Dental Insurance Should Not Dictate Your Oral Health Decisions

Posted on Dec 09, 2014 by William J. Claiborne, DDS MS

A few decades ago, dental insurance was rarely part of health care coverages. This may have been because many adults did not deem dental care support as a necessary part of their overall health and well being. With the vast amount of research and studies on how dental wellness contributes to overall health, our population is more educated on its benefits.

Today, many businesses include dental care coverage in their insurance packages. The positive effect of this is it has expanded access to more individuals for regular exams, cleanings and occasional repairs (fillings, crowns, etc.).

What has ‘gone wrong’ with how some perceive dental insurance is their unquestioned acceptance of its limitations. For example, if an individual needs treatment for gum disease to help them save teeth and rid inflammatory bacteria, unless the insurance company deems it ‘necessary,’ it isn’t covered and the patient postpones treatment, which simply enables the disease to progress.

Another example is a cracked tooth. When your dentist recommends crowning a fractured tooth before it can break below the gum line (which will require its removal), if coverage limitations have not been met for the year, some will postpone the procedure. I can’t tell you how many dental implants I’ve placed because a patient said their dental insurance wouldn’t cover the crown until the next year and the tooth broke before those benefits kicked in.

Insurance companies are for-profit firms. It does not behoove them to spend more on your dental health to help you avoid problems in the future. As a matter of fact, most coverages are designed to merely ‘help’ with basic dental needs. Just because your coverages are exhausted for the year or coverage for a procedure your dentist recommends is denied doesn’t mean you should not proceed with proactive measures to protect your dental well-being.

Before you decline a recommended procedure, discuss your coverage with your dentist or his/her financial coordinator. Ask about risks of delaying the procedure or if it can be done in stages to be more in line with your particular coverage. Also, ask about payment options. Many dental offices offer financial plans that are interest-free with no down payment required.

Let your dental health – your terrific smile – be guided by decisions that are in your best interests rather than the bottom line of an insurance company.


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