Dental Plans

Types of Dental Plans

Dental PPO (Preferred Provider Organization) plans allow you to visit any licensed dentists but you usually pay lower costs when you visit a PPO network dentist. These plans offer a balance between lower costs and dentist choice. PPO dentists who participate in the network agree to accept contracted fees as payment in full for patients with the PPO plan, rather than their usual fees. When you visit a PPO dentist, you typically pay a certain percentage of the reduced rate (called coinsurance) and the plan pays the rest. The percentage usually varies by the type of coverage such as diagnostic and preventive, major services, etc.

Dental Health Maintenance Organization (DHMO) plans, also referred to as prepaid plans, require you to choose one dentist or dental facility to coordinate all of your oral health needs. If you need to see a specialist, your primary care dentist will refer you; specialty care may require preauthorization. A typical DHMO-type plan doesn't have any deductibles or maximums. Instead, when you receive a dental service, you pay a fixed dollar amount for the treatment (a "copayment"). Often, diagnostic and preventive services have no copayment, so you pay nothing for these services. Generally, if you visit a dentist outside of the network, you may be responsible for the entire bill.

Discount plans, or reduced-fee-for-service plans are not insurance but instead offer access to dental services at a discounted rate from participating dentists for a monthly or annual charge. There is generally no paperwork, annual limits or deductibles, but you must visit a participating dentist to receive the discount. Also, you may be responsible for a greater portion of the treatment cost than with a PPO or DHMO plan.

The Medical Dental Connection

There is mounting evidence of a connection between oral health and a person’s overall health. It is well documented that a high percentage of health conditions have an oral component such as swollen or bleeding gums, ulcers, dry mouth, bad breath, metallic taste and various other changes in the oral cavity. Since most people have regular oral examinations, their dentist may be the first health care provider to diagnose a health problem in its early stages. Some health problems that your dentist may become aware of include diabetes, cancer, heart disease, kidney disease, anxiety and other medical conditions.

Dental Implants

Dental implants — artificial replacements for natural teeth/roots — are an alternative to partial and full dentures or bridges. The implant, working like a tooth, offers more comfort and stability than dentures. Implants can restore the ability to chew food and may improve speech and facial appearance. Implants are manufactured "anchors" that resemble cylinders or screws. Used in upper and lower jaws, they are surgically inserted into the jawbone to become a stable base for artificial replacement teeth. Unlike dentures, implants are not removed for overnight soaking and cleaning and need no adhesives. Implant surgery is performed in a dentist's office. The entire process could take up to nine months to complete, depending on the patient. The success rate for implants is based on many factors. Implants (depending on their location in the mouth) have reported success rates between 85 and 90 percent. The best candidates for implants are those in good general health who have healthy gums and sufficient bone structure. Success of the implant depends on regular dentist visits along with a personal commitment to good oral hygiene. Implants may be less successful for people who smoke, those who grind or clench teeth and patients with systemic diseases such as diabetes. Check with your dentist to see if implants are the right choice for you.

Information courtesy of the Academy of General Dentistry and the American Dental Association

Dentures

A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position. Complete dentures are either "conventional" or "immediate." A conventional denture is placed in the mouth about a month after all the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback behind an immediate denture is that it may require more adjustments after the healing has taken place.

Dentures are no longer the only way to restore a mouth that has little or no non-restorable teeth. Strategically placed support, or implants, can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble the "feel" of real teeth. Dental implants are becoming the alternative of choice to dentures, but not everyone is a candidate for implants. Call your dentist for advice.

Information courtesy of the Academy of General Dentistry