- New Patient Form
- Why You Should See The Dentist
- Baby’s First Dental Visit
- Dental Insurance
- Antibiotics Before Your Dental Treatment
Visiting the dentist is about more than getting clean, shiny teeth.
Regular dentist visits can help you prevent dental disease and find signs of disease early. This helps you keep your mouth healthy, which can save you both time and money.
Stop Tooth Decay from Causing Bigger Problems
- Decay caught early can be reversed!
- Untreated tooth decay can lead to cavities.
- Cavities can cause pain, loss of confidence, and tooth loss.
- Treating decay or cavities can prevent them from getting worse
Periodontitis (advanced gum disease)
Early Gum Disease Can Be Reversed
Periodontal (gum) disease is the main cause of tooth loss. Sometimes your teeth or gums may not hurt even though you have gum disease. See your dentist if you notice that your gums are red, swollen, or tender or that bleed when you brush or floss. Another sign of gum disease is bad breath that won’t go away. Treating gum disease early can prevent it from getting worse.
Whiter Teeth and Fresher Breath
- A dental hygienist or your dentist will clean your teeth to remove surface stains and any tartar (hardened plaque) that has formed.
- Your dentist and hygienist can give you tips for cleaning your teeth, caring for your gums, and improving your breath at home.
- Professional dental cleanings can also help you prevent gum disease.
Screenings for Mouth and Throat Cancer
- Your dentist checks your mouth and neck for signs of cancer every time you visit.
Your Oral Health is a Sign of Your Overall Health
- When you have problems with your mouth, it can get in the way of your everyday activities and it may be hard to eat the foods you like.
- An early sign of diabetes may be mouth sores, gum disease, or other oral problems. Your dentist is trained to notice these signs and can refer you to a doctor if needed.
Even if you wear dentures, you still need a regular oral health checkup.
- Over time, dentures can become loose because of changes in your gums and bones. Your dentist will make sure your gums are healthy, look for signs of cancer and check your dentures for proper fit.
Talk to a dentist about scheduling your baby’s first dental visit. It is a good idea for your child’s first dental visit to occur within six months after the first tooth erupts, but no later than the first birthday. Although this may seem early, a dentist can show you how to properly clean your child’s teeth, check for problems such as dental decay, and offer advice on your child’s diet and pacifier use. You should consider this a well-baby dental checkup for your child.
Having a well-baby checkup at this age connects your child to a dental home. This is a “home base” for dental care, a place where you can take your child from year to year. This helps the dentist get to know your child’s and your family’s specific needs, so he or she can provide the best care.
During your child’s first visit, we will teach you proper gum and tooth care for babies.
If your child is older, this visit may include a full exam of the teeth, gums, jaws, bite, and oral tissues. And if needed, the dentist might gently clean your child’s teeth to remove plaque, tartar, and stains.
After meeting you and your child, we will:
Explain each step of the checkup
Show the tools we will be using
Use a model to explain cavities
Show your child how to brush properly
Demonstrate any procedures that we are doing
Count and examine your child’s teeth
Clean and polish your child’s teeth
Having dental insurance coverage can make it easier to get the dental care you need. But, it’s important to understand that most dental benefit plans do not cover all dental procedures. When deciding on your treatment, dental benefits should not be the only thing you consider.
You should know what your dental plan covers and what it doesn’t. This information can help you understand why your dental benefits plan may not pay for all or even a portion of your recommended treatment. Ultimately, your treatment should be determined by you and your dentist – not by your level of dental coverage.
How Dental Insurance Plans Work
Dental benefit plans are not designed to cover all dental procedures. Plans usually cover some, but not all, of your dental costs and needs. Many plans involve a contract between your employer and a dental plan provider, but you can also buy individual plans on your own or through the Health Insurance Marketplaces.
Your Dental Coverage Is Not Determined by Your Dentist
Your dentist’s primary goal is to help you maintain good dental health, but not every procedure your dentist recommends will be covered. To avoid surprises on your bill, it’s important to understand what and how much your plan will pay. Your employer and the plan provider agree on the amount your plan pays and what procedures are covered. Your dentist is not involved in deciding your level of coverage.
Your dental coverage is not based on what you need or what your dentist recommends. It’s based on how much your employer pays into the plan. Sometimes, you may have a dental care need that is not covered by your plan. Employers generally choose to cover some, but not all, of employees’ dental costs.
Dental Insurance Plans Share Treatment Costs with You
There are certain cost-control measures that dental benefit plans use to determine how they share treatment costs with you. Here are some key terms that are used to describe these measures:
A deductible is the amount of money that you must pay before your benefit plan will pay for any service. It can take more than one service or visit to meet your deductible. Most plans don’t require a deductible for preventive services like cleanings and exams or for diagnostic services.
In most cases, after you meet your deductible you will be expected to pay a percentage of the allowed benefit amount of a covered dental service. This is called coinsurance.
- For example, Your dental insurance plan may pay 80% and you pay the remaining 20% owed to your dentist. If your bill was $100, then your plan pays $80 and you would pay the remaining $20.
This is the maximum dollar amount a dental plan will pay during the year. Your employer decides the maximum levels of payment in its contract with the dental benefit provider. You would pay for anything over that set dollar amount.
- For example:
- Your dental expenses: $3,500
- Your annual maximum: $2,000
- You owe: $1,500
If the annual maximum of your plan is too low to meet your specific needs, you may want to ask your employer to consider a higher annual maximum. If your plan also covers braces, there is usually a separate lifetime maximum limit.
Your dental insurance plan may not cover conditions you had before enrolling even though treatment may still be necessary. You would be responsible for paying these costs.
