We had our first French dentist appointments last week. It was incredibly efficient. I think all three of us were in and out in less than an hour. They took us one at a time, too.
The first step were some basic x-rays using a machine where I bit down on a piece of plastic while it whizzed around my head. The dentist used that to see if there were any areas of concern that she needed to look at further. Mine looked fine, so she went right into a cleaning. She brought out those metal tools that we’re all used to… but she didn’t really use them. Instead, she used what I’d call a “water pik on steroids” to blast the plaque off of my teeth. It wasn’t what I would call pleasant, but it was super quick. During his cleaning, Kristian mentioned to her that everything gets scraped in the US and she apparently recoiled as if he’d told her that Americans use cave paintings to store their dental records.
After the cleaning, they took a further set of x-rays using the kind of x-ray machine I’m used to (the one that gets aimed right at your face).
I still don’t qualify for French social insurance, so I had to pay out of pocket. It was a whopping 120 euros. I think I’ve paid more in the US for a cleaning and X-rays with insurance. I’m starting to understand the appeal of medical tourism.
Lilian’s x-rays revealed the presence of a tooth that’s lurking up in her gums, hiding behind a baby tooth that didn’t want to leave. Our dentist back in the US wanted to keep a watch on it, but the dentist here made an appointment for Lilian to see an orthodontist this week.
Lilian was super anxious about what was going to happen with her lurker tooth, but she was quickly put at ease by the orthodontist. He was so kind and reassuring! He also speaks English really well, which helped a lot. He explained everything matter-of-factly.
She’ll need to have the baby tooth pulled, and then they’ll use braces to pull the other tooth into position. It will likely take 1-2 years. Lilian is going back to the US for a few weeks this summer, so we scheduled everything for September. She’ll have one appointment to have mouth molds and x-rays done, then a second appointment immediately afterwards for his colleague to pull the recalcitrant baby tooth. She was scared about having the tooth pulled, but he reassured her that baby teeth are really easy to remove.
(I also reminded her that she once pulled out one of her baby teeth and then handed it to me all bloody. On Halloween.)
About a week after the initial appointments, Lilian gets her braces. We got an estimate for the more invisible braces, but she can do traditional metal ones if she prefers. Either way, because she’s starting her orthodontics before she turns 16, French social insurance will pay for part of the cost. She happens to need braces to prevent further dental issues down the line, but they’d pay the same amount if it was purely cosmetic.
We have supplemental insurance through a “mutuelle” which will pay for the bulk of the remainder. We did the math and we’ll pay about 800 euros out of pocket for the entire 2 year treatment. Every six months, we’ll have to pay up-front for the non-social insurance costs and then we’ll get reimbursed. The orthodontist offers payment plans, in case that would be a hardship.
This was basically my reverse “Dental Plan? Lisa needs braces!” moment.
Note to self: don’t move back to the US before Lilian is done with braces.
Obviously, it’s not a perfect system. The reimbursement from social security is a set amount, but most orthodontists aren’t obliged to cap their rates to that level. So, you can only take advantage of the social insurance if you have the means to pay the difference. We also need to be able to front the money before our mutuelle reimburses us. And if you want braces after the age of 16, social insurance won’t pay for anything. (Although you might have some coverage through a mutuelle).
But, hey, Lilian’s orthodontist told us his cousin just paid $14k for his kid to have braces. So, I think I’ll take it.
Dental is still all over the place in Europe, depending on where you are. I think the vast majority, if not all, have free under-16 or 18 (and often older if in full time education), but beyond that it varies quite a lot. In the UK, adult NHS dentistry is theoretically 50% of cost (vs. 40% in France). I say theoretically, because most practices that accept social healthcare patients have a waiting list for slots. So I end up paying full whack because I’m a “nervous” patient and quite fussy about who I go to. Which has been fine for 20 years until now, when I’ve needed a few root canals and crowns in the space of a year. Although I think it’s still worked out less than if I’d paid 3rd party dental coverage for 20 years. Similar to France, the basic processes aren’t too expensive, but specialist work gets expensive real fast and quite a lot of people go to Eastern Europe or Turkey once they need implants or veneers. We used to call a full set of shiny whites an American Smile, but it’s a Turkish one now. 😀 (cue jokes about British teeth that aren’t entirely undeserved)