Dental Cost Question: what is TP Wert?

Family, Education, Health and Pets
1
Dear All,

To get approved by my insurance I need to get a dental check up report first and I will have to pay the costs of this. And since I have no job = income at the moment, money is very tight. So I need to inform myself really well about the prices and what I can afford.

Now, I have no idea what a dental check up report cost with 2 bite wing X-ray's.

I looked on a few websites in my area and I see by the tariff cost:

TP Wert 3.60 for adults.

What does that means?

How is that calculated?

Why are there no 'normal' prices on the websites? (at least where I have looked so far).

Does anyone knows how Tp Wert is calculated?

(for a moment I was even thinking it could be the price per second..)

ps another question: last Friday I accidentally broke a piece of my molar (nr 45 in the dental diaframe). It was an accident, but the molar was already not in perfect condition, having filling and all. So probably the insurance wont cover that.

I assume that pulling the molar is cheaper then trying to fix it. And ehm..how long can I postpone that?

Thanks in advance for answering!

ps 2: How are Swiss Dentist, nice & patient? Especially with slightly fearful patients, for example and in general, adults who would cry, even before and or during a treatment????

2
galago,

TP Wert = Tax Punkt

Many dentists in Switzerland will be adhering to the SSO (Swiss dental organization) pricing guidelines; under the guidelines, each procedure has a number of 'points' (it is a tight range actually that covers degree of difficulty, but let's say 21, for an example). The pricing then is the points times the tax punkt - 21 x 3.6 = CHF 71.6. A procedure will typically include several positions depending on what was done.

Some of your other questions are difficult to answer as they depend on personal preferences or need an exam to fully determine. #45 is a premolar; many people would prefer to have a tooth in that position than not to have one as it can be visible when you smile.

3
The idea behind the TPW is as follows: Back in the 'nineties, when the current SSO tariff was issued, not everyone had a computer, let alone Internet access. Printing a new tariff every time inflation makes that necessary would have been pretty expensive.

Hence, the positions were given in Tax Points instead of plain prices, with a fixed tax point value for everything insurance-related but a certain degree of freedom for the calculation of the tax point value for non-insured stuff used by a practice, depending mainly on running expenses (a practice around Zürich Paradeplatz is much more expensive to run than one in Vicosoprano).

Actually, the insurance Tax Point Value as the base of the whole tariff system was meant to be adjusted according to inflation, with the SSO having the opportunity to apply for an adjustment once the National Consumer Price index exceeds a certain value above the one of April 1994, when the tariff was introduced. Please note that the SSO is only one of about half a dozen organizations and authorities that have a say in all things tariff-related. The main task of the SSO is taking all the blame in the media.

Since such things always yield a lot of bad publicity, the SSO never has applied for an adjustment, although said amount meanwhile has been exceeded many times. In other words, all insurance stuff is still done at the prices of 1994 (!), whereas the individual practice TPWs were adjusted, albeit way below the increase of the Consumer Price Index.

4
Dear joroianev & captain greybeard,

Thank you both for your (useful) advise!

In the meantime I got a temporary fix of the molar who was partially broken off.

this temporary filling cost me about 200 CHF.

Once I have a job -and therefor will be able to pay for a permanent fix- I would probably choose a different Dentist.

5
The rates of points can vary so it is worthwhile to ask before you start the work/book an appointment. Some of the dental clinics (at least in our part of the country) do work for CHF 2.95 per point. Some of the traditional dentists are around CHF 3.20-3.30. I have only seen the CHF 3.60 rate is for a very expensive orthodontist.

All that to say, you should shop around.

6
Galago,

Glad the advice helped you. Did you tell the dentist you are uncertain when you will come back for the permanent fix (likely to be a crown it seems)? In such (longer-term) instances we put in the stronger composite filling materials versus cement, so it can last longer.

Dr. Ianev (Uzunova)

7
As I mentioned on other similar threads, the rate of points makes a very small difference compared to what the dentists deem necessary treatment.

One dentist may tell you you need three implants and five crowns, an estimate somewhere between 15,000 and 20,000, bells and whistles included, while another dentist says, "Well, there are a few discolored fissures that need some observation, one of them needs deep sealing, and as long as that gap doesn't bother you and does not cause migrations or elongations of teeth, we can just put it on our watch list too. " Estimate one hunnid and fiddy, tartar removal included.

Same mouth, mind you.

Makes a difference of 10,000 %. Now where's the difference of 22 % caused by the rate of points?

8
Hi,

I did ask ahead of time how much aprox. it would cost me.

They do have their points (?) on their website, however I wanted to know what the total would cost me for the work they did.

They couldn't give me a clear answer, were a bit vague about it all.

So I did not get a good 'feeling' about it all and that's why I would be looking for another, more trustworthy, crystal clear / transparent Dentist.

He did the best he could do of course, but this vagueness is not for me.

9
Hello dr. Ianev,

I did tell him, also regarding my financial situation etc. but he was just keen on first doing a root canal treatment for aprox 1500 CHF, and if during that root canal he discovered that the root was dead after all, he would do a crown or pulling out, with all the costs added together - even though he took an x-ray of the molar and could see the nerves being dead, but he was not sure -hence the root canal etc.

