Dear friends, glad to see you again. Personally, I really missed our communication. My long absence from this resource is caused by an extremely large influx of patients. Among which, I am pleased to note, there were a lot of readers of my previous articles. And even, I'm not afraid of this word, commentators!
Once again, I was prompted to take up the pen by the fact that lately I had to deal with an incredibly large amount of hack work, which, mind you - not for free, but for a considerable price, was jested and played around somewhere.
That is why today I will open my soul for you. And I will write the truth. Only the truth. FUCKING THE TRUTH! Expressed in a simple, understandable layman's language.
In society, unfortunately, there is not the most partial opinion about dentists. We are both hand-crazed and grabbers, pouring 120th gasoline into our Porsches at 666 rubles per liter. Yes, that's how it is. I am also indignant and scold the sturgeon for the high cost of its caviar. I'm kidding, of course. I just ask you to take my advice and analogies in the article seriously. And somewhere with a smile.
Try not to read between the lines. Insulting colleagues? Yes, it's possible. The authors of some of the "works" below deserve an enema with gramophone needles. What I honestly say. Fuck this vicious corporate ethics.
Would you like to get such a "job"?
Or like this one?
But I will tell you more about this “work”:
This is an example of what not to do.
The implant stands at a serious inclination, its axis does not correspond to the axes of the “native” teeth. The load on the lever principle is distributed incorrectly, and the crown has an irregular anatomical shape - with overhanging edges, under which food and plaque are clogged.
Inflammation develops and, as a result, loss of bone tissue and gums around the implant. Few of you would be willing to pay money for work that will eventually go down your beard. Even individual abutments will not help here.
What do you think - what unites these three dubious qualities of work?
You will get the answer to this question by reading my article ...
How insanely insulting it sometimes becomes to me from the understanding that people, trying to save money, actually pay double the price, while they are forced to lose their nerves, their precious time, their health again and again. After all, any surgical intervention, whatever it may be and in whatever SuperMegaHyperNanoBomb Clinic (with its geishas, black administrators, naked assistants or elephants) it was carried out, it still remains a surgical manipulation, and the clinic is a medical institution, where, Agree, any normal person would like to apply as rarely as possible. There are more interesting things in life to spend your time on. And money.
So why can the cost of the same manipulation be different in different dental clinics? Based on what factors the price (price tag) is built and why it is so important to look not at the numbers in the first place.
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Tools and materials
I give a real case from practice - my school friend turned to me, having learned that I had been working as an implant surgeon for a long time, with a request for help. His father, in a more or less decent private dentistry, has already had implants installed several times in a row. Survival rate - 50%. Two put - one drops out. They put four more - two falls out. But it's inexpensive. But not very fun either. Of course, the correction of these jambs was carried out under the warranty, but the patient was a little tired. It was decided to continue treatment with us. After comprehensively conducting all the necessary examinations, I concluded that with a high degree of probability, the failures were due to the fault of heavily worn implant cutters, which formed the implant bed, which led to overheating of the cortical bone - its necrosis. In this connection, the bone tissue lost its nutrition and there was no osseointegration, i.e., fusion of the bone tissue with the rough surface of the implant. Oh b@!@# - I promised ... More precisely, it was the fault of worn drills, which drilled holes, into which, in turn, titanium screws were screwed like into a wall. Only without the chopstick. And all this crap happened only because some bad person decided to save some money and "forgot" to buy brand new and sharp shiny cutters.
I don't think the situation with burs and all the spinning-spinning-cutting tools in that office is no better.
This leads to the fact that when trying to remove, for example, a wisdom tooth, which, as a rule, needs to be fragmented () still has the same problem. Burs are blunt, black from overheating, they wedge, they break during operation. Instead of 15 minutes for removal, we get all 40 plus an additional injection of anesthetic and a broken off part of the overheated bur behind the cheek, (at best) as a bonus.
The same story is in therapy - after all, we all remember the smell of burnt teeth in dentistry, when the dust is in a column and cannot be inhaled. I am generally silent about the accuracy of processing carious cavities - when a blunt bur is inserted into a broken-down backlash tip, instead of a neatly virgin hole, we get a hole. Like the former.
Total, her mother, economy. But the prices are lower, the people are more willing ...
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Equipment
An important detail in the formation of the final cost of services is the presence or absence of a full-fledged X-ray room, which includes a CBCT (cone beam computed tomography) device for high-quality diagnostics and correct treatment planning. No self-respecting dentist will start both implantation and root canal treatment without this image. In the event that this damn useful device is not in the clinic, then get ready to wander from clinic to clinic (or to special diagnostic centers) where this device is available. Which, as we all understand, is not camille. For a second - such a device costs from 5 million rubles and more. But you can not buy it and save.
Many of you will say: - “Pf, I figured it out, are you snickering or what? It’s not difficult for me to go to a special center to take a picture.” I agree, but going to a specialized center to take a picture as planned is one thing.
It's quite different when it's:
- Sharp pain, and at the entrance they tell you: “take a picture in another place, and then come back!” At a minimum, this very “other place” may not be in the neighboring building. Who would like this attitude? Going to the dentist is always stressful, especially when you endured pain all night and finally (!!!) got to the clinic, where you think they will help you, and here - “there is no device, but you stay there, everything good and good mood!”
- When it is necessary to control the root canal treatment, or control the operation and the position of the implant, for example.
Will you go with “needles” in your mouth and a rubber dam (a “handkerchief” that isolates the tooth from the entire oral cavity) to a nearby center? But after all it is possible not to do this control. Then boldly say to the tooth - "bye-bye!"
But the prices are lower, the people are more willing ...
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Sterilization
I will pay special attention to the CSO (Central Sterilization Department). It is, of course, everywhere. But what?
