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Schools offer dental services that won’t chew through your savings

April 2012

Adele remembers the shock when she received an invoice from her dentist for $150 for a cleaning and exam, plus a toothbrush.

At the time, 20 years ago, she could not afford that kind of money and started looking around for alternatives. Luckily, Adele discovered the McCall Dental Clinic run by McGill University’s Faculty of Dentistry at the Montreal General Hospital.

Fees for services then, and now, are 20 to 50 per cent lower than the rates recommended in the annual guide of the Association des chirurgiens dentistes du Québec.

And Adele—she asked that her real name not be used—has never looked back or gone elsewhere for dental care.

The services are carried out by third- and fourth-year dentistry students, supervised by their teachers, who are accredited dentists. Adele recalled she felt a bit nervous about being treated by students, but after the first few visits, she became reassured.

“They knew what they were doing, they were closely supervised, and the equipment seemed more up-to-date than in your average dental office,” she said. Only once does she recall asking that another student take over her care, since she found the first student was using “too much force” in her mouth.

She appreciates that when a treatment plan is presented, there could be a Plan A and a cheaper Plan B, and you can pay it off in installments.

“I feel secure because they are up to date in their technology, they know what they are doing, and they are supervised,” she said. “It’s easier on my budget and I feel safer.”

The clinic, and a similar one at Université de Montréal, is open to all, and there is no means test.

Here, according to manager Joanne Chouinard at McGill, is how it works: Since the primary purpose is to perfect the training of future dentists, the clinic will only accept patients who fit their pedagogical needs at the time, and where the problems that have to be addressed are not “too difficult or too complicated.”

This will be determined after an initial evaluation, which costs $40, including full-mouth X-rays. A patient who is not accepted gets a CD with the X-rays. A patient who is accepted gets a second appointment and is charged an additional $45 for the completion of the detailed exam, preparation of treatment plan and estimated cost.

For patients with full dentures, the charge for the first appointment is $65.

Orthodontic treatment is available for children and adults, but only basic cases are accepted. The charge for the first appointment is $25.

It takes longer for procedures to be completed because students are having their first experiences and they are checked and supervised at every step. A filling that might take one hour or less at a private clinic could take three to four hours to complete at a university clinic, Chouinard said.

If there is a long treatment plan, lasting more than a semester, more than one student might do the work.

While many of the procedures cost half that recommended by the dentists’ association, the 20-per-cent reduction is limited by fixed commercial laboratory charges for such things as crowns and implants,
Chouinard explained.

It could take two to four months for a first appointment, and there are no appointments in the summer.

An exception is this July, when McGill’s dental clinic is offering free basic care to children 10 to 17 and physically or intellectually disabled persons 10 and up. Teeth can be checked and cleaned and minor dental work, such as fillings and extractions, carried out from July 2-27.

A similar clinic is offered by the Université de Montréal at the Roger Gaudry Pavilion, 2900 Edouard Montpetit. Second-year students take X-rays and see patients for preventive measures and full dentures. Although applications are being accepted for a variety of patients, the clinic there is looking for those who need root canals, partial bridges, full dentures, and minor orthodontics (for patients aged seven to 12).

McGill Undergraduate Teaching Clinic: 514-934-8545. Université de Montréal: 514-343-6750.

Fees are set by individual dentists

Fees for dental services at private clinics in Quebec are set by each dentist. They use a guide, updated annually by the Association des chirurgiens dentists du Québec, to help determine how to charge fees.

There is no public input in the committee of dentists that establishes the guide, and it reflects only the difficulty of the procedure and the time it takes, comparisons with rates in other provinces, inflation and costs of operations.

The guide is not made public, and is accessible only at the National Library, association president Serge Langlois says. Even if it were available online, it would only be comprehensible to professionals who understand the codes that use technical terms.

He said the association plans a PR campaign to explain its fee-determination process, but he acknowledged that the association representing 3,800 Quebec dentists has a transparency problem.

He suggested that patients discuss the issue with their dentists.

Examples from the guide:

Complete oral exam, without panoramic X-ray: $70-115

Scaling and cleaning: $94 and up

Amalgam-gray filling: $67 (molar)

Composite-white filling: $104

Extraction (per tooth): $101

Surgical extraction: $163-$349

Root canal treatment: $431

Crown: $726 plus lab fees.

Children under 10 get free services (except preventive and cleaning), paid for by the Régie de l’Asssurance maladie du Québec. Welfare recipients and their dependents get most dental services covered by the RAMQ.



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