Is Arestin necessary?? not covered by in

Avatar for evyrosa
iVillage Member
Registered: 03-25-2003
Is Arestin necessary?? not covered by in
3
Thu, 02-03-2005 - 1:08pm
I was just at the dentist and shocked when I saw the "Treatment Plan" they had for me. They told me I needed scaling and root planning or simply put a "deep cleaning". I figured as much since it had been over 2 years since I had been to a dentist. The cost per quadrant (Upper right, lower left, etc.) is $165 after insurance I only have to pay $25/each. But they said they would administer Arestin into the infected pockets. It is an antibiotic for the gums, and it is NOT covered by my insurance...the total $2600!!! plus the $100 for the 4 quadrant cleaning! I am outraged. I asked her why is it not covered by my insurance and she told me some insurances don't cover it. Well, if this Arestin is so necessary why do some insurances not cover it??? Is it really necessary?
Any other dentists suggest this?
Thanks!

Evy

(Mom to Alex and Marlena)

iVillage Member
Registered: 11-08-2004
Thu, 02-03-2005 - 3:12pm

First of all, I can assure you that I speak from experience in this area, having dealth with periodontal treatments and consequences for the past 3 years.


I completely understand your frustration with the price tag on the Arestin and will explain what I know. Perio disease is, essentially, a disease of bacteria beneath your gum line that effects soft tissue and bone tissue. When root planing and scaling is done, the bacteria is removed, however, some can be left behind and therefore an antibiotic is recruited to finish the job that the tools missed. This antibiotic can come in numerous forms - the old fashioned pill form, the newer chip form or gel form or the newest bioadhesive form (such as used in Arestin). They all have their advantages and disadvantages.


That being said, I could not afford the high price of the form that my periodontist recommended and asked for the next best alternative which happened to be the gel form (pushed down with a tool and then rinsed away after many, many minutes. Looking back, I think I would have preferred a pill form of antibiotic but that would have effected ALL of my body and not just my gums, which is the best option.


The reason that your insurance will not cover the Arestin, and the reason that it is so expensive is two-fold. One, it is brand new - only out for consumer use for about two years. Two, it is proprietary. Only one company makes it. Insurance company like tried and tested products and they like even more products that are made by many companies. You could say that insurance companies despise a monopoly.


Your options? Any good dentist will be willing to discuss alternative methods and there are several in this area...don't let them fool you. They may not be AS fast, easy, whatever, but there are other methods that have proven to work equally well.


If, in the end, you are bullied into choosing the $2600 option, please consider a second (and/or third) opinion. I left a periodontist because of pressured salesman tactics and I was happy I did. I now have an excellent dentist that listens to me and is mindful of my abilities to pay, not his abilities to sell.


Good luck and let us know how this works out for you!


April

Did I mention how imporant it is to floss? Well let me mention it again...

Did I mention how imporant it is to floss? Well let me mention it again...

Avatar for evyrosa
iVillage Member
Registered: 03-25-2003
Fri, 02-04-2005 - 3:17pm
Thank you for your very informative reply. I plan to first call my insurance company so they can tell me the reason why they don't cover it. Then I plan to call the dentist office back to talk about other options, gel, pill whatever is less costly. With a brand new baby I can't afford to spend $2600 on some new medicine...I rather wait for my teeth to fall off then I know the insurance will pay to repair that!
Thanks again!

Evy

(Mom to Alex and Marlena)

iVillage Member
Registered: 11-08-2004
Fri, 02-04-2005 - 5:40pm

Wow! A brand new baby is definitely worthy of congratulations! However, this could be the reason your perio/dentist did not automatically go with oral anti-biotics, especially if you are breastfeeding.


That detail aside, there are still some suitable localized antibiotics that could be used...mine was just Tetracycline applied to the root scaled areas and left to absorb for several minutes, the rinsed away and suctioned out. There are others, I'm sure.


As for letting your teeth fall out instead...probably not as easy or affordable as one would like to think! Take it from me, I'm still facing quite a few extractions because of serious bone loss and it has taken me months to get accustomed to my upper front partial!


April

Did I mention how imporant it is to floss? Well let me mention it again...

Did I mention how imporant it is to floss? Well let me mention it again...