They also charged me for asking information regarding the treatments for my molar and what would be the best for this situation. I thought that would be free, but guess not.

Also during the treatment - without letting me know first, or asking permission, he started to file down a few of my molars.

All and all, I don't like this sort of treatment, even though a Dentist knows what they are doing, I would like to be (well) informed before people start filing, rooting and god know what else to my teeth.

he said the filling is temporary and I should come back as soon as possible.

I won't because:

1. at the moment I can't afford anything extra except the household bills and basic groceries

2. I don't trust the vagueness

So I guess I should chew carefully for the coming months!

:-)

10
Galago,

Well, ouch, there is either a giant misunderstanding on your part of what the dentist said/did or you managed to find a dentist that stopped his education in the 5th semester. Nothing of what you state makes sense.

First, you can't see on an x-ray whether the nerve in the root is dead or not; BUT, you can CLEARLY see whether there was a root canal treatment previously done on that tooth.

Second, you cannot OPEN the root canal 'to see whether the root was dead' - there isn't such 'exploratory' option in dentistry. The only time you would open a root canal is if you intend to do a root canal treatment - i.e. to pull the nerve out and fill the canals.

Third, there should be no charge for providing information. Are you sure you are not confusing that with the dental exam charge? What is the item on the invoice?

Fourth, a dentist would do the root canal treatment ONLY as an attempt to save the tooth. Doing a root canal treatment as an exploration for a dead or alive nerve, then pulling the tooth out is, well, words fail me ... let's just say it is not an established procedure.

Fifth, that a dentist will start randomly filing other teeth is strange at best, free or otherwise. To what end?

What we can do for you is to review your x-rays and give you our opinion. We assume the dentist did x-rays on the impacted tooth; if you have paid for the x-ray, you are entitled to get a copy - they are yours. It is best if they can send them to you via email - jpg, jpeg, pdf - so you can forward the email to us. If you get a paper copy, scan it to a high resolution and email it to us. Reference this discussion in the email so our front-desk nurse will direct to me.

If the tooth is not significantly impacted there is still a possibility to build it up with composite filling material even after the root canal treatment. If that is not an option (likely, given what got you to the dentist in the first place), then a crown is your best bet. If that dentist told you that you should come back as soon as possible for the more permanent treatment, it is likely he used cement. It will serve for a period, but likely it will not hold past 6 months. And there could be other unpleasant outcomes (tooth fracture, root inflammation, etc.) - hard to say without seeing the tooth.

Dr. Ianev (Uzunova)

11
Hi,

I am the one who misunderstood him.

From what I can clearly remember, they took 1 x-ray of the molar.

When he looked at the picture via the computer, he said that he wasn't sure if the nerve was dead.

he asked me if I had a root canal treatment done to this molar.

I said no, which is the truth, I never had ANY root canal treatment done to any of my teeth.

However, the dentist in Holland, this was maybe 12 years ago, treated this molar with something filled with formaldehyde. That is what this dentist said, because he could smell that (he scraped some of the filling out).

I believe him, because I did not know what the other dentist in Holland had put into my filling. I wasn't asked if I want formaldehyde in my filling. I feel still upset about this. This dentist told me that this wasn't that bad, I should not worry about it.

Aprox a third of the molar was broken and only the outer ring of this molar is intact, the inside is almost completely filled.

So this dentist filled removed the old surface filling, filled it with a new temp. filling.

He then literally said, he would want to do a root canal treatment to see if the root nerve was really dead (I assume this has to do with the formaldehyde filling?) and he said that if during this root canal treatment I felt pain, i.e the nerve was still alive.

And if the nerve was still alive, he has to do this root canal then before filling the teeth on a permanent basis, otherwise it could cause infection etc.

Here I was wrong, he did want to save the molar. Not do a root canal and then pull it out.

If the tooth would break or was not savable -he would just pull it out, so I guess he wants to do the root canal to see if the molar is savable.

I am giving him the benefit of the doubt, I am sure he is very capable and he wants to do what is best.. It is just that -for me- it doesn't click.

Regarding the bill; I didn't get a dental exam done, because they told me that the insurance would not take me on, because I don't have perfect teeth (which is true, all my molars are filled).

So the bill was purely for all the work done there that one day:

1 tarif 4000 - befundaufnahme ------------------------ 79.20 CHF

1 tarif 4011 - information uber zahnartz therapie ---- 54.00 CHF

1 tarif 4050 - zahnrontgenaufnahme -------------------19.80 CHF

1 tarif 4500 - provisorische fullung ---------------------39.60 CHF

total-------------------------------------------------------192.60 CHF

===sorry== I have to write a reply after I fixed my laptop. i dont know what is going on, during typing -out of its own will, the page scrolls down really fast????

what th

e heck..it takes me forever to type, because the screen keeps scrolling down.

sorry about that

thank you so mcuh for your offer.

i will contact them and ask for a copy of the xray

take care