheapest deal in town. It will get you in trouble, as you always get what you pay for. This aspect of dental care has become so highly commercial that sometimes it is hard to distinguish what is a good recommendation and what is a bad one, let alone the consequences it may have long-term. Look for your dentist’s credentials and level of education. It is one of the best things you can do for yourself.

While specialists do good work, Austin is lucky to have several highly qualified general dentists who can provide you with excellent care in various aspects of dentistry. If you choose to go to a general dentist, look for those with lots of continued education and if they belong to Academy of General Dentistry, an organization providing them with opportunities for continued education and fighting for the higher standards in the dental community. Masters or Fellows of AGD are setting a great example for the dental community. Or if you choose to go to a specialist, like prosthodontist ( dentists working with restoration of implants, dentures, doing crown and bridge work), look for similar credentials according to the field of specialty. Keep in mind, you will still need a good general dentist to help coordinate all aspects of treatment you need.

If someone finished dental school 30-40 years ago and is not staying updated on modern techniques and materials, odds are – they will not have a very good perspective on all of your options.  Dentistry can differ like night and day depending on who offers it and what it can do for a particular patient. Over the last decade so many things got revolutionized in the field that not updating your dental knowledge in it should be simply shameful. Yet, don’t be fooled by the latest and the greatest. It is not what you should look for. Look for experience that can distinguish between substance and trends, knowledge of research of what is a fact and what is a myth. For a patient being picky is very important, as in our practice, for example, a significant portion of our work is redoing previous work that was done without sufficient diagnostics, planning and adequate expertise and quality standards.

In addition, don’t expect your insurance to pay for quality work. Sadly, insurances did not evolve much since the 80s and only pay for the cheapest solutions that are outdated, and often not the best and lasting option. In general they don’t pay for cosmetic work at all.

So if you are looking for cosmetic dental procedures of any kind – whitening, veneers, crowns, implants –  consult with a qualified doctor first. It is what you don’t know that can make your out-of-pocket investment go to waste. A good dentist will never do crowns and implants on someone with advanced gum disease or insufficient bone. A good dentist will never do a teeth whitening for you if you have significant sensitivity already. Crowns, bridges and tooth-colored fillings do not bleach. All that you will find out from your dentist, and only after you invest into adequate diagnostics, which insurance doesn’t pay for 100% either. But quality work is a great investment, as it can lasts longer than statistical averages and can truly change your life by giving you health, beautiful smile, confidence and shed years off your appearance! Smile makeovers do change lives every day!

Read the article from Angy’s List.

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A Failed System. Why Doesn't My Insurance Pay For This?

Given the current trend with the American healthcare system taking a drastic change, insurance is undoubtedly the hot topic among Americans. We have briefly discussed this trend previously, but have yet to dive into what insurance means within the dental world. More specifically, what it means for a practice like Austin Smile Creations where a whole body approach to optimal dental health means choosing an almost solitary journey and certainly a journey away from what insurance considers the dental standard.

Unlike many practices and dentists, Dr. Tor Gotun and the Austin Smile Creations‘ team choose a path that is far above dental insurance standards. There are not very many general practices that are adding bone, titanium mesh plates, and membranes to generate growth of new, healthy bone, so patients can plan to keep their teeth for a lifetime (or at least the most biocompatible and structurally compatible prosthetics available to their natural teeth- implants). Even the most necessary of procedures that allow patients to keep their teeth and therefore sustain a quality of life that cannot be compared, many dental insurances won’t even consider covering.

We must then explore what are dental insurance companies’ standards? Since there aren’t any regulations on how insurance companies decide on reimbursement levels, there is no way of knowing what they will actually pay until a claim is submitted and an explanation for that claim in sent back to the provider. Think of one dental insurance company. One dental insurance company has hundreds of plans underneath it’s umbrella. Now, take twenty-three large dental insurance companies, hundreds of third party, smaller insurance companies that link themselves to several of the large companies, hundreds of plans that an employer has the option to pick from, and hundreds of different guidelines for 10,000 different dental codes. To say in the least, it’s a mess and clearly meant to confuse it’s consumer- the patient. Consider everything outside of actually extracting teeth is optional. This is what dental insurance companies believe, an archaic principle. It applies to eighteenth century folks who didn’t have the technology and education available that we have at our fingertips today. So if everything except extracting a tooth is optional, it would make sense that dental insurance pays the least expensive alternative treatment, like a composite (white) filling at an amalgam (silver filling) rate. It would make sense that they have age limits, exclusions, pre-existing conditions, deductibles and annual maximums for the year. On one end, patients who need several major procedures performed to improve or even sustain a quality of life, the expense becomes mostly out of pocket for the patient. On the other end, patients who only need minor work and routine cleanings, end up paying a higher premium than what’s actually used at their dental office. Either way, insurance companies make money.

