Dr. Hall,
I think I am a candidate for dental implants. Is there dental insurance that will help with the cost?
- Gary from Pennsylvania
Gary,
Dental insurance, if you already have it, will usually help pay for dental implants, but not very much. What most dental insurance plans will do is pay for the least expensive option for replacing missing teeth, which usually ends up being something removable – either a removable full denture or a removable partial denture. These are the most uncomfortable dental restorations.
Another point I’d like to make is that it appears that you’re looking to buy some insurance on your own to help pay for implants. If that is the case, think through what you want. It sounds like you’re thinking of trying to take advantage of the insurance company. You want to pay them a certain amount of money and then get them to pay you more money back in benefits than you paid them in premiums. Good luck trying to talk a for-profit dental insurance company into that business deal.
- Dr. Hall
|
We thank our advertisers who help fund this site.
|
|
Comments Off
I was told I had gum disease and I have no insurance to go back and get this checked. I’m waiting to get some and I noticed my gum in front on the bottom is so low under my 2 bottom front teeth. They have become slightly loose and I know I’m gonna lose them. Please help! If they both come out will my other teeth move forward to fill that gap in? What do I do to save my teeth without having to lose them or get a partial?
- Nicole from Tennessee
Nicole,
Gum disease is serious and once teeth become loose from gum disease, there usually isn’t anything you can do to save them. And if some teeth are already loose, others probably aren’t far behind.
My advice if you have gum disease is to take matters into your own hands and not depend on dental insurance. Preventing gum disease isn’t that expensive—you just need to be faithful with checkups and cleanings, and then do your basic home care.
You would have been much better off had you kept up with your regular dental care. My advice to you now is to go to the dentist and try to slow down or stop the gum disease. The sooner the better.
- Dr. Hall
Click here to ask Dr. Hall a question.
|
We thank our advertisers who help fund this site.
|
|
Comments Off
My 13-year-old daughter was born with a lack of tooth enamel. After braces her smile is straight but the two main teeth have two different colors on them – they’re splotchy looking. Will my dental insurance pay for this? It’s Anthem Blue Cross
- Pam in California
Pam,
When teeth are splotchy-looking right after getting braces off and they weren’t that way before, it’s probably because they weren’t really good about brushing their teeth while the braces were on. When you’re wearing braces, it’s a good idea to carry a toothbrush with you, because you need to get all that gunk off after each time you eat, or it will damage your enamel.
And since this is a situation that involves damaged tooth enamel, yes, your dental insurance is probably obligated to pay benefits. But there are a couple of cautions here.
First, your dental insurance is only obligated to pay for repairing the physical damage, and they will probably pay at a very minimal level. Don’t think of them as “covering” the repair, because that implies they will pay for the whole thing. Think of it as that they will “help” pay for the repair. You’ll want this done in a way that looks beautiful and natural. Your insurance is only committed to making the repair be functional.
Second, don’t let your family dentist do this. You want an expert cosmetic dentist. This may cost a little more, but the repair may involve free-hand tooth bonding or even porcelain veneers. You need a dentist-artist, and only 1 or 2 percent of dentists are artistic enough to produce a beautiful result with your front teeth.
- Dr. Hall
Click here to find an expert cosmetic dentist.
Teeth bleaching WILL NOT WORK for these splotches. Read our cosmetic dentistry horror story about how teeth bleaching made splotched teeth worse.
Comments Off
I have some dental issues with my upper teeth, missing three back teeth and have one bridge that is 37 years old. I would like to have all my upper teeth replaced with permanent denture implant. I have struggled with peridontal disease and go in every six months for scaling/root planing. I did try a partial dental plate but it made me gag, and I could never get past that or trying to eat with it in.
I would like to get an estimate for this if it can be done and it could be considered a medical condition so that my medical insurance would help pay for it.
Thank you for your time.
- Bev in Utah
Bev,
That’s a point that we don’t mention maybe as often as we should. One distinct advantage of dental implants over say a removable partial denture or a complete denture is that there is no extra hardware in your mouth, and people who are prone to gagging can sometimes have great difficulty with a plate, say, that goes across your entire palate as many dentures need to have.
As far as your insurance, your medical insurance won’t likely cover anything, so you will need to go to your dental insurance for any help. We get variations of this question a lot – “My teeth are affecting my general health, so can’t I expect my medical insurance to help pay for it?” But almost all medical insurance contracts have an exclusion clause that specifically denies coverage for any dental problems. Otherwise, even a simple cavity could be called an infection and it does affect your general health. The only exception is that medical insurance will generally cover dental damage from an accident. So if you break your front tooth diving into a shallow pool, medical insurance will generally help you pay for it. Otherwise, anything done to your teeth will be excluded from being covered by medical insurance.
