At work the other day, we had a call from a dental surgery. A clasp had broken off from a casting that we made for one of their associates a few months ago, which shouldn’t happen. We said that we’d repair it free of charge, because it shouldn’t have failed so early in its life. Yesterday they called us again to ask how much we’d originally charged them for the work, which seemed a little suspicious since we’d already agreed that the problem could be put right without money changing hands. It isn’t as though we’ll have to remake the whole thing for them, because the design is sound and as far as we know it fits perfectly. It will take about half an hour to put on a replacement clasp, and the combined time used by the surgery staff has been about an hour.

This morning we had a call from the prescribing surgeon, who had been informed by his former associates that they were billing him for a complete remake of the denture. Apparently his profit-sharing position in the surgery obliged him to repay to them any costs incurred after the fact on any work he conducted for them. Furthermore they were adding £150 for their time. Their one hour of working time: half an hour to see the patient and discuss the options, half an hour to have two ten-minute conversations with us and put the broken denture in the post.

If I were feeling charitable, I’d assume that the surgery intended to guarantee absolutely that the device would not fail again by asking us to make it again from scratch rather than make a simple repair to it, but I’ve seen enough of dental surgeries to take a more cynical view. I suspect that what they will actually do is get us to repair the damage for nothing, then claim the best part of £500 from the original surgeon, possibly bill the patient for their time too, and laugh all the way to the bank. The only fly in their ointment is that we go back a long way with the original dentist, and he called us as soon as he heard from them. What happens next is fortunately not our problem. We’ll make the repair, send it back and let them all fight it out amongst themselves. However, the situation does offer a nice example of how much penny pinching, marking up and general unprofessional money grubbing goes on in the dental trade. If you thought that the laboratory bill for dentures was about what the surgery charges, think again. I’ve heard of twice the bill for making the dentures being added on to the patient’s account by the surgery for their time, which is typically about three half-hour appointments and a couple of phone calls to their laboratory. More than that, there are still some surgeons who try to make an even bigger profit than that by buying the cheapest technical work they can possibly find and then charging it out as the most expensive.

What does all this mean? Well, for those who have good teeth, not much. Look after them, floss, use mouthwash, avoid contact sports and don’t pick any fights, and the preceding story will always be irrelevant to you. If you do need dentures, I’m saying that you should be aware how much your dentist pays for the work he fits in your mouth. Despite that degree and the fancy surgery, he’s just as likely to rip you off as a car mechanic or a builder. The surgery is legally obliged to supply you with a certificate of manufacture that will tell you where the work was done, and most technicians are finally catching up with technology and have websites with price lists on them (a surgeon once asked us to take ours off line in case his patients saw it, but it’s still there). If your work was done overseas for resale, you’re entitled to know that too; make sure you ask, since the Dental Laboratories Association is currently running a campaign promoting British dental technology.

In short, then, it’s not just what’s being done in your mouth that you should worry about, but what’s being done in your wallet. Apply the same standards to your dental work that you would to any other product purchase. In the end it’s your health, and caveat emptor never applies more than it does in that area.