Remember when I was all “I’m going to the dentist to get my TMJ taken care of finally” and I knew it was going to be expensive but I was okay with that, mostly, because I’m in so much pain?
I don’t like surprises. So I went ahead and did my research before I went back, yesterday, so that I could maybe get over any sticker shock beforehand. According to what I’d read, I could expect to pay $400-$500 for the custom bite splint I expected they were going to recommend for me. Not chump change, to be sure, but I was steeled and ready. This is FOR MY HEALTH, I told myself, as I walked into the office. THIS IS SOMETHING I HAVE TO DO, I reminded myself, as I checked in. IT’S JUST MONEY, I repeated silently, because I am a total freak about money and I knew I just needed to get over it and take care of my health.
The dentist brought me into his little office with the desk and the awards and certificates on the walls and a metal contraption which now held a ceramic (?) reproduction of my teeth and how my bite works. The first thing I thought when I sat down was, “Man, my parents should TOTALLY demand that my childhood orthodontist give them their money back.”
There’s a fancy word for what dentists and orthodontists call my particular kind of bite, but I don’t remember what it was because I stopped listening, briefly, when my dentist opened with the news that really, what I need, is jaw surgery.
As soon as he noticed the horrified look on my face, he rushed to clarify that while jaw surgery would be the only thing that will truly and permanently take care of my TMJ and tooth wear, he “never recommends that as a first line approach,” and I could rest easy in the knowledge that surgery was NOT what he was going to recommend for me, today. No no no. Besides, insurance almost never covers that! The FIRST thing to do is a specialized bite splint to try to correct my “jaw malformation.”
People, I am nearly 40 years old. I could’ve happily gone MY ENTIRE LIFE without being told that my jaw is “malformed.” I mean, I know I (still) have a bit of an overbite, but now I sort of feel like an orthodontic Quasimodo over here. (“DON’T LOOK AT MY TEETH! I CAN’T BEAR IT WHEN YOU LOOK AT MY TEEEEEEEETH!”)
Perhaps the dentist does not understand that I am soft and pink and quivery with delicate sensibilities on the inside. Okay.
Next the dentist whipped out a large plexiglass-covered side view of a skull, complete with rubber bands for muscles and a plastic hinge for the jaw joint. For the next twenty minutes I learned about proper bite and jaw alignment, and was given a full demonstration of why my (MALFORMED!) jaw with its anterior (INFERIOR!) alignment is causing my muscles to work overtime, and then—while I try to sleep—spasm and clench and grind. The dentist swapped out lower jaw pieces to show me the right way and my way, and when “my” bite was in place, poor Plexiglass Man was all misaligned and clearly pissed off that his insurance won’t cover having his jaw surgery.
FINALLY (it seemed like this entire thing took hours, or maybe days), the dentist inserted the bite guard analog piece into the anterior bite and showed how it magically made everything align properly once again, and peace and harmony ruled the world.
“And so that’s what we’re recommending for you,” he concluded. “It’s called a Tanner bite splint, and it will allow your jaw to align in a position of rest at night, which will allow your muscles some respite and let that joint start to heal up.”
I nodded. “Okay,” I said. “Are you going to tell me what this is going to cost?”
“We drew up some paperwork for you,” he replied, never missing a beat, reaching down into a folder. “Now, I don’t want you to panic when you see this,” he added, handing the paperwork to me.
I paused, hand in the air, papers clenched. “This isn’t covered by insurance, right?” I asked, already knowing the answer.
“Oh, actually it is!” he said, clearly relieved to have some good news for me. “And it’s not even your dental insurance, it’s your medical insurance. Because this is actually an orthopedic issue, so generally we see pretty good coverage.”
“Well THAT’s the first good news you’ve given me today!” I said, and we laughed. Oh ha ha ha, JAWS AND THEIR ASSOCIATED COSTS ARE SO FUNNY.
I set the paperwork down in front of me. The first page was an “Information on Temporomandibular Joint” sheet, which could basically be distilled down to “You and your malformed jaw are totally screwed, sucker.” One of the things I enjoyed about it, however, was that among the “other recommended treatments” they listed biofeedback, cranial osteopathy, and PSYCHOLOGICAL COUNSELING. Because if only I could tell someone how my malformed jaw makes me FEEL, all could be made better.
The second page outlined the treatment plan, which included—as expected—the custom bite splint, as well as 6-9 month window for weekly or biweekly visits for adjustments.
The cost for this was set at… $2,000. With a disclaimer that treatment might be unsuccessful and then we’d have to discuss jaw surgery.
I blinked at the last zero a couple of times. It did not go away.
The dentist told me he’d send in the office manager to discuss financials, and reminded me (again) that insurance coverage is available, and not to worry. I nodded.
The office manager came in and sat down and asked me if I had any questions. I repeated what the dentist had said about insurance coverage, and asked her if that was really true.
“Well it’s true for some plans, yes,” she said. “Tell me again which insurance you have?” I told her, and she frowned. “Oh, Mir, I’m sorry. They don’t cover this at all.” I looked back down at the $2,000 on the sheet in front of me.
“It’s, uh, open enrollment?” I finally squeaked. “I mean, right now is open enrollment. Would a different plan cover it…?”
“Well, I know you have another option that will cover about half,” she said, carefully, “But I think that plan costs about twice as much, so I wouldn’t recommend you switch just for this. I just don’t think it will save you anything in the end.” I nodded. “We do offer a payment plan,” she added. “Did you want to discuss that?”
I probably should’ve discussed that. But instead I opted to burst into tears, because the thing about where I’m at, psychologically, right now (me and my malformed jaw, that is), is that a surprise of a $2,000 magnitude is just not something I can deal with rationally in the moment. I just couldn’t. So I apologized and took my information sheets and left.
I came home and called Otto.
“THEY WANT TWO THOUSAND FUCKING DOLLARS FOR THIS,” I managed, between tears. “WE HAVE WORMS AND ROTTEN CHILDREN AND CHRISTMAS AND THINGS AND THEY WANT TWO THOUSAND DOLLARS.”
“We’ll find a way—” he started.
“No we will NOT!” I countered. “I am not giving them two thousand dollars. For a hunk of plastic. For my stupid mouth with my stupid teeth. I WILL NOT. I WILL JUST GRIND MY TEETH INTO NUBS AND I DON’T EVEN CARE.”
“Mir. I think—”
“I WILL GO ON A LIQUID DIET AND STOP CHEWING EVER.”
“You… I… um. I’m sorry? I know you’re upset.”
“IT’S POSSIBLE I AM BEING SLIGHTLY IRRATIONAL AT THE MOMENT. JUST POSSIBLE.” And then I laughed, and Otto laughed, and it wasn’t okay—I mean, $2,000 didn’t fall out of the sky into my lap while we giggled—but it was better.
But if you think I’m not seriously considering how I might have a bike accident or something that might necessitate—emergency, insurance-covered—jaw surgery, you obviously haven’t met me. And my malformed, stupid, expensive jaw. (I am kidding, of course.)
Who wants a smoothie?