Tooth Decay

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I know this has been discussed before but I can't find exactly what I am looking for and wonder if you guys can help.

I have had two teeth pulled as a result of decay caused by the radiation therapy. Now, in an effort to save my other teeth I need to have two root canals and two crowns which are very expensive. My question is does medical insurance (not dental) cover this treatment and if so I imagine I need a diagnosis. Not sure if there is a specific term beyond tooth decay.

I'm also doing the heavy flouride treatmentrs with both Prevident toothpaste and now the mouth trays with fluoride as well as other rinses.

For those of you wondering about HBO tretments, I did not have them. My Oral Surgeon, who is also a Harvard Professor, says that the school of thought used to be that the treatments helped as far as the bone goes. She says that new thoughts are that not only do HBO treatments not help in most cases but in face may cause problems in and of themselves.

Anyway, relative to the insurance, I would appreciate any thoughts you might have.

Thanks.

Comments

  • jtl
    jtl Member Posts: 456
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    I am by no means an expert
    I am by no means an expert on the subject but I did read a little about it some time ago. My sense was that it is a difficult case to make and takes a great deal of effort. Having said that I am always willing to give things a try. Good Luck.
    John
  • ratface
    ratface Member Posts: 1,337 Member
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    My 2-cents
    I've had one root canal and several crowns and one extraction post treatment. I don't have dental insurance so I can't speak to the insurance issues. I do recall some posts about surgery being covered. I question your Harvard professor as I have done extensive reading on HBO and all evidence is to the contrary. I will concede that it is possible for a medical position to be totally wrong but generally well done scientific research with blind controls is all we really get to make decisions on and your professor is totally against the documented empirical data. I would at least question her regarding her change of opinion proceeding slowly and possibly entertaining a second opinion here. There are for certain some posts/threads under HBO, Hyperbaric treatment, teeth, extractions?????
  • Arthur123
    Arthur123 Member Posts: 19
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    ratface said:

    My 2-cents
    I've had one root canal and several crowns and one extraction post treatment. I don't have dental insurance so I can't speak to the insurance issues. I do recall some posts about surgery being covered. I question your Harvard professor as I have done extensive reading on HBO and all evidence is to the contrary. I will concede that it is possible for a medical position to be totally wrong but generally well done scientific research with blind controls is all we really get to make decisions on and your professor is totally against the documented empirical data. I would at least question her regarding her change of opinion proceeding slowly and possibly entertaining a second opinion here. There are for certain some posts/threads under HBO, Hyperbaric treatment, teeth, extractions?????

    Actually I did question her
    Actually I did question her about the treatments as I had seen most of the same data and had another Oral Surgeon say that he would not take the teeth out without the HBO treatments. Her reply was that much more research had been done over the last five years proving her point and getting a near unanimous agreement from her department at Harvard Medical School. I suppose it's like anything else that different opnions are offered by different people. I did however have two teeth removed without the treatment with no adverse effects.
  • jtl
    jtl Member Posts: 456
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    Arthur123 said:

    Actually I did question her
    Actually I did question her about the treatments as I had seen most of the same data and had another Oral Surgeon say that he would not take the teeth out without the HBO treatments. Her reply was that much more research had been done over the last five years proving her point and getting a near unanimous agreement from her department at Harvard Medical School. I suppose it's like anything else that different opnions are offered by different people. I did however have two teeth removed without the treatment with no adverse effects.

    I thought I read somewhere
    I thought I read somewhere but where is anyone's guess that HBO may increase tumor growth by increasing the blood supply to an otherwise almost microscopic tumor. It was not something I was all that interested in so I may be mistaken.
  • ratface
    ratface Member Posts: 1,337 Member
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    Arthur123 said:

    Actually I did question her
    Actually I did question her about the treatments as I had seen most of the same data and had another Oral Surgeon say that he would not take the teeth out without the HBO treatments. Her reply was that much more research had been done over the last five years proving her point and getting a near unanimous agreement from her department at Harvard Medical School. I suppose it's like anything else that different opnions are offered by different people. I did however have two teeth removed without the treatment with no adverse effects.

