Cost of Visiting
Thursday September 7, 2006 

Dear Dr. Mady: The cost of visiting a dentist for treatment has seemed to have increased quite a bit over the past fifteen years. Why has this happened and does each dentist just make up their own fees?—Doris in Windsor


Dear Doris: I have been asked these questions repeatedly over the past thirteen years in my own practice. Although different dentists may have different opinions and answers, I will attempt to shed some light on these topics through my own eyes and the views of other dental professionals that are close to me.

            With respect to why the cost of dentistry has increased over the past several years, the answer is simple. It has climbed due to dental office overhead increases. This is the cost for a dentist to run their practice from which they provide these needed services. As far as fees go, any dentist can charge whatever they want for the services they provide, but it is important to understand that there is only so much that a client and/or their dental insurance company is going to pay/reimburse for each service.

            As a member of the Ontario Dental Association, I am provided with a “Suggested Fee Guide” each year and I, like most dentists, tend to follow almost exactly with the fees that my association suggests. Even most non-ODA members follow these suggested fees. The dental insurance companies seem to use this as a guide also when they consider amounts for reimbursement to patients for services. The fees in this guide are based on the provision of dental services under normal conditions. This guide is designed as a reference for the dentists to enable development of a structure of fees which is fair to the patient and their dentist. The guide is not obligatory and even though each dentist is expected to determine independently the fees that will be charged, most follow it closely. I personally refer to the ODA fee guide to determine the maximum that I will charge for a service.

            Adjustments to the prices in this fee guide are based on interpretations of demand for services and the value patients place on these services. As a result not all fees increase each year. Some serviced increase in price and some decrease. Many believe that dentists merely charge a certain percentage more each year.

            There are many factors that contribute to the determination of dental fees and that effect office overhead costs. I believe that most individuals fail to recognize all the facts. Fees for dental treatment are directly correlated with the cost for providing the care. To make it more understandable I will try and explain the situation through my own experience in running my own practice, Madison Dental.

            Most dental practices have a staff that may include an office manager, one or more dental receptionists/administrative assistants, one or more dental assistants (level 1 or 2), one or more dental hygienists, and possibly a treatment coordinator. This is the largest expense in any practice.

            The next main expense is dental supplies and equipment, which sell at higher-end average prices because there are a limited number of consumers (dentists) that will purchase them. For example, if oil companies had only 1% of the population buying gas, they would have to increase the price of gas even higher just to stay in business and to provide that commodity. Under this umbrella I am speaking of dental lab fees, all dental materials used in the clinic, equipment like instruments to clean teeth and dental handpieces (drills that require constant repair and maintenance), and infection control products and barriers.

            Other expenses that are incurred by any business are the cost of water that must run constantly in dental suction units, electricity for high powered equipment and compressors, gas and equipment maintenance, and all types of taxes. Additional costs are incurred through insurances for building, malpractice, disability and there are numerous other ones. In fact the cost of running an average dental office is commonly seen at anywhere from $150 to $300 per hour. This hourly overhead cost does not even include the dentist’s cost for insurances. The hourly rate may even be higher in larger practices or in larger cities like Toronto, Onatrio.

            The other side of the cost for dental services is the expense required for the service itself. Most dentists have at least 7 years of education after high school before obtaining this type of health care license. The education is very mentally strenuous and extremely costly. Many dentists graduate with their degree and a debt of approximately $100,000 to $200,000 and then when they go to open their own dental clinic, the cost can be tremendous lying anywhere between $250,000 and $500,000 and even higher if the office is real high-tech. This cost is for leasehold improvements and equipment and is assuming no purchase of a building initially.

            Geographic location also plays a role in determining overhead costs. An office on the ground level with parking on Tecumseh Road in Windsor will certainly pay more for property tax and rent or purchase than a practice on a side street or one on an upper level of a multi-floor building in Lakeshore or Dresden Ontario.

Even though many do understand what determines the cost for dental services, it can still be an obstacle for certain individuals. To keep your own dental care expenses at a lower level, visit your dentist at least twice every year to prevent unnoticed and future costly damage to your teeth and their supporting structures.

This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5



1275 Walker Rd. • P.O. Box 24008 • Windsor • Ontario • N8Y4X9