More About The Truth About Dental Insurance

added on: April 22, 2014


Several months ago I wrote a blog entitled: The Truth About Dental Insurance: Are You in My Plan? In it, I suggested that dental insurance is not actually insurance against loss (such as car or home insurance), but rather a fixed benefit towards services intended to lead to better dental health.

I shed some light on what happens in offices that accept PPO plans, where the reduced fees to the practice require high volume care with patients treated on a “tooth assembly line” rather than one patient at a time. I also asked the question: What is the relationship between long term dental health and dental insurance?

This is what I believe: If you rely only on dental “insurance“ to get or keep you healthy, you may be disappointed as you experience problems that simply cannot be addressed by dental insurance alone. Dental decay, gum disease and bite/TMJ issues are why people lose their teeth and dental benefits vary greatly for these issues.

There are basically two ways to approach dental health. The most common is the reactive process – wait until problems that require treatment develop or you start to feel or see something that is not quite right, and then get it “fixed” by your dentist. This is called disease care – fixing problems without addressing the causes. The less common yet more predictable approach is a creative process – partner with a dentist for a plan to take control of your dental health, stop just managing your symptoms and prevent chronic disease in your mouth (decay, gum disease and bite issues). We are not born with the knowledge of how to prevent dental disease – we need help. This is a health-centered approach. So where does your dental insurance fit?

If you were to learn a foreign language, could you learn it on your own, and then go visit your instructor every six months? Of course not. But if your plaque control is such that you are always getting decay and always having bleeding gums, does it make sense that you would come every to the dentist six months later (rather than sooner) to get feedback on your home care? So if dental insurance is about dental health, why doesn’t it cover preventive care based on your needs?

Do you have worn teeth, loose teeth, grind or clench your teeth, broken teeth, jaw joint pain, etc.? We have known for years that if these bite and TMJ issues are left untreated, it will lead to disease, pain and costly repairs. So if dental insurance is about dental health, why doesn’t it cover care related to bite issues, worn teeth, TMJ, etc?

I think you see my point. The fact is dental insurance is about managing costs and managing disease, but not creating health. If you are making decisions about your dental health based only on whether your insurance will cover it, the consequences may be ongoing dental care (I am always breaking a tooth); chronic disease (my gums always bleed a little) or more costly care down the road as continued breakdown slowly occurs.

Many times our patients ask us “will my insurance cover that treatment?” Of course we are happy to help you understand what benefits you may have. What I hear less frequently is, “what can I do to prevent disease in my mouth?” As a Dental Health Coach, my passion is helping my patients understand the causes of dental disease and how it progresses, so at some point they ask me “How can I stop this from happening “ instead of “How much will my insurance pay to fix this?”

You can eliminate your need for dental insurance by finding a dentist who takes the time to help you be healthy rather than just race you through a system that attempts to fix disease. You can learn how to take control of your dental health so you don’t have to spend your life “fixing” your teeth. That is what you will find in our practice.

The three keys to dental health are having great home care; partnering with a dentist for a plan for a lifetime of dental health; and having long lasting dentistry that can be maintained by you. With our approach to dental health, there is a very good chance you not only won’t need dental insurance, you may not even need a dentist!