Going to the dentist is stressful for
many people. The chair and the sound of the drill can cause some
people to experience anxiety. Luckily, learning more about dental
procedures and processes can help familiarize you with what to expect
at the dentist.
If you believe you need to visit the
dentist soon, check out these four different categories of dental
procedures and whether or not your insurance covers them.
1. Preventative
Preventative dental care is perhaps the
most important step in your dental process because it prevents dental
problems like cavities. Naturally, preventative care includes
everything you do at home - brushing, flossing, avoiding sugar, etc.
- but it also includes many other dental procedures, including
routine exams, cleanings, X-rays, and others.
In most cases, if you have dental
insurance, preventative care is covered at 100
percent, and the deductible may be waived. Preventative care may
not be covered if you recently had the procedure. For example, your
insurance may cover two cleanings a year, but if your teeth are
particularly bad or you are pregnant, you may need to go more often,
which means paying out of pocket. Luckily, preventative care is
cheap.
2. Minor Restoration
Sometimes, going to the dentist and
keeping your mouth clean doesn't do the trick. A little bit of plaque
here and there can build up and lead to decay. This type of minor
decay can be fixed with minor restorations such as fillings, routine
tooth extractions (non-surgical), re-cementing existing dental
crowns, and periodontal scaling and root planing.
Root canal therapy may also be included
in minor restoration, but some insurance companies list it as a major
procedure. With a minor procedure, most insurance carriers will pay
80 percent, and you'll only have to pay the remaining 20 percent of
the total cost. However, some insurance carriers may only pay 60
percent.
3. Major Restoration
Major restoration is needed when your
teeth are severely decayed or weak or your gums are diseased. Common
major restoration includes a dental crown (that is necessary to
strengthen the tooth), surgical tooth extractions, dental bridges,
and dentures. In rare cases, insurance may even include dental
implants as a major restoration procedure.
Major restoration procedures can be
expensive, and most dental insurance only covers about 50 percent of
the total cost. Therefore, even with insurance, you may pay thousands
of dollars out of pocket if you neglect preventative care.
4. Cosmetic
Cosmetic dental procedures are usually
never covered by your insurance carrier because they aren't necessary
to strengthen your existing teeth. For this reason, porcelain veneers
are usually considered cosmetic. They only add cosmetic benefits
(making teeth look white and straight), but they may actually weaken
teeth, so they aren't not medically necessary.
On the other hand, you may be able to
have the insurance carrier pay for some of a porcelain crown. This
provides all the cosmetic benefits of a veneer, but dental crowns
strengthen teeth, so even if you get them for cosmetic reasons, if
the teeth are weak, insurance may front some of the cost. Similarly,
if you lose a pre-existing crown, the tooth needs a new one to
prevent sensitivity and immediate decay, so insurance will likely
cover some of the cost as a major restoration.
If your teeth are perfectly healthy,
don't expect coverage for any cosmetic procedures.
Every dentist charges differently, and
different insurance carriers have different policies. However, for
the most part, insurance will cover all preventative care and some
restoration costs. If you are only worried about improving the look
of your smile, your dentist can help, but your insurance carrier
won't.
For more information about dental
procedures, contact
us
at the dental offices of Teresita V. Hernandez, DDS today.
