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1. Who really makes the decisions about the quality of care you receive?

Unlike medical insurance, which started being offered in 1850 by the Franklin Health Insurance Company of Massachusetts, Dental Insurance is a fairly recent phenomenon. Dental insurance was first introduced in California in 1954, and quickly rose in popularity. By the 1970’s, these plans were widely available and usually provided a maximum annual coverage of about $1000 (which is still about the maximum today). The first plans didn’t distinguish between in-network and out-of-network providers. They simply established usual and customary rates for the area, and would pay (typically) 100% of preventative care, 80% of minor dental work (such as fillings) and 50 percent of major work (like crowns, bridges, etc).

Today with the advent of PPO the dental insurance landscape has drastically changed and this is how.  Dental insurance companies are owned by stockholders, equity firms and investment bankers for the purpose of making money.  Unlike medical insurance companies that can run into unlimited liabilities with large claims dental insurance has a cap on the coverage.  We will cover this in number 6 but as a matter of fact annual maximums have hardly changed since 1970. In 1970 the cost of an average new car was $3,542.  The average price today is $33,560. If dental insurance would have kept up with their annual maximums, today they would cover up to $10,000 a year.  Do you see the problem?

Bottom line dental insurance is a very lucrative business.  If they want to make more, the company owners decide to reduce their coverage by limiting the coverage on care you can receive without considering the consequences to you.  It’s not your health they are worrying about.  It’s about how to recover from recent Affordable Care Act losses and their bottom line.

PPO dental insurance plans peaked in 2011 with 65% market share but have been losing ground ever since. As they continue to lower and lower payouts, dentists are dropping out of the networks because they are uncomfortable with the care dictated by the insurance companies and are unable to run a business on the reduced fees. Don’t be surprised if one day the closest dentist in your PPO coverage is in the next state.

It is not uncommon to have dental insurance companies altar the dentist’s treatment plan.  The question becomes “How many years have insurance executives in fancy boardrooms spend in dental school?  What are their qualifications to decide your care?”

2. Preventive care is controlled by insurance companies and can sometimes be detrimental to your health.

Although experts agree that routine dental exams and regular cleanings may help prevent the incidence of higher-cost treatments such as periodontal surgery, root canals, extractions and fillings and early detection and prevention can minimize your need for more serious dental treatment, insurance companies continue to reduce coverage on those services.  First, they restrict the number of visits you may need to control gum disease.  Some people who have the genetics and lifestyle that contribute to gum disease need to be monitored more closely.  Regardless, insurance companies will only cover a fixed number of visits for gum therapy.  Some limit the visits to as few as one covered appointment per year and restrict some test and x-rays necessary to monitor your progress to once every 5 years. Gum disease has been found to have a correlation with heart attacks and even early onset of Alzheimers.  Can you imagine if you were a cancer survivor or a patient with acute high blood pressure having such restrictions?

Although with the new digital x-rays patients get 1/20^th the radiation from an x-ray, insurance coverage refuse to pay for many x-rays that are necessary for the dentist to monitor your dental health.  If something goes undetected until it causes pain, inconvenience or even loss of teeth it doesn’t really matter to the insurance company.  Remember they will only cost them a maximum of $1,000 per year.

I have had patients come into the office with an abscessed tooth two weeks after their 6-month re-care visit.  The reason this happened was insurance companies would not cover adequate x-rays to detect the situation earlier and the patient decided they knew best.

3. Best care options are frequently denied.

Many times when your dentist is designing a care plan for you, you and he might like to consider optimal care that would include treatments that the insurance company refuses to cover.  Your choice is to do what is best and the insurance company pays nothing or except the care that is covered at 50% or less and live with the inconvenience of coping with less than optimal solutions. I have patients who live with a piece of plastic in their mouths, catching food, causing mouth odor and promoting more dental disease because that was all the insurance company would cover.