    Generalizations vs. individuals
    Arthur, she may be entirely correct. Or she may be correct for your circumstances which is why we must be very careful in accepting anything as normal with cancer because we are all so different. I began to research HBO because I needed an extraction and my dentist was insisting on HBO. I really did not want to spend the time nor money on the treatment. The research convinced me that it had merit and was beneficial for my recovery. Ironically the dentist after conferring with the rad doctor came to the opposite conclusion because of the location of the extraction and dosage of radiation to that specific tooth. i.e. non cancer side and only partial radiation to that side. I would be interested in any source she could provide that argues her position as this can be a future path for many of us. Is it possible that it has merit sometimes or does she now believe it is totally not indicated?
  • George_Baltimore
    George_Baltimore Member Posts: 303
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    Insurance
    I am in no way a medical expert. That being said, back in 2004, I had my remaining teeth pulled before I started radiation. They weren't in great shape and I was advised to do this by my oncologists and the oral surgeon. At that time, I had BCBS as my only insurance. I never had to pay the surgeon anything to the best of my recollection. I am sure I would have remembered paying thousands. I believe it all has to do with the way they code their charges. Fast forward to 2011, same oral surgeon, different problem but still has to do with the cancer. At this time, I am on Social Security Disability so I have Medicare even though I am not old enough for it plus BCBS Medi-Gap. I went to him a couple times about my mandible necrosis. Once again, I never owed him a cent. So, if your surgeon codes the claim properly, I would think that it should be covered. Don't be afraid to discuss the finances with her ahead of time. By the way, inbetween those two events, I had a total of 120 HBO dives to see if it would relieve the soreness in my throat. It did a little but it didn't stop me from having bone death a year or two later. The original extractions were supposed to do that but that didn't work either. Good luck.
  • Roselvr
    Roselvr Member Posts: 30
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    The best advice I can give
    The best advice I can give you is to get another opinion & make sure they know radiation damage. My hub got a root canal about 5 months out of treatment & guess what? It didn't take. The dentist wanted to do a reverse root canal (forgot the name) where they cut into the gum & go in the tooth bottom. He was going to do this because retreating the root canal was not covered under insurance. I put my foot down & took him to a larger oral surgeon who gave him antibiotics & thankfully it cleared it up. He said that after rads; the mouth doesn't always heal on its own & antibiotics may be needed. Keep it in mind that if this happens to you; you could need a few rounds of antibiotics.

    As far as medical insurance covering the root canals & crowns; probably not unless your insurance normally covers teeth. Our health insurance only covers extractions. Most dentists have a loan that you can apply for & I'd rather see you do that instead of pulling your teeth because pulling could end up being more expensive in the long run.

    You can get root canals without putting a crown on & I'd actually suggest that just in case you end up losing the teeth anyway. Our dentist did a retreat on me ($700+) & did not fill the tooth correctly & it broke at the gum. This is a top "fang" tooth & while insurance will cover pulling it; it won't cover an implant
  • denistd
    denistd Member Posts: 597
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    Roselvr said:

    The best advice I can give
    The best advice I can give you is to get another opinion & make sure they know radiation damage. My hub got a root canal about 5 months out of treatment & guess what? It didn't take. The dentist wanted to do a reverse root canal (forgot the name) where they cut into the gum & go in the tooth bottom. He was going to do this because retreating the root canal was not covered under insurance. I put my foot down & took him to a larger oral surgeon who gave him antibiotics & thankfully it cleared it up. He said that after rads; the mouth doesn't always heal on its own & antibiotics may be needed. Keep it in mind that if this happens to you; you could need a few rounds of antibiotics.

    As far as medical insurance covering the root canals & crowns; probably not unless your insurance normally covers teeth. Our health insurance only covers extractions. Most dentists have a loan that you can apply for & I'd rather see you do that instead of pulling your teeth because pulling could end up being more expensive in the long run.

    You can get root canals without putting a crown on & I'd actually suggest that just in case you end up losing the teeth anyway. Our dentist did a retreat on me ($700+) & did not fill the tooth correctly & it broke at the gum. This is a top "fang" tooth & while insurance will cover pulling it; it won't cover an implant

    Tooth decay
    I have travelled the teeth route, I got my medical insurance to pay for the extractions, I eventually had them all pulled, insurance will not pay for root canals and crowns as it is not a medical procedure, tooth extraction can be extraplolated as surgery. My Onc and oral surgeon did all of the negotiating with the insurance company as at first they said no. In my case the whole thing cost close to $15000, but try with the help of your docs.
  • HAWVET
    HAWVET Member Posts: 318
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    denistd said:

    Tooth decay
    I have travelled the teeth route, I got my medical insurance to pay for the extractions, I eventually had them all pulled, insurance will not pay for root canals and crowns as it is not a medical procedure, tooth extraction can be extraplolated as surgery. My Onc and oral surgeon did all of the negotiating with the insurance company as at first they said no. In my case the whole thing cost close to $15000, but try with the help of your docs.

    I would say it depends on
    I would say it depends on the medical plan whether root canal is covered. My regular retirement insurance through my previous employer pays for half the cost under our medical plan. I also retired from the military and we do not have dental and must subscribe to a separate dental plan.
  • fisrpotpe
    fisrpotpe Member Posts: 1,349 Member
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    No Wondering
    I do not wonder about HBO. i certainly believe HBO helps with growing any cancer cells with in my head and neck area. My original doc believed the same and told me he would not ever allow me to have HBO. Several years after he died from cancer I had a problem and along with that needed HBO along with IV antibiotics. I went 12 years without cancer showing its ugly head until 3 months post HBO. I found the problem early and spot was removed from tongue.

    Since that time I have had 6 teeth removed at two different times with only using antibiotics and being watched closely. No problems since in the last three years.

    Talk to your doctors, i have heard many have had them write to insurance saying cancer and treatments caused the problem and have convinced insurance to cover.

    good luck
    john
  • Karri
    Karri Member Posts: 9
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    insurance
    Have your radiologist send a letter to your medical insurance company explaining how this is a special circumstance and it was caused by your cancer treatment. I had much of my dental work covered under medical because of the damage the radiation did to my teeth. I do however, have concerns about people saying that the HBO causes cancer cells to grow? I am currently looking to have two extractions done and of course my insurance doesn't cover oral surgeons and not sure about the HBO treatments yet. I am fairly sure my radiologist is going to want them done but having a tooth ache vs. cancer well that is a no brainer!