Dental insurance benefits these days often max out before even one tooth can be restored or replaced.
Dental Insurance has changed dramatically in the last 5 decades. Consumers, both employers and the beneficiaries of these plans, need to be aware that dental insurance is not necessary for dental health. Any catastrophic dental needs are usually covered by some other insurance such as auto insurance (in the case of an accident) or medical insurance (for accident or severe health issue affecting the teeth and jaws) or they simply are not covered, by any plan, including a dental insurance plan.
In our country our mindset needs to shift in order to be better health care consumers and most importantly to be healthier!
Dental disease is largely preventable and starts with effective self-care, habits you do or don’t engage in, and the foods and beverages you choose. Examples of habits are smoking, nail biting, tooth clenching and grinding, chewing tobacco, frequent snacking….. Nearly all insurance carriers say they cover preventive services, but they do not. They do not cover nutritional counseling, tobacco counseling or ongoing assistance with learning how to clean your teeth and mouth on a daily basis. They do not cover mouth guards or bite splints to keep your teeth from chipping, wearing down, gum recession and headaches and jaw issues. Your dental health professionals are your true partners in caring for your health.
Like any profession, dental health care providers that have practiced in the insurance arena have a practice model and structure that may also need to be re-examined. Waiting until teeth decay (so they can be filled), or break (so they can be root canaled and/or crowned) to intervene is not preventive in nature and will lead to preventable (unnecessary) loss of tooth structure or tooth loss.
Most employers and employees would benefit from a direct reimbursement program where your employer sets aside a certain sum of money to be used for health related costs such as dental care. You are the consumer. You should decide with the help and guidance of competent professionals what is best for your health and your family’s health.
As a dentist, I don’t want to see my patients deteriorate unnecessarily and then step in and fix a problem that could have been prevented, minimized, or slowed considerably. I’d rather prevent cavities, oral cancer, periodontal disease, headaches, jaw clicking and popping, tooth wear and fracture. It is what I am trained to do and it is what makes sense. I love restoring teeth that are decayed and broken, rehabilitating jaws that ache and pop; I am trained to do this as well. I love giving patients a whiter, straighter, more appealing smile. The self-esteem, confidence and pride that come with a healthy smile is priceless.
If you do have dental insurance, look at the services you would most like and benefit from. Are they covered??? Nope, or not very much. What is covered is some diagnositic services like exams and xrays, but when it comes to intervening and helping people, the covered services are the shortest term solution (fillings).
In my opinion the best, preventive services that should be basic to patients of all ages are:
Comprehensive Evaluation and Xrays
Dental Models and bite analysis
All services for gum health (it is what is connected to the rest of your body and the foundation for your general health) including prophylaxis, periodontal maintenance, debridement, nonsurgical and surgical gum care.
Mouth guards and bite splints
Consultation and evaluation appointments for self-care, nutrition, anxiety management, and counseling to eliminate harmful habits.
I also believe patients get the best results when they are investing their time and money in the process. They take better care of themselves and they make better choices because their money is on the line too.
Some ideas I think would work are:
All services covered at a fixed percent. Both consumers and third party payers contribute.
A rewards system where you earn points for health by seeing your dental health care providers for examinations, xrays, preventive services and consultation you are entitled to a discount on additional services you require or choose.