Dental insurance

I have just been given a devis for some very expensive dental work. Can anyone tell me the best way to fund this i.e. a reasonably price insurance or bank loan? The difference between what social pay and the total amount to be paid seems to be getting greater with remunerations getting smaller making it harder to get the right cover.

Thanks Catherine. My toes are curling in fear just at the thought of going to see him. Plus Henry hates driving and will have to drive me back after any treatment - so I will have to listen to lots of swearing, and "some people shouldn't be allowed own a car", etc., etc. :-)

Unfortunately for me, my fear of dentists goes back to when I was a child, so I have only ever gone when I HAD to go. Anyway, keep your fingers crossed for me. Will arrange appointment for early next week.


Don’t let the dentist pull the tooth if he/she can save it. I have had root canals on two molars, one was about 15 years ago, both teeth still there. Of course, the tooth can’t always be saved but if so, get a devis for a root canal as well as an extraction. I think SS pays 70% in either case.

Thanks for that Catherine. When I was a kid, the dentist could "knock you out" for a difficult extraction, but don't think they are allowed do that at this stage. Hope all is now well for you.

First, I hope you feel better soon. This has been “my year of the teeth.” In addition to the implant mentioned in my earlier post, I also had to have an abcess treated about 3 months ago, ended up having to have a root canal but no cosmetic work. I think the SS paid 70%. We did not take dental coverage with our mutuelle so can’t help you with that. My portion was around 50€.
For my root canal my dentist really numbed my gum, I didn’t feel anything other than slight pressure. Insist on this or find another dentist. Good luck.

Hi all. Just back from the doctor as I suspected an abscess on my gum. Am taking antibiotics, and a mouth wash 3 times a day with instructions to go to the dentist. With apologies in advance to Margaret (and any other practitioners who might read this), I dread going to the dentist. I have never, ever had a pain-free dental experience (and I might add have delivered 3 children without so much as an aspirin, so am not a wimp). What are other people's experience of dentistry in France? At what point am I no longer covered by Carte Vitale + mutuelle. Are extractions done under the normal SS + mutuelle cover? Sorry for all the questions but am extremely anxious at this moment in time.

I needed dentures in 2009, whilst living in Switzerland, where dentistry is also horrifically expensive and insurance is woefully inadequate. I considered Hungary and Austria, where my wife had good treatment for a problem for Eur 100 (the dentist was actually Hungarian) but I wasn't able to get any reasonable estimate without going there.

I came across a website, where you could post what you needed and dentists would make offers, which were considered binding. I had one quote from a dentist in South Germany for EUR 1500, which seemed reasonable. I had some correspondence with the practice via email and phone. The dentist said he could do all the work in 1 day, if I could get there for 9am. I was living in Bern at the time. I considered staying overnight but finally left home with the first train at 6am and was there just after 9. After a little wait, I met the dentist, who did Xray, extracted 2 teeth, sewed up the holes and explained how to extract the thread in a week, preparations for dentures. Then I went to the hygienist, who used some salt based cleaning system - the most pleasant hygienist experience I've ever had. The denture technician came in whilst I was there to check the colour of my teeth and maybe some other fine tuning. Then I was told to go away and come back after 2pm, when the dentist fitted the dentures. He told me they were temporary and good for 2 years, which was bit of a surprise, but they've lasted 4 years so far and are still as good as new.

He tried to persuade me to consider implants, as there was enough gum, but a, they are very expensive, b, I knew people who'd had implants and had a lot of pain after the fitting and c, I had a crown fitted 20 years ago and was on very strong codeine for weeks until the pain went - I complained to the practice, who'd fitted the crown and they told me to clean my teeth with warm water.

The dentist asked no money upfront. A couple of weeks later, I received the bill. It was a bulky package with everything in minute detail. The invoice amount was Eur 1200, which was less than the original offer. The practice was ultra modern, looked brand new and there were plenty of other customers, so I guessed that the dentist wanted to see what the internet would bring.

Incidentally, over the years, I've had the best dental experiences in Germany and for little money. In 1997 a dentist in Frankfurt gave up 3 hrs of her Xmas Eve to fix a problem. At the end, the assistant having left, she asked for my insurance details and I said I had none and would pay cash. In that case, she said "100DM" (55EUR). I would have gladly paid much more.