What we do different at Austin Smile Creations is that we have chosen to be of service to each patient. Patients have individual needs for treatment and therefore have highly specialized and individual treatment plans. If insurance weren’t in the business of making money, they would understand the medical necessity for procedures that dentists like Dr. Gotun provide: allografts, autografts, PRP, PRGF, sinus lifts, and bone augmentations to name a few. The Austin Smile Creations’ team knows the quality of dentistry they provide to each patient, and such, continue on this uphill battle against insurance companies standards. And we continue on this journey, refusing to accept an unacceptable standard of care.

Austin Smile Creations Introduces an Interview with a Master Dentist.

There are not very many opportunities an individual gets to speak or even work with one of the best in their line of work. It’s an even rarer occurrence to sit down every day and witness their thought processes. At Austin Smile Creations in Westlake, TX, we have that rare opportunity to not only work beside, but to have a close relationship with a true dental guru: Dr. Tor Gotun. But then we need to answer the following to obtain any credibility in that statement, how can anyone label another as the best? We could very well consider Dr. Gotun’s richness of qualifications to validate such a bold statement. Imagine 30,000 hours of continuing education beyond a Doctoral Degree, a 99% success rate in surgically complicated dental procedures, holding the title of a Master in the Academy of General Dentistry, mentoring and teaching some of the best in the dental field, genuinely caring and therefore individualizing each patient’s treatment plan, and persistently reading dental literature. In all this busyness, Dr. Gotun took the time to sit down with the Austin Smile Creations’ team and answer a few questions we had.

ASC Team: Dr. Gotun, what do you think sets your practice and you as a dentist apart from most other dentists out there?

Dr. Gotun: Let me start by saying there is nothing necessarily wrong with how other dentists practice, I just choose to practice differently. I take what I like to call a whole body approach to dentistry. The thing about it is that teeth are not independent of themselves. The body is a system in which all parts have the potential to affect other parts. An infection in your heart will eventually flow to other parts of the body. The same is true for teeth. I look at the body as a whole and how I can achieve the best results for each individual given their needs, medical and anatomical boundaries, and dental history. I collect so much information on a patient through accurate diagnostics that my ability to predict success and carry it out is exceptionally high.

ASC Team: What has kept you motivated to practice dentistry for 30 years?

Dr. Gotun: The medical field is not only a rewarding field to be in because you get to help people feel better and achieve a result they may not have ever imagined, but it’s also ever-evolving. It never gets old. There is always something else to read, try, see, participate in, and perfect. It’s my passion. It’s hard to describe because it’s in my bones, and truly something I love to do. Some people never find that passion. I am lucky to wake up every day and do what I love.

ASC Team: One more question Dr. Gotun, what made you choose not to specialize in the dental field, say a periodontist or an oral surgeon?

Dr. Gotun: It’s funny you all ask that, since most people think a general dentist doesn’t perform to the level of care as a specialist or may not know the extent of what a specialist may know. I never specialized because I am able to practice all forms of dentistry from crowns to periodontal surgeries, oral surgery to treating temporomandibular disorders, and orthodontics to endodontic therapy. It keeps my work interesting, as well as allowing me to provide a service unparalleled to my patient base where they can receive treatment all in one place.  

While Dr. Gotun’s accent can be intimidating at first, he is clearly a dentist who candidly cares about quality dentistry in an industry that claims anything besides extracting teeth are optional. Dr. Gotun is a dentist that visualizes dentistry in his dreams and thrives on perfecting his own technique. Such passion and conviction certainly set the standard high, keep his staff alive, his patients satisfied, and his practice thriving.

Austin's Dentist Standard of Care. Planning in Dentistry.

Clinically, planning is everything in dentistry. It’s what we believe at Austin Smile Creations, your Westlake Dentist. We drive this point home among colleagues, patients and, well, really anyone we have the pleasure of meeting. Planning is the difference between success and failure, we believe. While any dentist may experience success without planning, it’s the risk they are willing to take at a patient’s expense. Planning goes hand-in-hand with perfection in all areas of dentistry, and because we strive for perfection in all areas of dentistry, the key to reaching that is all in Dr. Gotun’s expert planning.