We can’t give estimates for specific dental work. For that you need to consult a local dentist. We do have a page on dental implants cost to give you some general guidelines.
Comments Off
Dr. Hall
I’m seeing a dentist covered by my dental insurance and need 3 crowns. I asked for a bill and see that I’m being charged the insurance rate $328 for each of the crowns but additionally I’m being charged $350 per crown for ‘Zirconia Upgrade’ and for tooth number 14 I’m being charged an additional $275 for ‘Upgrad Porc. on Molar’. What are these upgrades. Money is tight for me and I’m wondering if I need to pay $1325 additionally for upgrades. If it makes a significant difference I will take loans and do it, but I don’t want to unless it is necessary.
Thank you,
Ira in Maryland
Ira,
Whether these charges are “necessary” or not depends on you. You need to have a discussion with your dentist about this. Do you want porcelain on the dental crown for tooth #14, or will a metal crown do? And do you want zirconia crowns on the other teeth, or will the crown the insurance pays for be all right? That part I can’t answer, but I can help you know what is going on here. In the eyes of your dental insurance plan, these extras aren’t necessary, but keep in mind that they only have their bottom line in mind.
Your dental insurance plan is trying to save money to stay within a certain budget that your employer wants to pay for. And this dental insurance plan appears to me to be extra cheap. They have allotted a certain payment for a certain type of crown, and it appears to me that the dentist feels squeezed either in the costs allotted or in the types of crowns your insurance is willing to pay for, and is looking for a little leeway. (I have to admit that I’m going on sketchy information here, so I’m guessing at some things to fill in the blanks.) I don’t fault the dentist for this. When I was dealing with a chintzy insurance company, I would give my patients the option of choosing the more expensive all porcelain crowns for front teeth because they looked so much better. But I gave them a handout that explained their options, the amount of the extra cost, and all the pros and cons of the different choices. It looks, from your confusion, like your dentist left out this step.
You are entitled to complete information from your dentist, including all of the options available and the pros and cons of each choice, to help you make an intelligent choice about these options. So ask for that.
- Dr. Hall
Related information: Read about the costs of porcelain crowns.
|
We thank our advertisers who help fund this site.
|
|
Comments Off
Dr. Hall,
My wife recently had porcelain crowns on front upper teeth. At a follow-up appointment, the dentist attempted to “buff” the crowns to make the color match color of surrounding teeth. Now her color is still off and the crowns have no shiny appearance. The dental assistant who says she was present during buffing says the color is as close a match as possible with what was available and that porcelain won’t be shiny like natural teeth. Unfortunately, the dentist is not a cosmetic dentist. We are seeing him because he’s on our insurance approved list.
Any advice will be greatly appreciated-
- Charlie from Indiana
Charlie,
A couple of points.
First, yes, you are right, the porcelain should be shiny. But it’s worse than you think. Besides looking dull, when the dentist buffed off the glaze on the porcelain, he or she made them so that now they will stain, so they will look even worse as time goes on. But a cosmetic dentist can bring the shine back with a diamond polish.
Second, you have to decide if you just want your teeth “fixed” so they are functional, or if you want them to look nice, because if you want them to look nice, you will have to pay for it. You will not get a beautiful result from a dentist that is on any insurance company approved list. Dental insurance companies make these approved lists by finding dentists who are willing to cut corners and thus cut costs. That approach is simply incompatible with good cosmetic dentistry.
My advice would be to find a cosmetic dentist near you from our list of Indiana cosmetic dentists, and have that dentist bring back the shine and make these look as good as possible. The dentist you are going to may be a good “fixer,” but does not appear to even understand the esthetic problem he or she has created.
- Dr. Hall
Related links:
Read about Cerec crowns
Comments Off
Hello Dr. Hall,
I was wondering if you can tell me if medical insurance would cover the treatment of my teeth from tetracycline damage? My teeth are very weak and sensitive. I am afraid to bite into anything because I have chipped my front teeth before and I was hoping that because my teeth were damaged due to tetracycline to treat multiple infections due to asthma when I was a child. Please advise.
Thanks
- Jessica from Idaho
Dear Jessica,
It would sound reasonable that medical insurance would cover treating the side effects of a medical treatment like tetracycline teeth stains. But in reality, the medical policies usually list exclusions of any dental work. I have not heard of a case of medical insurance helping to pay for any treatment of tetracycline teeth stains.
But if you want to get a more authoritative answer as regards to your particular medical plan, I would call the insurance company and ask.