So if you live within reach of Germany and need dental work, I recommend you give them a go.

Wow! What a brilliant and comprehensive reply. Thank you x

Hi again Denise, ok, so I get the picture from your info. So, I presume your front two teeth need to be replaced (11 and 21). I'm wondering why your dentist wants to go as far back as the first premolars(14 and 24) with his bridge? Are all the other teeth already root filled (14 rhs first premalor, 13 rhs canine, 12 rhs lateral incisor, 22 lhs lateral incisor, 23 lhs canine, 24 lhs first premolar)? If so, they are fragile and need to be protected with crowns or together in a bridge. However, if the canines are still alive ie not root treated (the canines are often the strongest teeth in our mouths, with long roots) then they should be kept alive .. in this case the bridge should span only from canine to canine. If the first premolars are root treated then it would be better to crown them individually .. that is if the canines are strong enough (root treated or not) to support the bridge. The laterals alone are certainly not often strong enough to support the central incisors in a bridge. The thing is, that teeth should be kept alive if at all possible. Crowns and bridges can be cemented onto teeth that are kept alive after special preparation. Unfortunately in France most dentists root treat ALL teeth when doing crowns and bridges, which is not necessary, and detrimental .. even if a root canal is well root treated problems can occur at a later date ie micro abcesses and cracks (resulting in extraction). However, in trying to keep teeth alive, same old story, the dentist earns less money, and the work is actually more difficult. Just because a tooth is going to be part of a bridge does NOT mean it has to be root treated. So if a tooth is kept alive then an 'inlay core ' is not needed. Now on the subject of inlay cores .. the system is such that patients get better reimbursed for an 'inlay core' than a 'reconstruction'. Plus an 'inlay core' is prosthetic dentistry (made by a lab) and the dentist can increase his price above the Sec Soc limit. The crazy thing is that it's most often much better for the tooth (much less tooth structure is destroyed) to do a reconstruction, but actually much more work for the dentist. So guess why practically all dentists only do inlay cores? .. the Sec Soc is trying to fight against this mal practice but with little effect! The 'nomenclature' for a 'reconstruction' is SC33 at 79.53€ .. 55.67€ reimbursed by the SS and the rest reimbursed by the worst mutuelle (as we are not allowed to go above the SS price for this act). An inlay core is SPR57 (!! crazy, as a crown is only SPR50) tarif de base SS= 122.55€, reimb SS=85.79€, but in this case the mutuelle will give more eg mut at 100% of the TB will give an extra 122.55€. So, in this case, if the dentist asks for 122.55 + 85.79 ie 208.34€ for an inlay core then the patient will be fully reimbursed .. the patient is happy (financially) the dentist is happy (financially), but was the best (medical!) choice of treatment taken. At this point I'd like to make a few comments after reading some of the other replies to this discussion. I have been practicing my profession for long time now, and have worked in several different countries over these years. Believe it or not, dentistry is actually part of the medical professions, and is not a commerce ! Mouths and teeth are the same all over the world, but what changes the treatment given is the system in which the dentists are working. Unfortunately, here in France, because of human nature, the best treatment is not always given because it is most often more time consuming, more difficult, and less financially rewarding. How does one find an honest and good dentist in France?. Let's start with 'honest' ie a dentist who will undertake on his patient the exact treatment he would want to be done on himself. Impossible to judge, therefore one 'trusts' their dentist, or not .. (it's only after being treated by the same dentist for many, many years that a patient can judge his own initial judgement of 'trust'). When I see a new patient who says to me, and often with embarrassment, before opening his mouth "oh dear, I'm sorry, it's my fault, I've never had strong teeth", I think to myself (yes, only think, as we must never criticise), maybe this poor chap has simply never been treated correctly. As for 'good' .. it's not all the shiny , up to date equipment that makes a dentist better. Dentistry is an art! In fact they should chose students that have finished art school before doing a dental degree! The number of young dentists I've employed here in France that, even although they have all the necessary information in their heads, and try very hard, are just not good with their hands! So basically, the treatment given can be average, or below or above average, and patients usually have no idea! .. (it is in no way an exact science .. each same treatment done by the same dentist is of a slightly different quality) .. only when the work is well below acceptable levels does the patient start wondering (and even then some patients believe it is their own fault). I could diverse into how students are chosen at University here in France .. but I won't go there. In other countries where preventive restorative treatment is well paid the patients often have very healthy mouths. Here in France it's not the case .. dentists make their money doing prosthetic work. When my patients move away and ask me how to find a decent dentist I tell them that a good test is the 'detartrage' (cleaning and scaling). As we don't have hygienists here in France (another absurdity) the dentist has to do the job. How much do we get paid? .. 28.92€!! even if the patient hasn't been to the dentist in 10 years! So, ok, it should still be done, done thoroughly, and usually every 6 months. A good test to see if the dentist cares. Beware of the dentist who wants to know what mutuelle you have and how much reimbursement you will get for any prosthetic treatment! Something I'd like to add is that 'crown and bridgework' is probably the easiest part of our job technically, and even the average dentist can have a satisfactory enough result (the dental technicien can often hide the defects .. and only years later will these defects come to the surface, so who cares ?). I'm really sorry if all this seems very depressing, but I've become very angry over the years, although I still plod on, as I still feel I am in one of the caring professions. Don't get me wrong, there are good and honest dentists out there .. just not enough .. and those of us who try very hard are given the same bad reputation as the others.
So Denise, back to your case .. as far as the price of the crowns in the bridge are concerned. 520€ is a reasonable price for one crown (I presume the temporary crown is included in this price?). However what is the infrastructure made of? At that price it's not gold, or even white gold .. but just make sure it's not the alliage 'nickelchrome' (still used in France but forbidden in many other countries because of allergies to nickel) .. if you can't have a precious or semi-precious infrastructure then ask for 'chromecobalt' (more dificult to work with, but a much better option for the patient). The thing is that it's easy to ask less when the dentist does so many at once. A mouth that has been well looked after by a dentist might, all the same, need a crown one day to protect a fragile tooth. Surely after all the underpaid (in France) preventive restorative work already done, the patient would be more than happy to pay only 520€ (a little thank you) .. because, really, in the end, the dentist, by working well, has helped the patient save money. It's a fact that in France a dentist that does no prosthetic work can not pay his overheads (unless he bills extra as 'hors nomenclature' .. another subject). A dentist that waits until the patient has a problem before treating a tooth ends up only root treating and crowning , then extracting, and then making bridges or placing implants (all day long).. he's laughing all the way to the bank even if he only asks 300€ for a crown! So, it's not the price of prosthetics, but the quality of the long term treatment. Golly, I do hope I've been clear in my, what might seem like, exasperated babbling. Gosh, I've also realised I made a mistake in my last repy .. I meant Burns' night , oops :-)

