Long Family Dental of Cleburne Blog

Here at Long Family Dental, we have seen several patients this summer with rampant decay.  When asking the patients about some of their dietary habits, one common thread is apparent:  Sipping on sugary drinks throughout the day.

Now, for years most dentists have expressed concerns about too much sugar in a diet and how that can negatively impact the health of teeth.  The truth is dentists are not anti-sugar!   It’s how you consume sugar that has a large impact on your teeth.

Having a soda or Gatorade or energy drink is not the problem.  Sipping on it all day long is the problem. If you crave a sugary drink, have one with a meal, or all in one setting, and then stop.  It’s having the sugar and acid constantly in the mouth all day, little sips at a time that is wreaking havoc and causing massive decay, in some cases on every tooth!

If you must sip on something all day, make it water! Not only is that healthy for your teeth, but has many other health benefits as well!

As employers cut the dollars available for dental coverage, the insurance companies are coming up with creative ways to decrease benefits.  Some of the challenges we are starting to see are:

• Insurance considers x-rays at the basic level of coverage versus the preventive level, so the patient has to pay a deductible and a certain percentage on x-rays which historically were covered at 100%.
• Insurance “downgrades” things like porcelain crowns on back teeth or tooth colored fillings on molars, causing the patient to pay more out of pocket.(Most dentists don’t even do silver fillings anymore!)
• Even when a pre-determination is sent, insurance doesn’t reveal how they will actually pay once the procedure is completed and a claim sent, causing surprises for the patient after treatment.
• Insurance determining a minimum age for x-rays even though a dentist is legally responsible for what is in their patient’s mouths and the conditions that exist.
• Insurance only paying for an “alternate procedure” because it is the less expensive way to go, but not necessarily best for the patient’s oral health.

At Long Family Dental, we have experienced all the above and more!  We do our best to give our patients an estimate for their dental treatment, but as you can see, it is challenging.  Unfortunately, patients don’t understand why the estimate we give them is not always accurate.  There are over 1,000 dental codes and it would be impossible to go through each one to find out the coverage and any restrictions individually.  And, every time a call is made to the insurance company, there are multiple warnings that the information is not a “guarantee of benefits” and may have limits and exclusions that are only revealed once a claim is filed.

Oral health is an important part of a person’s overall health and many people do not realize how the conditions in their mouth can affect other areas of their health.  Our doctors continue to stay abreast of the latest information and research in dental technologies, dental products, procedures and treatments so we can confidently promote optimal oral health.  It is discouraging when a patient makes a decision about their dental treatment based on whether insurance will cover it or not, and even worse when a patient becomes upset with the dental office because their dental plan has unique benefit restrictions or limits and exclusions.

Patients should continue to look at their dental insurance as a supplement to their oral health.  As the insured, you may be able to find out more about your policies limits and exclusions, but it is our hope that you will still consider what is best for your oral health.  This information can only come from your dentist, not your insurance company.

Dental insurance was developed in the 1960’s as a separate benefit for oral health care.  At that time, the standard level of coverage was $1000 maximum per year; preventive services at 100%, basic services at 80% and major services at 50%.  Does this sound familiar to anyone?  Most plans are still at this exact same level.  There are now some plans with maximums that are a bit higher, but the coverage levels are usually the same.

Back in the 1960’s, a patient could easily have their teeth cleaned and examined twice a year, have their necessary x-rays, and have a good amount of basic care for their teeth.  Now, you would be hard pressed to find anyone that doesn’t max out their benefits with their two cleanings and one crown.  Dental insurance has not kept up in any way with the increased costs in dentistry.

We have known this trend for many years and encouraged patients to think of their dental insurance more like a supplement rather than a “pay-all”.  However, in the past couple of years, more challenges have arisen with dental insurance.  Many employers are struggling in this economy to continue to provide dental coverage for their employees.  So they go to the insurance company with a certain amount of dollars for dental coverage and ask the insurance company what benefits can be provided for that amount. Insurance companies then begin to create all different kinds of limits to a plan in order to provide a policy for the designated dollar amount.

Stay tuned for more information on current trends in dental insurance.