Surgery at Dental School

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#1 Post by **Round2inAZ** » Wed May 28, 2008 9:34 am

Hi all,

Has anyone here actually had their surgery performed at a dental school? If so, where was it done and how was the experience? Are you pleased with the results? How much less expensive was it than having it done the "other" way -- at a regular hospital by a regular practicing oral surgeon (i.e. not in an educational setting)?

Thanks in advance!

#2 Post by **eggraid101** » Wed May 28, 2008 11:52 am

I would tend to agree; the fee may not be that much reduced because of the high cost of the hospital fees. As far as quality you may actually get better care at a university. It is likely they do more surgeries than a surgeon in private practice, and have quite a bit of experience. The oral surgery resident may be the one "doing" the surgery, but there will often be several residents there, along with one or more instructors. You will, generally, be very well attended to.

#3 Post by **Round2inAZ** » Wed May 28, 2008 3:15 pm

Thanks for your replies. I concur with all points raised.

Yes, I'm aware that reduced surgeon's fees won't put a dent in that hospital bill! But we self-payers will take a break wherever we can find it!!

Calling some schools in my region reveals why there is a dearth of these patients:

U of AZ -- no dental school
U of NV -- has a dental school, but it's new, and they only offer emergent
general dentistry services

Any school is CA is off the table -- the hospital bill will be outrageous

U of TX has a dental school and a program, but they're currently not accepting new patients and won't be for several months. But, I don't need surgery tomorrow so will call them back.

So, I keep on pluggin'.....

#4 Post by **suetemi** » Wed May 28, 2008 6:07 pm

Have you looked into county hospitals? A while ago I was in a grim situation with my insurance and convinced I'd have to pay out of pocket. I contacted the oral surgery department at the local dental school and inquired about the possibility of getting discount surgery rates. One of the surgeons there suggested having the surgery at the county hospital since I was a resident of the county, and the surgical fees would be waived. I would've had to pay only consult fees and hospital fees, which are very minimal and based on what you can afford. THe county hospital here has several top notch voluntary oral surgeons. Just a thought...

#5 Post by **Delag** » Wed May 28, 2008 6:13 pm

Have you talked many oral surgeons? Mine does most of his surgeries in house so there is no hospital bill....his fee more than makes up for it though

This place has a place to stay over night with nursing staff if it is a big surgery. There are pros and cons to in house operating suits of course. The big stirke against is that if there is an emergency you will need to be moved to a hospital ASAP. However, there is much less chance of catching some weird hospital 'bug', cost is lower, and it very unusual to have a crisis in this type is surgery.

#6 Post by **Round2inAZ** » Wed May 28, 2008 8:44 pm

Those are both FANTASTIC ideas! Love that thinking outside the box

.

Suetemi, unfortunately there is NO surgeon in this city/county who will do my surgery. So, I am having to travel elsewhere to find one. That would, of course, exclude my county hospital.

Delag, excellent point about decreased risk of MRSA, etc. So far, on the list of potential surgeons there is one guy who has his own surgical suite. He is both a plastic surgeon and an OMFS up in Scottsdale, but I have no idea what his fees are (astronomical I would imagine). I will be consulting him this fall -- it would be crazy to go up there right now. It's even hotter there than here; temps have already reached over 110 degrees up there!

Thanks again to both of you for some great suggestions.

Anyone reading if you can think of some other things, please post them!!

#7 Post by **Arvensis** » Wed May 28, 2008 9:29 pm

unfortunately there is NO surgeon in this city/county who will do my surgery.

I'm still confused about whether your surgery is cosmetic or functional? It seems really strange to me that all these oS's aren't willing to do it.

#8 Post by **Round2inAZ** » Wed May 28, 2008 10:13 pm

Arvensis wrote:
unfortunately there is NO surgeon in this city/county who will do my surgery.
I'm still confused about whether your surgery is cosmetic or functional? It seems really strange to me that all these oS's aren't willing to do it.

Hey, join the club!!

All I can only tell you is that two different OMFSes in two different states told me that it is cosmetic and outside of their comfort zone. And the one here added that there is nobody in Tucson who does this.