So what does this mean for the patient? Put simply, we give each patient the best quality and most individualized care that can be offered in dentistry. When we say Dr. Gotun tackles each case on a case-by-case basis that’s exactly what we mean. He dissects each case individually, after thorough examination and in-depth diagnostics. Remember all those x-rays that are taken at an initial appointment- 18 to be exact? Or what about the gooey impression material needed to create exact replicas of each individual’s teeth and bite? Or maybe a 3D image called a CBCT scan- Cone Beam Computed Tomography– basically a 3D map of both head and jaw? All are diagnostics, which are part of necessary planning in what we consider our only option at Dr. Gotun’s office: taking really good care of people. Because we care about each patient’s health in it’s entirety (did you know your dental health affects your overall health? More on that later…), we are absolutely keen on proper planning for patient’s to recieve only the best dental care.                                                  

From a patient perspective, if you ask me, there’s nothing else I would want more than knowing and trusting I’m getting the best dental care. Any dentist has the ability to cement a crown, but is that dentist looking at how that crown will affect your bite? Does the dentist look at the way the temporomandibular joints align and possible tension on those muscles and joints naturally? Do they study if a procedure will affect your comfort? Are they using a semi-adjustable articulator to analyze your models before even beginning to plan treatment? Do they complete in-depth research of what will treat the problems and not just the symptoms? This is our standard of care at Austin Smile Creations, because this is the philosophy we all believe in.

Ultimately, we want patients to know what kind of quality they receive in our practice. We want patients to be involved, understand and ask about treatment options. We dedicate ourselves to finding the longest lasting results, because we want to have the happiest patients! For the team at Austin Smile Creations to reach these goals and provide exceptional dental care all begins with proper planning in every stage of dentistry.

Dental Insurance. In and out-of-network providers.

This is a very complicated topic. The intricacies of the insurance system and variables in dental practices make it very complicated to explain, but we will try to share some insights into the world of insurance confusion.
It is a fact that dental insurance is nothing like medical, and you should keep that in mind. The coverage is very different, and there is nothing that dental insurance realistically covers at 100%. Most PPO plans state that they pay 100% of preventive services ( cleanings and exams), 80% of basic services ( fillings) and 50% of major ( everything else). There are some variations in which services fall into which group based on the plan. It is important to know that they pay percentages of their “usual and customary fees” which they define based on some national averages. Also keep in mind that these fees have not been updated for 15 years or so, so do your own math and figure what realistically the payment can amount to, especially if you live in a prominent area, say, such as Westlake Hills in Austin. Another important thing – the yearly maximum that insurance pays on most plans is $1500. While it is better than nothing – it will not help you tremendously if you need a lot of dental work and you need it done in one year. Insurance does not cover TMJ disorder treatment, cosmetic services, implants. Most insurance agents offering better policies do not sell dental insurance at all. So it is up to you to make a choice if dental insurance is worth the premiums for you for these benefits.

It is also a fact that there is a difference between in-network providers and out-of-network providers. While most people don’t realize it, no two dental practices are the same, even without any affiliations with insurance networks. Every dentist is different when it comes to education and experience, has a different approach to dentistry, chooses different equipment and materials, techniques and methods, and also how to run their business. When it comes to determining fees –  all of those factors plus the going rates in the area where the practice is located are crucial. Knowing that, even if you do shop around, you will probably not find a big difference comparing fees of dental practices of similar philosophy. If you find a big difference –  odds are – you are comparing apples and oranges and you may want to ask yourself what that difference gives you and what you might be sacrificing by choosing one practice over the other.

With in- network providers, the insurance company and your employer negotiate the rates and what is covered. So the insurance companies set their level of reimbursements to the doctors for various procedures and the rest of it is your out-of-pocket. Unfortunately, because of being very outdated ( ask any insurance agent) – the reimbursement rates are very low, and the doctors who strive to produce cutting-edge dentistry using the latest equipment simply cannot make it work, otherwise there would be no out-of -network providers. There is a reason why many dental practices choose to be independent –  so they could be the ones setting the bar for themselves. And even then, there are apples and oranges.

Hopefully this helps you a little bit to understand the big picture ( or at least see that it is even bigger). We believe, that one factor in determining your choice of a dentist trumps all others -it  is not insurance, not if the dentist is in- or  out-of-network, but the dentist himself.  The level of continued education, experience, desire to stay current with technology, and if you can trust him or her is what will help you get your money’s worth and get many more benefits in the long run. You want to develop a relationship with your doctor that will help you achieve and maintain your oral health for a lifetime, not just for the time of your appointment. And that is what we do every day and love it!