Finding a Shortcut to Treatment: A Caregiver’s Perspective

A caregiver’s mother needed dentures, but after more than a year and countless doctors, North Carolina Hospital Dentistry stepped in and pushed them right across the finish line.   

When I became a caregiver for my mother, it was unexpected, it happened fast, and I had no idea what I was doing or what to expect. Honestly, after 18 months, I still don’t, but I’m learning. During the last year and a half, the single most valuable lesson I learned came from our experience with Dr. Ravindran and his team at North Carolina Hospital Dentistry: Sometimes, the best option is the one you don’t know about.

Mom already needed dentures when I started taking care of her. I didn’t think much of it, given how prevalent dentures are today, and the fact that humans have been using them for almost three millenia. It took a few weeks to get the dentures made, and then we only had one thing left to do: Get her teeth extracted. Neither of us could have imagined the ordeal ahead of us. 

The dentist referred us to an oral surgery clinic, and a few weeks later, mom was evaluated and specific extraction procedures determined. Mom has always had severe anxiety about dental work, to the point she needed some level of sedation for even routine cleanings. For multiple extractions, she was going to need full sedation, which required medical clearance. It took a couple weeks, but we got her in to see her PCP. Unfortunately, we had not expected that, due to the complexity of her health history, the physician referred her to cardiology and pulmonary specialists instead. 

So, I called to schedule the evaluations as soon as possible. “As soon as possible” turned out to be over four months waiting for available appointments. After more than eight months since the initial dentist appointment, she finally had medical clearance for sedation, and there was light at the end of the tunnel. We were almost at the finish line. Until we weren’t.

Many, perhaps even most, oral surgery clinics are not hospital affiliated. They can’t coordinate directly with your healthcare providers, so the patient (or caregiver) may need to act as a sort of liaison to coordinate and communicate. Unfortunately, most of us do not work in healthcare, so when doctors use medical terminology, they may as well be speaking Ancient Greek. As it were, that’s often literally true, since much of modern medical terminology comes from Ancient Greek - cardiology comes from Greek “cardia” - and Latin - the “dent” in dentures.

Imagine the child’s game “telephone,” where the message you’re supposed to pass on is in Ancient Greek. Also, if you mess up, it can have a very real impact on the wellbeing of a loved one. It took several more weeks, countless phone calls, emails, and even faxes, but we eventually managed to get the correct information and documentation to the correct people. Since an anesthesiologist had to be there for the surgery, it was another few weeks to get mom scheduled, but at long last we had her date for surgery, almost 12 months after the first dentist appointment. Including the anesthesiologist, the clinic’s estimate was around $12k. We weren’t thrilled, but we agreed to pay out of pocket, because even well-staffed clinics don’t. 

Nothing is ever easy. Oral surgery clinics don’t have Emergency Departments, so the threshold for safe levels of anesthesia is lower than in a hospital. Mom’s a fighter. Even unconscious, she fought, and despite their best efforts,the anesthesiologist simply could not safely sedate her enough for the surgeon to perform the procedure in the clinic. It was less than an hour before the surgeon informed me that they couldn’t proceed; mom needed the surgery done at a hospital, under general anesthesia. 

Don’t get me wrong, the clinic provided top-notch service, a comfortable setting, and an accommodating, professional staff. It was frustrating that they couldn’t get the job done, but in hindsight, I’ve realized just how much they did help. The single most helpful thing any doctor, dentist, or clinic did for us over 12 months was referring us to North Carolina Hospital Dentistry.

My first contact with NCHD was in December and the holidays were rapidly approaching. NCHD communicates primarily by email, and I was expecting the standard 24-48 hour response time, or longer due to the holidays. NCHD responded within hours. Due to the holidays, we couldn’t get x-rays from the dentist until after New Year. Mom once again needed medical clearance for anesthesia, as it had been so long since she was cleared for the clinic. 

I assumed we had another months-long ordeal ahead of us. It turned out, that’s not how NCHD works. On January 9, I received an email from NCHD with scheduling options for two appointments: one for medical clearance, and the other for the surgery itself. We'd been through this before, and assumed we'd be looking at another $12k or more out of pocket. Almost half of that was just for hospital costs and anesthesia. 

In an unexpected twist, thanks to NCHD working directly with the hospital, the pre-op exam and anesthesia were both categorized under Medicare’s medical insurance, rather than dental. The medical insurance claims were approved, zero hassle, and covered some 80% of the anesthesia and other hospital costs. In hindsight, while inconvenient, were very fortunate that the oral surgery clinic couldn't do the procedure, because we saved more than $3k thanks to their referral to NCHD. 

Mom was in the recovery room with her new dentures before the end of the month. Even though Dr. Ravindran had done his part, and mom's dentist took over her care, he checked in on her recovery regularly for the next week. Even beyond that, we had a lot of questions, and the dentist sometimes took days to answer. When I sent the questions via email to NCHD, I got answers right away, and even a call from Dr. Ravindran, just to make sure I understood everything. He made it clear that we could reach out anytime. I took him up on that, and almost a month after the surgery - long after he had any obligation to do so - he was still actively involved, until we finally ran out of questions. 

Even if we hadn't saved thousands of dollars, the total costs were similar to the clinic anyway, the hospital setting was safer for mom, and of course, they concluded our 14 month odyssey in a matter of weeks. 

It’s impossible to express how grateful I am to have found our way into the exceptional care of Dr. Ravindran and the extraordinary staff at NCHD. I'm confident that anytime NCHD is an option, it will be your best option.