#9 Post by **Emaciated** » Thu May 29, 2008 8:29 am

I had my upper/lower/genio performed at UCLA Dental School/Hospital. I made sure the senior surgeon was the one actually performing the surgery but he had a team of students assiting him, including one of my friends who's a student there. The results are fantastic and the whole experience was a positive one. I'm glad I went to that hospital and would not have changed anything.

As far as the price goes, it was phenominally less expensive than what I was being quoted from other surgeons. In Los Angeles plastic surgery is out of control so I was being quoted costs like $40,000, $60,000, etc. from private practices. My insurance only pays for 90% of the surgeon fees so that's still a huge chunk of money for me to have to cover. At UCLA, the actual surgeon fee was something like $12,500 so I only had to cover like $1200 or something out of pocket in the end.

#10 Post by **Round2inAZ** » Thu May 29, 2008 6:39 pm

KarlClayLA wrote:I had my upper/lower/genio performed at UCLA Dental School/Hospital. I made sure the senior surgeon was the one actually performing the surgery but he had a team of students assiting him, including one of my friends who's a student there. The results are fantastic and the whole experience was a positive one. I'm glad I went to that hospital and would not have changed anything.

As far as the price goes, it was phenominally less expensive than what I was being quoted from other surgeons. In Los Angeles plastic surgery is out of control so I was being quoted costs like $40,000, $60,000, etc. from private practices. My insurance only pays for 90% of the surgeon fees so that's still a huge chunk of money for me to have to cover. At UCLA, the actual surgeon fee was something like $12,500 so I only had to cover like $1200 or something out of pocket in the end.

Hi Karl. Wow!! Sounds like you had a great dental school experience and made out very well!

UCLA Med Center is known for their expertise in oral and maxillofacial. You may have heard the story of entertainer Ann Margaret, who was in an accident in 1972 in Taho when she fell from a stage. Roger Smith stole a plane to fly her back to LA so she could be treated at UCLAMC. She had some pretty bad injuries -- a broken cheek, broken jaw, etc. They did a beautiful job of putting her back together. The orthodontist who did my intial braces back in the late 1970s was part of the team who treated her.

Unfortunately insurance will not be covering my procedures. As a self-payer, and with the hospital bill being a much larger chunk of the costs than the surgeon's fees, that is one of the main things I am looking at. And, generally speaking, everything in CA is expensive, so I'm assuming that hospitals there charge more than in other parts of the country. Having said that, I don't like to operate on assumptions so will be researching this.

Thanks for sharing your story!! I checked out your site, and congrats on a job well done.

#11 Post by **Delag** » Fri May 30, 2008 11:55 am

With all of the problems you mention I have to agree with other posters and wonder out loud why these doctors say this is cosmetic. I think you need some new doctors to take a look at you. Phil sent his records to Dr. Wolford for a long distance consultation. I think he said it would cost around $500. It might be worth it to send your info along to one of the big guns (Arnett, Wolford......) and see what they have to say. I know you want to get the ball rolling, but you really need to take your time and do this the right way. Pain in the TMJ has a tendency to get worse not better - doens't sound cosmetic to me.

My OS told me that there can be geographical zones where there are a lot of great OMSs and areas where they are non exsistant. Dallas and Houston were the places he mentioned - in one there are dozens of great docs, in the other there are none he recommends. Maybe you are just in a OMS dead zone

#12 Post by **Round2inAZ** » Fri May 30, 2008 1:22 pm

Delag wrote:With all of the problems you mention I have to agree with other posters and wonder out loud why these doctors say this is cosmetic. I think you need some new doctors to take a look at you. Phil sent his records to Dr. Wolford for a long distance consultation. I think he said it would cost around $500. It might be worth it to send your info along to one of the big guns (Arnett, Wolford......) and see what they have to say. I know you want to get the ball rolling, but you really need to take your time and do this the right way. Pain in the TMJ has a tendency to get worse not better - doens't sound cosmetic to me.

My OS told me that there can be geographical zones where there are a lot of great OMSs and areas where they are non exsistant. Dallas and Houston were the places he mentioned - in one there are dozens of great docs, in the other there are none he recommends. Maybe you are just in a OMS dead zone

Hello Friend South of the Border,

An OMS dead zone?! Wow.