- For example: If you had a missing tooth before the effective date of your coverage, then benefits will not be paid for replacing the tooth. Even though your plan may not cover certain conditions, you may still need treatment to keep your mouth healthy.
Coordination of Benefits (COB) or Nonduplication of Benefits
These terms apply to patients covered by more than one dental plan. The benefit payments from all plans should not add up to more than the total charges. Even though you may have two or more dental benefit plans, there is no guarantee that all of the plans will pay for your services. Sometimes, none of the plans will pay for the services you need. Each dental plan handles COB in its own way. Please check your plans for details.
Plan Frequency Limitations
A dental plan may limit the number of times it will pay for a certain treatment. But, you may need treatment more often to maintain good oral health. Make treatment decisions based on what’s best for your health, not just what is covered by your plan.
- For example, Your plan might pay for teeth cleaning only twice a year, but you need teeth cleaning 4 times a year, so you would pay out of pocket for the extra 2 cleanings.
Not Dentally Necessary
Many dental insurance plans state that only procedures that are medically or dentally necessary will be covered. If the claim is denied, it does not mean that the services were not necessary. Treatment decisions should be made by you and your dentist.
If your plan rejects a claim because a service was “not dentally necessary,” you can appeal. Work with your benefits manager and the plan’s customer service department or your dental office to appeal the decision in writing.
Other Cost Control Measures
- Claims Bundling – 2 different dental procedures are combined by the dental plan into one procedure. This may reduce your benefit.
- Downcoding – when a dental plan changes the procedure code to a less complex or lower-cost procedure than was reported by the dental office.
- Least Expensive Alternative Treatment (LEAT) – if there is more than one way to treat a condition, the plan will only pay for the least expensive treatment. However, the least expensive option is not always the best.
- For example your dentist may recommend an implant for you, but the plan may only cover less costly dentures. You should talk with your dentist about the best treatment option for you.
Make Your Dental Health the Top Priority!
Although you may be tempted to make decisions about your dental care based on what your dental plan will pay, remember that your health is the most important thing. Talk with your dentist to make sure you are getting the treatment that will get your mouth healthy again.
Antibiotics Before Your Dental Treatment
Should You Take Antibiotics Before Your Dental Treatment?
Most Dental Patients Should Not Take Antibiotics Before Treatment
For the majority of dental patients, the American Dental Association does not recommend taking antibiotics before dental treatment.
In the past, people who had orthopedic/joint implants like hip or knee replacements, metal plates or rods, etc. used to take preventive antibiotics before dental treatment. This is no longer recommended in most cases.
A small number of people with specific heart conditions may need to pre-medicate with antibiotics before dental treatment to prevent a serious heart infection.
This brochure explains both the possible harms and benefits from taking antibiotics before dental treatment. Use it to help talk with your dentist and physician, orthopedic surgeon, or cardiologist to understand whether taking preventive antibiotics is right for you.
Why Would Certain People Take Antibiotics Before Dental Treatment?
Taking antibiotics before dental treatment is called preventive medicine, or antibiotic prophylaxis (pro-fuh-LAX-is). This is done with the belief that antibiotics might help prevent infections. But most people are able to fight infections on their own, so taking an antibiotic doesn’t lower their chance of developing an infection.
Certain people who have other health conditions and also had a joint replaced may benefit from taking an antibiotic before dental treatment. They may have an increased risk of a problem, so taking an antibiotic can lower their risk.
Those dental patients who may benefit from taking preventive antibiotics include:
- People who may not be able to fight an infection on their own, which can increase the chance of developing something more serious from an infection
- People who have a medical condition or are taking certain medications that increases their risk of infection
Why Shouldn’t Most People Take Preventive Antibiotics?
Many people think that there are no harms associated with taking an antibiotic for preventive reasons. But, as with any treatment, there are both benefits and potential harms. In most cases, taking antibiotics as a preventative measure is more likely to cause a problem than to defend against one.
Here are some problems that can happen with taking preventive antibiotics:
- Antibiotics can cause side effects that can range from mild stomach problems to severe and life-threatening reactions.
- Taking antibiotics can destroy good bacteria that protect against infection.
- Improper use of antibiotics can lead to the development of drug-resistant bacteria.
Also, there is scientific evidence that dental treatment procedures are not connected with prosthetic joint implant infections. The antibiotics that are provided before dental treatment do not prevent these types of infections.
Who May Be Recommended to Take Preventive Antibiotics?
The list below explains why some people with certain health conditions are told to take antibiotics before having certain dental treatments.
If You Are One of a Small Group of People Who Have a Specific Heart Condition (described below)
For a small group of people, there’s concern that bacteria in their bloodstream can cause an infection of their heart lining or valves. This infection is called infective endocarditis (end-oh-car-DYE-tis).
The American Heart Association only recommends preventive antibiotics for people who would be in the most danger if they developed a heart infection. This affects a very small and specific type of person with a heart condition(s).
If you have one of these heart conditions, we or physician/cardiologist may recommend that you take an antibiotic before dental treatment:
- artificial heart valves
- a history of infective endocarditis
- certain specific, serious congenital heart conditions, including:
- unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits
- a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure
- any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device
- a cardiac transplant that develops a problem in a heart valve
If You Had Complications with Your Joint Replacement Surgery or if You Are at Increased Risk of Infection
You may be taking antibiotics to prevent joint implant infections or because you experienced complications from a joint replacement surgery. Or, you may take antibiotics if you are at increased risk of infection because of other drugs or diseases.
Talk to your orthopedic surgeon before any dental treatment. They can best determine if you need to keep taking antibiotics before you see your dentist for planned treatment.
Talk to Your Dentist or Physician, Orthopedic Surgeon or Cardiologist
If you have any questions, or if there are any changes in your health history or the medicines you take, let your dental office know so they can update your records.