FAQ

I am concerned about the cost

Modern dentistry can be an expensive service to provide. To obtain the best staff we always pay well above award wages. The costs associated with laboratory fees, dental materials, equipment, disposable items, servicing, compliance with regulatory authorities, insurance, compulsory continuing education and repairs are high. Virtually all dental practices have overheads in the region of 60 - 65% of fees generated.

However, once you reach a stable state of good dental health, regular maintenance is very affordable. Health funds will provide a co-payment towards the cost for their members. This varies from fund to fund and is dependent upon your individual level of cover.

Once you have received your examination, a treatment plan will be discussed with you and we will provide a written estimate of all costs prior to commencing treatment. Should circumstances alter during treatment, then again you will be provided with a revised estimate to be fully informed of the total cost of treatment. There are no ‘hidden’ extras.

It may be possible to spread out non urgent dental care to make budgeting easier.

Can I go overseas to obtain cheaper treatment?

Of course you can!

A few patients decide to get dental treatment at lower cost in places such as Bali. Yes, it’s cheaper. It is also unregulated, standards of sterility and accountability are often lacking, the qualifications of the dentists are usually not acceptable by Australian standards and, if treatment fails, the costs associated with reparative work can make this a very costly mistake.

Before you take part in so-called medical tourism ask yourself this: "if the country is unable to provide safe drinking water from the tap in my hotel room, is it likely that their dental care will be of a greater standard than at home?"

Why are we not preferred providers?

When you take your account or treatment estimate to your Private Health fund they will almost certainly point out that, if you went to one of their ‘preferred providers’, you would receive higher rebates. We feel it is important to explain the current ‘preferred provider’ scheme so that you understand why at this stage we have decided not to join.

  1. ‘Preferred provider’ might signify that the dentists who belong to the scheme have been selected for reasons of competence or sterilisation standards etc. This is completely false. Any dentist may become a ‘preferred provider’ providing they sign a contract with a Private Health Fund and agree to abide by this health fund’s terms and conditions.
  2. The idea of having private health cover is to give the individual freedom of choice with the health professional they attend. It is morally wrong that all Private Health Fund members pay the same premiums for ancillary cover but that members who attend a ‘preferred provider’ get higher rebates. This completely removes the freedom of choice.
  3. In any event, private health payments are not insurance as dental disease is not an insurable condition. What they are is a co-payment. In other words your Private Health Fund agrees to pay something towards the cost of your dental treatment, NOT cover the cost.
  4. Under a contract with your Private Health Fund we would not be allowed to reduce our fees as we do now under certain circumstances. Their contract stipulates that we have to charge the usual and customary fee for an item of service each time that item is used. Unfortunately schemes where patients receive higher rebates often lead to instances of over-servicing or fraud.
  5. Many Preferred Provider Dentists send their patients laboratory work i.e. Crowns and dentures to a laboratory who in turn sends it overseas. (Mainly Indonesia and China). This saves a significant amount of money (up to 25% on the total cost of a crown) but in a vast majority of cases the work is of poor quality. The types of metals and plastics used are often unknown and can lead to an early failure. We certainly want to know which products we are placing into the mouths of our patients! We take great pride in using high quality dental laboratories with experienced technicians, using high quality materials to fabricate the final product. Our Crowns are guaranteed for five years. In order to reduce costs some Preferred Providers have to decrease the time spent on treatment and use less expensive materials which can lead to an early failure of the restoration. Quality Dentistry takes time and we are not prepared to compromise the treatment of our patients.
  6. The Australian Dental Association does not support these ‘preferred provider’ contracts and believes their intent is that the Funds will eventually be able to control the level of fees and services. In other words your dentist may not be able to provide the treatment that he or she feels to be in your best interests as, by doing so, it may breach fund rules current at that time.

We trust that this explanation allows you to make up your own mind on this matter. Please do not hesitate to contact the practice if you wish to discuss this issue further.

regarding this issue: Article in Bite magazine, 28/08/2014: ADA cautions Senate about health insurers

I’m nervous about dental treatment and have had bad experiences elsewhere

You’re not alone!

Let’s be honest, going to the dentist is probably not the most fun you’ll ever experience. However, at Castlegate Family Dental Care our first priority is to make sure that you are as comfortable as possible throughout treatment. It’s in our best interests also, as we’d like to see you again!