Ancient used ear autoclave, bought in a secondhand shop. Not beaten, not painted. One owner, and even that one - an old German grandmother, who on weekends sterilized cans for seaming Bavarian sausages in it. It no longer holds either the desired temperature or the desired pressure.
Therefore, there can be no talk of any sterility. In addition, in a normal CSO there should be a bunch of special equipment and solutions that are designed so that, even if all the inhabitants of the three stations and their ladies with low social responsibility were treated in front of you, you would not get infected after them.
But the prices are lower, the people are more willing ...
Lyrical digression
The other day I went to the cultural capital, to the Griboyedov Canal, to feed the drakes and their ducks with a bun. While admiring the beauty of the Church of the Savior on Spilled Blood, I did not notice that there was no more delicious bread.
Sorry, drakes and their ducks. Next time I'll definitely feed you. But it is not exactly. Having refreshed myself, I visited a former classmate who works as a surgeon in a notorious clinic. What can I say, comrades. Then there will be trash and waste.
I step over the curb, enter the front door ...
— Eee! Put on booties! I hear someone's voice. Either the reception desk is high, or the girl forgot to get up, but I was really scared of an angry shout. And, only embarrassed putting on shoe covers and retreating to the waiting room for receptions, I realized that the aroma that had been pestering me since the visit was not caused by an attack of my fear, but by drains from a leaky basement St. Petersburg sewer pipe. I want chu-coffee! The body longed for a cup of hot, strong, fragrant coffee. But here is a bummer.
3 in 1 coffee and Lipton sachets, which are offered to be filled with hot water from the cooler, discourage all desire.
But, unfortunately, I didn’t manage to see the guardian of sexual purity at that time. A bucket full of used shoe covers - succeeded.
But it might be otherwise. No shoe covers, because there are special people who receive a salary for cleaning. With good coffee, which any metropolitan coffee shop would envy. Multi-stage air purification and aromatization system. Trained administrators. And just a pleasant, relaxing atmosphere in which you forget that you are in a dental clinic. Whether it's worth the money or not is up to you.
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Rent and utilities
Contrary to popular belief that renting in the center of Moscow can significantly increase the final price, I responsibly declare that this is a provocation. Because the difference in the cost of renting 500 sq.m. in the center of Moscow and on its outskirts is an amount that can increase the cost of one appointment by a maximum of 100 rubles. “Over-rent” pays off in a few hours of clinic operation, trust me.
What kind of global increase in the cost of treatment can we talk about? Ask - how do I know this? In the title photo, my causal place is covered by the leg of the clinic's founder's wife. Just don't tell him about it.
Now forget everything I wrote about above. By and large, it does not matter which chair to sit in - in a comfortable, ergonomic, or old one, in which the lifting mechanism broke 10 years ago, and the couch remembered the outlines of the hussar loins and has marks from the spurs of their boots. And the percentage of successful dental procedures does not depend on the quality of free coffee.
But I couldn't write a one-paragraph article.
So why do different clinics and different doctors have different prices for the same procedure? In fact, everything is not simple, but very simple.
Imagine that all existing clinics work with the same materials. And they exist in the same conditions - it is not uncommon for very expensive and very cheap clinics to be located literally ten meters from each other, sometimes even in the same building. And it can be assumed that they bear the same rental and operating costs.
If we imagine that they work according to the same rules for pricing and calculating profitability, where does the difference come from? Here's where from:
For example, we have yesterday's student who is ready to work for food, and his assistant, who eats leftovers after the student, and the administrator on a severe low-calorie diet, or, more simply, on water. The labor cost of such personnel is minimal. Now there are a lot of offers from novice specialists (trainees) who can make a “masterpiece” for free or for a small fee. But it’s one thing if it’s hair or nails with cilia that will grow back, and teeth are another thing ...
In the other corner of the ring are specialists gathered and recruited from the best dental clinics. Demanded doctors, assistants and administrators, for whose services there is a demand. A staff whose quality of work is exemplary, whose heads and hands are trusted by thousands of patients. Unfortunately, such specialists are unlikely to work for food. They were also lured away from other clinics by better working conditions, incl. and salary. And now, this salary must be paid.
While typesetting the article, my Chief, it turns out, fought in his LiveJournal with one not a little venerable gentleman on the same topic. I can't share the screenshot. Enjoy.
Py Sy.
Everyone, including me, started out as a homeless person. This is neither good nor bad - it's a fact! I worked for more than one year at an installation where there was neither "water" (cooling), nor "light", nor "aspiration". Illuminated the operating field with a flashlight from the phone, cooled the heating elements with a syringe with physical. solution, asking the person to spit into a bowl (and it was just a canteen plate) every few seconds of work.
I'm not saying that it's impossible to meet a hand-ass in an "expensive" dentistry, but the likelihood that you will stumble upon an asshole in a basement on the outskirts of the city, and a clinic in the center, is far from the same. If you walk away from a consultation feeling that you don’t understand anything at all, moreover, there are even more questions than before, and there is a fleeting feeling that the doctor is an asshole, then most likely it is. Go to another clinic and listen to the opinion of other specialists. This will be the right decision even if you liked the doctor. There will be something to compare. To do this, in normal clinics, consultations are free, so that you, having weighed all the pros and cons, consciously make your choice.
I emphasize that, of course, it is important how good the coffee is pampered in the dental clinic, and whether Boston Dynamics robots pour elite booze for you, and Hmayak Hakobyan continuously shows his masyaska in the hall.
But still more important STAFF.
Sincerely, your insider in the world of dentistry,
Andrey Dashkov
What else to read?
About dental implants:
About wisdom teeth and their removal:
Source: habr.com