Goodevening Denise, I'll get back to you this w-e sometime. Just finished my day's work, and trying to sum up enough energy to celebrate Burn's night .. which I'm sure I'll manage :-)

I have very good teeth, but lost two stoppings in molars over a year ago. I have been to the only dentist I could find. I was quote 1200 euros to replace these two stoppings. I asked my doctor if he could give me the name of a good dentist. He said yes but non of the good ones locally will take any more clients. You will have to go to agen - that is 100km at least

Good luck Denise. From what I read in the article, you can visit the hospital and firstly ask for a devis to see if they can help you. You don't have to ask your existing dentist first for permission to visit there.

Thank you Rosie, we live near Limoges where there is a training hospital and, in fact, my dentist is attached to this CHU..........maybe that's another option. We have notified the dentist that his devis is too expensive and asked if he can suggest something else. Watch this space !

Denise - this may be of use to you. In a French magasine I saw an article about dental costs, and an alternative way of getting expensive treatment done. If you are near a large town where there is a training facility for student dentists, it is permitted that you can go and have the treatment done there. All under expert supervision of the tutors. The costs for implants and crowns are a minute fraction of the charge of a normal dentist. It may be that there is a facility near you. Just a thought and I hope it helps.

Hi Margaret, thank you so much for your comprehensive reply. My problem is I have had a bridge for a long time, fixed only on one side (front right incisor) and cemented (?) in. The bridge has four holes available for posts to have been fitted in but for some reason these were never made so for time to time the bridge comes unstuck and has to be put back in. Over time, the one fixing point has become weaker and my dentist has now proposed making a new bridge, removing another two teeth (one each side) making a total of eight teeth on the new bridge plus all the all the fixings. Total of 5390€ I have copied the details and attached them and would welcome your comments. He hasn't suggested any alternative treatment i.e. just making a more secure fixing to my existing bridge. So I think I may need to get a second opinion and devis?