That is a GREAT IDEA about a consultation with Arnett or Wolford. It never hurts to get additional opinions -- especially from one of those guys. It would be $500 well spent.

I just hung up from scheduling a full workup at an orofacial pain center (covered by my insurance). In light of yesterday's TMJ "attack," I think it would behoove me to find out if indeed I have TMD and if so obtain the documentation. If nothing else, it would be a tick in the "functional" column that would may help get me a surgeon.

I have been habitually not biting on the back teeth and can't hold that for longer than a few seconds. This was discovered at my orthodontic evaluation -- I hadn't even noticed that I was doing it. So, this AM I forced myself to do it and hold it. In short order I developed fatigue and a headache!! This stuff definitely warrants further investigation.

Thanks so much for your input, Delag.

#13 Post by **Round2inAZ** » Fri May 30, 2008 3:49 pm

Meryaten wrote:Well, biting the teeth closed for a period like that could cause anyone pain, even if there are no orthodontic or skeletal issues - we're not meant to do that! A normal, relaxed posture has the teeth slightly apart and the tip of the tongue resting on the roof of the mouth.

One word of caution on Arnett and Wolford - I've heard from another member here that they are both extremely agressive about operating. I'd be very hesitatnt to open up and operate on the jaw joints unless I was entirely sure this was the best course of action. And this may be what they recommend (and is not really what you're looking for).

Well I didn't make myself clear -- I don't EVER bite down on the back teeth. I can't do that for even a few seconds -- the orthodontist even remarked on it. So that is NOT normal.

Thanks for the warning. I suspect that my TMJ problems are too mild to make much difference at all, especially from the insurance perspective (a road I don't want to go down anyway), so I seriously doubt that anyone would want to operate on them. If anyone suggests it, I will refuse. TMJ diskectomy guarantees eventual OA in the joint. No way, Jose. The only reason I'm pursuing the workup is to have more documentation than what I have now, which is only "TMJ click" notation on an initial orthodontic workup. I need a surgeon, and the better case I can make the easier that will be. This "cosmetic" box they've put me in sucks.

#14 Post by **Round2inAZ** » Fri May 30, 2008 7:06 pm

Meryaten wrote:But a mild posterior openbite doesn't necessarily mean surgery is required either. But my point holds even more if this is something your teeth cannot naturally do, and require you to force your jaw into an unnatural posture - it's even more likely that would hurt!

No argument there. My point is merely that the pain/fatigue should not be there, so obviously something ain't right.

Never said it was an indication for surgery. Two have already said that based on my teeth I am not a candidate -- at least not for their "functional" correction.

#15 Post by **Round2inAZ** » Sat May 31, 2008 10:16 am

Meryaten wrote:Why shouldn't the pain be there? Let me make an analogy: if you bend your little finger back further than it's meant to go and hold it there, wouldn't you expect it to hurt? By the same token, if you have a posterior openbite (be it dental or skeletal in origin) and you try to force those teeth to close together, don't you think your jaw joint might be in pain? All I am trying to say is this doesn't necessarily mean there is anything wrong with teh jaw joints, and indeed doesn't necessarily mean there is any skeletal issue. It may all be dental.

Have you considered seeing an orthodontist first?

Please go back and reread my posts: As stated several times already, it was during the orthodontist's examination that this was discovered. It is NOT NORMAL, and he made a remark about it.

As for my holding the position, it was just an experiment that I conducted to see what would happen. Nowhere did I express surprise at this outcome, so your comments are mystifying.

Additional info: There ARE jaw issues: I have already been diagnosed with TMJ syndrome (I had crippling arthritis with TMJ involvement, now in remission) in the remote past but don't have those records. The "recent" stuff includes one flaming "attack" two days ago plus intermittent facial and head pain going on for years that I have been (a) ignoring to a large extent since it is mild and (b) blaming on other things, particularly wearing eyeglasses (which I do while working at home). The orofacial pain/TMD eval I will be undergoing will determine the source of that pain. At any rate, if I DO have TMD I need the documentation which will probably assist in my quest for a surgeon.