Topical anaesthetics in the form of a pleasant tasting gel are applied to the injection site prior to any local anaesthetic being given. Injections are given slowly with the finest gauge disposable needles to minimise discomfort. “The Wand” which is a computerised local anaesthetic machine is also available. You can elect to combine this with inhalation sedation in the form of a nitrous oxide / oxygen mix delivered though a nasal mask. This “happy gas” will reduce anxiety and make time appear to pass more quickly. You will be able to drive home afterwards.

For very nervous or young patients a full general anaesthetic session can be arranged where all treatment is completed in the one visit. This is carried out using specialist anesthetists at the Southbank Centre in South Perth and has additional costs. The vast majority of our patients are able to accept treatment under local anaesthesia, which will “numb” a region of your mouth. Once anaesthetised, treatment should be without pain. All patients are instructed to advise the dentist if the anaesthesia isn’t adequate for their needs. In these cases treatment ceases until the required level of anaesthesia has been achieved.

Your genuine concerns regarding adequate levels of pain control are never ignored or brushed aside.

Can I get a second opinion on treatment / prices over the phone?

Sorry. We are happy to see you and provide a second opinion after an examination but it is not possible, or ethical, for us to diagnose over the phone any more than it would be for you to expect your garage mechanic to tell you exactly what was wrong with your car without seeing it first.

Although you may have been given a treatment plan by another dentist and have the item numbers, we can’t just give you our prices for the same item numbers as we may decide that, in our opinion, the treatment for which you have been quoted is incorrect or more complicated than at first thought. Even if the treatment was for a single crown, we would still have to be satisfied that the treatment was suitable. This may involve taking an X-Ray and checking the tooth’s vitality as well as discussing alternatives and the different types of crown (cap) available.

Unfortunately your dental health choices aren’t as simple as shopping around for the best price on a particular model of refrigerator.

I want to change practices. Can I take my records and X-Rays?

Copies of your dental records will always be provided on receipt of a signed release from you. However dental X-Rays (radiographs) remain the property of the dental practice where they were taken. This is for medico-legal reasons, as they may be the only proof a dentist has of the diagnosis he or she made.

However you are entitled to receive copies of X-Rays, although such copying will incur a fee.

In certain circumstances your X-Rays can be mailed to another dentist for viewing and returning. However the original X-Ray always remains the property of the dentist who took it.

But I paid for the X-Ray, so surely it is my property?

Unfortunately no. You paid for the diagnosis from the X-Ray, not the film itself.

I’ve heard some dentists send their laboratory work overseas to obtain cheaper rates. Do you do this?

No, and we suspect that very few dental practices in Australia do this. First, many overseas dental labs are not as regulated as in Australia and the metals used may have unacceptable levels of lead etc. Secondly it is important to ensure that skilled Australian dental technicians are able to survive in business without trying to match wages paid in Third World countries. Thirdly, it is vital to be able to communicate your laboratory prescription with a skilled dental technician or ceramicist with whom you enjoy a professional relationship.

At Castlegate Family Dental Care we have been using the same dental technicians for over 20 years. This is because the standard of work we receive from these laboratories is consistently high, making our job easier and your appointments trouble free.

Local laboratories will send computer scans of teeth prepared for certain all ceramic restorations to Sweden for the manufacture of the ceramic core. The core is then returned to Perth for our dental ceramicist to build up layers of porcelain to match your existing teeth.

Do you guarantee your work?

Because of the large number of variables involved in medical or dental treatment, it is not possible to give a ‘guarantee’ of the longevity of a particular restoration or item of treatment. The mouth is a hostile environment and your teeth are being used many times every day. Also there is a responsibility on your part to maintain your mouth in a healthy state to give any treatment you receive from us the very best chance of long term success.

However, in the rare instances where something we have provided fails within a short period of time (not including trauma), it would usually be replaced at no charge.

Do you use amalgam (silver) fillings?

Rarely. Despite what you may read in the media or on the Net, there is no scientific evidence to say that amalgam fillings are responsible for any health issues, or that their removal will improve the health of an individual. In fact, research has shown that amalgam fillings last on average twice as long as the newer composite (“white”) fillings.

However, composite and glass ionomer materials are routinely used in our practice due to their better aesthetics and superior bonding capabilities, allowing less removal of sound tooth structure. Glass ionomer materials are very biocompatible, but are unsuitable for larger restorations (fillings).