Long Family Dental of Cleburne Blog

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.

Are you anxious about having dental treatment performed?  You are not alone!  Many people postpone having necessary treatment due to a high level of fear. Most dental conditions worsen when they are not treated and can put a person’s health at risk in some cases.

At Long Family Dental, we offer several levels of sedation to make it comfortable for you to have treatment. The first level is nitrous oxide or laughing gas. Many dental practices offer this level.  It relaxes you and gives you a “floating” feeling so you are distracted from what is going on in your mouth.

The next level of sedation is oral sedation.  A patient arrives about an hour prior to treatment and takes medication prescribed by the doctor according the medical history and existing medications.  Again, the patient feels very relaxed and many times will go to sleep.  The patient is aware at a certain level that dental work is being performed, but they are so relaxed they really don’t care.

The highest level of sedation offered at our practice is IV conscious sedation.  The patient is put on an IV drip of medication prescribed according to the medical history and existing medications.  The patient’s vital signs are monitored closely as the patient rests comfortably and is generally unaware of what is happening.  When treatment is complete, the doctor stops the IV medication and the patient wakes up with no to little memory of the procedure.

If you need dental treatment but are afraid, let us schedule you for an exam and discuss which option would be best for you.  Remember, postponing the treatment will allow the conditions to worsen and negatively impact your health.  Once you have experienced sedation dentistry, you won’t be afraid to have dental treatment in the future!

The importance of a person’s dental health should be a focus from the time teeth are present in the mouth. Many times we are asked about when to start brushing baby teeth, when should a child be brought in for their first visit and the importance of keeping baby teeth healthy.  All of these are important factors in setting a priority for dental health, which promotes overall health.

A child that is brought in early and regularly has a better chance for good oral health. This child also grows in to an adult that has oral health as a priority.  We recommend parents begin to care for baby teeth as soon as they can be seen in the mouth.  Using a very soft, small brush to massage the teeth 2 times a day helps keep them clean. Use an age appropriate fluoride-free toothpaste.  Even a washcloth can be used to perform this cleaning.

As far as when to bring the child for their first visit, at the age of 3, we can typically do an exam and a cleaning with their cooperation.  As soon as the child responds positively to radiographs, we would do those regularly as well so we can make certain there are no cavities or tooth infections. Of course, should the child be experiencing a dental problem before age 3, we would want to see them earlier.

Should a child develop a tooth infection, it is important to treat the tooth and save it.  Baby teeth serve an important purpose.  Not only do they help with the digestion process by helping the child properly chew their food, baby teeth are also place holders for future permanent teeth.  If a baby tooth is lost too early, the permanent tooth doesn’t have room to come in and this leads to an orthodontic (braces) need for the child. Sometimes parents think they are saving money by having baby teeth extracted, however the investment in saving the baby tooth now is much less than the cost of orthodontic treatment later. Additionally, if a baby tooth is infected it must be treated because that infection will move through the bloodstream and cause health issues overall.

If you have further questions about your child’s specific oral health, please feel free to call us at Long Family Dental and we will be happy to answer your questions or schedule your child for an appointment.