LOOKING INTO THE TOOTH... I MEAN TRUTH!

Dental insurance is great. It’s even better when your company is paying for it. And like all great things, there are limitations. These limitations come in the form of money. Most dental insurance policies have a deductable, waiting period, a co-pay, an annual maximum, and limitations on x-rays, dental exams and cleanings.

These policies are commonly mistaken for dental health guidelines and it saddens me when patients refuse treatment because their insurance won’t pay. I get even sadder when I think about how the insurance industry fails to recognize that everyone is different and there is a need to expand its policies.

More that 50% of patients need more than two cleanings a year. In today’s market the price of one crown will max out a patient’s annual coverage. With the reality as it is, dental insurance should be thought of as an adjunct benefit. People should assume an annual financial responsibility for their general well-being. Ultimately, the patient must decide how to proceed with their finances, their treatment, their teeth.

The following is a shortened realistic scenario of what can and does happen if an insurance policy is used to dictate a patients needs:

Patient only wants two cleanings a year because that is what insurance covers. Patient builds up a lot of tartar. Six months of tartar and plaque accumulation is too much to clean in one appointment.

The hygienist does the best they can. Most of the plaque and tartar is gone, but some still remains and starts to cause inflammation and bleeding. The gums swell up and get sore. While swollen, bacteria from the tartar have access into the blood stream and make its way down the sides of the teeth. Your body reacts to the bacteria by shying away. Gums pull away from the teeth, attachment is lost and the bone diminishes.

Meanwhile, this is happening all while new tartar and plaque is being formed. The cycle keeps going and going until the patient ends up having surgery or is loosing teeth. This is not an exaggeration and no one is smiling at this point, literally or figuratively.

All of this can be avoided by listening to the recommendation of dental professionals rather than insurance companies. I know I would rather pay $100-$200 more a year to have a healthy clean mouth than wind up missing teeth or at the surgeon’s office. And trust me, they ain’t cheap!