- Dr. Hall
Read more about dental insurance
Read about cosmetic dentistry and dental insurance
|
We thank our advertisers who help fund this site.
|
|
Comments Off
Dr. Hall,
I need a crown, and my dentist wants to do a “post and core” also. My insurance will cover the crown, but not the “post and core.” Is the “post and core necessary?”
- Marilyn in Pennsylvania
Dear Marilyn,
I could give you a whole discussion about dental insurance companies, but why don’t you just click the link and check out our pages where we explain how they operate.
Your dental insurance company is trying to economize. They’re not really that interested in your health or in the long-term, because people change jobs a lot. And while some dentists are opportunists, the great majority are really sincerely trying to take care of you, in my experience.
Many dental insurance companies want the dentist to just put a crown over an old filling and be done with it. However, we were all taught in dental school that when we do a crown we should clean out all the old filling material and build up everything fresh so that we know that any decay or other problems that may become visible when we do that are taken care of. Plus the post and core help reinforce the tooth so it doesn’t break later, and help hold the crown on.
Bottom line – I’d listen to your dentist and not your insurance company.
- Dr. Hall
|
We thank our advertisers who help fund this site.
|
|
Comments Off
Dr. Hall,
I want porcelain veneers! Can I get dental insurance to cover this? Do you know where I can go for this?
- Bill from Georgia
Bill,
I’m really curious about how you were raised. Where did you get this idea of getting someone else to pay for what you want? What ever happened to the work ethic that should teach us to work for what we earn and pay for what we get?
Dental insurance companies go into business in order to make a profit. Not only is this required for survival, it is perfectly proper for them to expect to make money. They are not going to sell you a policy and give you a loophole to be able to be able to turn around and get them to pay for a set of porcelain veneers. Come on–think this through.
And while we’re on the subject, they’re not going to sell you a policy and then want to pay out ANY benefits in excess of what they collected from you. These dental plans that promise you free cleanings and/or discounted dental work for a small monthly premium, here’s how they make money for the company: The company gets a list of dentists who are willing to give free cleanings or exams or whatever and discounted fillings and other work. What you pay the dentist–that’s all the dentist gets. The company doesn’t pay the dentist anything–the money the company collects from you then is pure profit. And think about it, do you really want to go into an examination and have a dentist who knows that he has lost money on you unless he or she can find some fillings or root canals or something to fix? I’ll tell you as an insider in the business–you do not want to be tempting your dentist that way.
A word to the wise.
- Dr. Hall
|
We thank our advertisers who help fund this site.
|
|
Comments Off
Hi. I am a 52 yrs young woman, needing several crowns due to huge fillings loosening, root canal treatments and the like. I have been prepared for 1 crown so far and asked the dentist for all porcelain crowns, wanting to rid my mouth of ANY metal as the work continues on. They told me it would be an Empress crown. My insurance company pays for Porcelain/ceramic substrate crown at a certain rate. Even though the Empress crown is all porcelain or ceramic my dentist says that the Empress is not coded on the insurance form and he will have to charge me over $1000 for the crown. (The insurance says the charge for code 2740 porcelain/ceramic substrate s/b $370). I am not sure if I am being told the truth by the dental office. It just doesn’t make sense to me. Can you comment on this affair? Thanks. PS. I do have some budgetary issues, so if I need 8 or so crowns, the cost does count!
- Pam in Florida
Pam,
I think you are being given correct information by your dental office. There is no special code for Empress–Empress is a brand. And $1000 is on the low end of fees for dental crowns so that’s a reasonable deal. Dental insurance isn’t like auto insurance or life insurance or medical insurance, which is designed to cover risk. Dental expenses are pretty predictable, so think of your insurance as a benefit plan where they are helping you a little with the costs. So unlike medical insurance where the higher the cost the more you need to rely on the insurance, this is a case where the higher the cost, the more the insurance company wants to protect itself, so it can make a profit. From what you said, you implied that the all porcelain crown was your idea, not the dentist’s. I need to warn you about this. This is very risky, doing an all porcelain crown, if the dentist didn’t recommend it. Many dentists are not very good at the sophisticated bonding techniques for placing all porcelain crowns, and you could be pushing the dentist out of his or her comfort zone. Good cosmetic dentists will really resist doing porcelain fused to metal crowns on front teeth, because they’re ugly. So if your dentist didn’t recommend all porcelain, I’d take that as a signal that you’re in the wrong office, if that’s what you want.
- Dr. Hall
Related information:
Read about one-visit Cerec crowns.
|
We thank our advertisers who help fund this site.
|
|
Comments Off