Dental Insurance

Dental insurance can be confusing. And to make matters worse, every insurance plan handles things differently.

Dental insurance plans are a contract between you and your insurance provider. It is important that you read your insurance policy or talk to your insurance representative so you can understand how your plan helps pay for dental treatment.

Even though most plans pay only for basic services, we believe that you should be able to choose the most appropriate dental treatment for you and your family.

How insurance plans determine payment 
Some plans pay only for dentists who belong to the plan’s network, while others let you see the dentist of your choice.

To determine how much they pay for dental treatment, insurance plans use several methods. One is called the Table of Allowances in which the plan lists the treatments it pays for and the amount it pays for each.

Another very common method is called UCR. This stands for “usual, customary, and reasonable.” In these cases, the plan calculates a maximum amount allowed for a particular treatment, and then pays 50 to 80 percent of that amount. You pay 20 to 50 percent of the remaining UCR fees, plus the difference between the actual cost of the treatment and the insurance plan’s UCR fees.

Payment methods not based on statistics

Many people assume that insurance companies base their fees on statistics. However, while statistics are gathered, insurance companies are not required to use them, and sometimes the statistics are out of date. This means that an insurance plan’s UCR fees are usually not representative of what local dentists actually charge.

In fact, different insurance companies’ dental plans often have a different set of UCR fees for the same geographical area and for the same group of dentists. And it is not unusual for the same insurance company to pay different UCR fees to the same dental office, depending on which of the company’s plans the patient is enrolled in.

The choice is yours
You should know that most insurance plans have not kept up with advances in dentistry. They may cover only minimum quality materials and services and exclude treatments they can label as “discretionary.” These often include common treatments such as implants, white fillings, bonding, fluoride treatments, and some periodontal care.

In addition, dental coverage maximums have not kept up with the times. In 1960, a typical annual maximum benefit was $1,000. These days, many plans still offer that same maximum, but to stay up with inflation, that $1,000 in 1960 would have had to increase to more than $6,500 dollars today.

For all these reasons, it is common for our patients to choose a dental treatment that their dental insurance plan does not fully pay for. We urge you to choose the best treatment for you.

Dental Emergencies

Our rule-of-thumb for dental emergencies:  if you think it’s an emergency, we do, too.  Please call our office right away.  If it is after hours, leave a message on our voicemail and we’ll respond as quickly as we can.  In the meantime, here’s what to do until you get to our office.

BROKEN FILLINGS.  Save the filling so we can have a look at it.  Rinse your mouth gently with lukewarm water to remove debris – dissolved table salt or baking soda is soothing.  If the tooth is sensitive, protect it with dental wax or, in a pinch, sugarless gum.

LOST CROWN.  Displaced crowns can sometimes be reused; hang onto it.  Try to affix the crown with denture adhesive or, if it won’t stick, use dental wax to keep the tooth away from air.

KNOCKED-OUT TOOTH. Don’t panic. If we can treat you within about an hour, chances are we can reseat the tooth for good. Don’t touch the tooth root–this could damage delicate nerves. Gently replace the tooth where it belongs if you can, or keep it moist in milk.

DAMAGED BRIDGES, DENTURES, PARTIALS. Do not risk home repairs. Glue can destroy composition materials and cause tissue erosion. Keep all the pieces, even the smallest, and call us. We can usually return an emergency repair to you in a few days.

TOOTHACHE is common and nasty. Toothache tells you something is wrong that needs attention. Rinse your mouth with warm water and try to floss away any food particles. Don’t lodge aspirin near the tooth–it will irritate, even ulcerate, gum tissue. Ice packs or a numbing agent may make you more comfortable while you’re scheduling an appointment. Toothaches may “go away,” but the source of the pain won’t.

LACERATIONS OR JAW DAMAGE require immediate treatment at a hospital facility or an oral surgeon’s office. Take such injuries seriously. Delay may result in further damage.

Dental Phobia: How to Cope

The bad thing about dental phobia is that it prevents people from seeking the care
they need – when they need it. The good thing about it is that, today, we can treat
fear as successfully as we treat tooth decay or crooked teeth.

Over six million people experience some degree of anxiety when they visit the dentist. Two million dental patients are plain scared – so scared that they suffer shaking, confusion, heart palpitations and changes in speech and blood pressure just thinking about dental treatment.

We’ve learned a lot about what causes fear over the years. And we’ve got some

* Come into the office with someone you trust – your mother, a close friend. You’ll
feel more secure.
* Make an early appointment – that way you won’t spend the whole day worrying
about your visit.
* Think about an experience you thought might have been unpleasant, but turned out okay – and hold that thought.
* Don’t tell everyone you’re going to the dentist. Fear is contagious and some people love to pass it on.
* Share your fears with your dental team. We have some very effective treatment techniques.
* Don’t be a hero. This is not a good time to be embarrassed about pain.
* Relax. Your emotions affect your pain threshold.

Finally, dentistry is just not the same as it used to be. And we can prove it to you. Just give us a call to make an appointment.