Qt Désignation Dent LClé & Coeff Base RemSS Honoraires
1 CERAMO METALLIQUE 14 SPR 50 107.50 520.00
1 CERAMO METALLIQUE 13 SPR 50 107.50 520.00
1 CERAMO METALLIQUE 12 SPR 50 107.50 520.00
1 CERAMO METALLIQUE 22 SPR 50 107.50 520.00
1 CERAMO METALLIQUE 23 SPR 50 107.50 520.00
1 CERAMO METALLIQUE 24 SPR 50 107.50 520.00
1 inter bridge ceram rbt 21 SPR 30 64.50 520.00
11 HN 1 0.00 520.00
1 INLAY-CORE 24 SPR 57 122.55 205.00
1 INLAY-CORE 23 SPR 57 122.55 205.00
1 INLAY-CORE 22 SPR 57 122.55 205.00
1 INLAY-CORE 12 SPR 57 122.55 205.00
1 INLAY-CORE 13 SPR 57 122.55 205.00
1 INLAY-CORE 14 SPR 57 122.55 205.00

Not an insurance solution but my dentist let me spread the payments for an implant, which helped enormously. The implant was a lower front tooth which had had a root canal 35 years ago; I was lucky it lasted so long with just a veneer.

BTW, implant here was 2000€ all-in versus $4,000 in the States. My first and I hope only implant but I’m pleased with the result.

Exactly Jo, but then I am extremely lucky to have not only excellent teeth but also to have worked for a dentist in the past. In the words of my current dentist, I am too well trained to make him any decent!

Hi Denise, I am a dentist working in my own practice in France (degree from Edinburgh Uni. in 1978).The system in France is such that dentists are not allowed to ask any more than the Security Social rate for all dental work apart from prosthetic dentistry where there is no limit to what can be asked (for the same work). It is a twisted system because we are underpaid for restorative dentistry, and therefore many French dentists tend to exaggerate their prices for the prosthetic treatment .. some dentists don't even do any preventive restorative treatment because it is so badly paid! .. they wait until the patient has a problem, and then it's often too late, and a root treatment is needed, and therefore also a crown because the tooth is now fragile (these patients often end up with implants, and all because the dentist didn't do the right treatment in the first place!). When I arrived in France I couldn't understand why so many patients had so many teeth already root filled and crowned .. now I know why. I could talk on this subject for hours because it makes me so angry, but I'll refrain at this moment in time .. all I want to add is that an honest and good dentist working in the French system has to work very hard to make a decent living. Some dentists work the system by calling certain treatments 'hors nomenclature', which is frowned upon by the Sec. Soc. So, let's get back to the subject .. a mutuelle at 30% is sufficient to reimburse all basic treatment because the SS reimburses 70%. Now, for an example of prosthetic treatment let's take a crown .. tarif de base Sec. Soc. is 107.50€, therefore reimbursment SS = 70% ie 75.25€. Now when you chose a mutuelle their reimbusment is based on these figures. eg a very good mutuelle would be at 400% of the 'base' .. which means 107.50€ x 4 extra. A basic mutuelle would be 100% of the remboursement SS .. which means 75.25€ x 1 extra. Sometimes it's not worth paying for an expensive mutuelle .. it's a calcule to make. If you let me know what sort of prices your dentist is asking I can let you know if he is above the average rates or not. Remember, it's not because you pay more that the work is of a higher standard! Sincerely, Maggie

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Get yourself a very good "mutuelle" with the highest rating for prosthetic dental work (I imagine that's what it is) bridge, couronne etc. You should aim for at least 400% of the social security. This said, if you haven't got social security in France then you would need to enquire about whether you can have a mutuelle or not. If not, go to Hungary, there are French dentists who specialise in recommending dentists there. A friend of mine did this for a bridge, he was very satisfied.

Hope this helps.

I'd suggest Hungary, Bulgaria, Russia or India, but if you want to stay in France I'd say you need a second quote from another dentist, dental school or the Red Cross.