4. Hidden costs with insurance with deductibles.

In 1970 dental insurance companies typically covered 100% of preventive services (with less restrictions than today) and 80 % of all other work with a $50 deductible on and of the 80% covered services.  Today many insurance companies have deductibles as high as $200 but let’s assume it is $50. They may say your preventive is covered at 100% but in the small print it says you must pay the deductible first.  So if a cleaning and x-rays comes to $200, you will pay $50. They will cover a 100% of $150, the remainder after the deductible.  That would be the same as covering your preventative at 75%.  That’s pretty sneaky in my books.

5. Correcting pre-existing conditions are frequently not covered.

Although dental insurance companies claim to cover major reconstructive dental care like removable partial dentures, dentures, bridges and implants to replace missing teeth.  Be aware of the small clause “pre-existing conditions”.  What this means is if a tooth was missing prior to you being covered the insurance company will NOT pay claims on replacing them. I have had many patients disappointed because they had dreams and aspirations that dental insurance companies would help them finally restore their confidence and a healthy smile, only to find out they had not read the “pre-existing condition” clause.

6. Waiting periods can jeopardize your health.

Many insurance companies have waiting periods before they will cover certain dental procedures.  This creates an inconvenience minimally or can actually be detrimental to your health if you are encouraged to wait until your care is covered.  I have had a patient wait to get a root canal until her insurance would cover the care.  Ultimately she ended up in the hospital with a life threatening infection and experienced a stroke from the accompanying high fevers.  Waiting periods promote health risks and bigger problems.

7. Many dental insurance companies create a paperwork barrier to processing your claim.

Supposedly lost coverage requests and Insurance claim denials are a standard operating procedure with most dental insurance companies. It is called “stall as long as you can”.  There are only two things that can happen with that game.  The dentist gives up on collecting the money he earned and cuts his losses.  Or the insurance company gets to keep his earned money a little longer to invest it somewhere else.  When a claim is denied or ignored, it is not uncommon for a dental employee to be left on-hold for over 30 minutes.  If a dental office has 16 unpaid claims you can see the dentist will have to hire someone full time to do nothing but listen to elevator music while trying to recover the money the office has already worked for. Some dental offices have a policy that if they don’t get paid by the insurance company within 60 days you will pay and join them in the fight to get your insurance benefit back.  How well do you like elevator music?

8. Braces are rarely covered or slightly covered.

Although experts know that crooked teeth not only cause psychological and social problems, crooked teeth promote dental disease.  It just makes sense when teeth are bunched up and growing in different directions that it is difficult if not impossible to keep them clean.  Food trapped between crooked teeth causes tooth decay, gum disease and bad breath.  Many insurance companies dodge the correction of crooked teeth with the pre-existing conditions clause.  Those companies that do cover that correction sometimes pay benefits as low as 20% of the fees, leaving you with the rest.  You will be disappointed if you depend on your dental insurance to straighten your smile.

9. Cosmetic care is never covered.

In today’s competitive world, jobs, opportunities and even romance can be affected by your smile and how you feel about it.  Insurance companies don’t care.  If you have multiple cavities on front teeth the solution they will pay for is white fillings.  Although white fillings are not bad even the best white fillings microscopically look like sandpaper as compared to tooth enamel.  So imagine what happens when you eat cherry pie or have a glass of red wine.  Yep you’ve got it.  White fillings turn a light shade of pink.  This might work during breast cancer awareness week but for the other 51 weeks it is not so cool.  Also I have seen white filling catch food between the teeth causing tooth decay on adjacent teeth.

I can’t count the times insurance companies have declined to pay for more comprehensive and aesthetic porcelain crowns because they want their customers to experience the consequences of bubble gum and bailing wire dentistry with white filling alternatives.

I had patients who have let insurance companies influence their decision on accepting large white fillings up front come back later regretting their decision. Many of them decided to pay out of pocket to do it right in the first place.  Although they are much happier today they paid a heavy price.  They paid the deductible and co-pay for the fillings and then for the full coverage porcelain crowns.  Plus they had to go through an extra dental procedure.

Solution:  You may want to join others who are reaping the benefits of the Custom Dental VIP Savings Plan.  It is not a dental insurance plan however it does give you 2 FREE COMPLETE exams, ALL NECESSARY x-rays and 2 FREE Cleanings per year and a savings of thousands of dollars on other services. And the BEST News is:

NO yearly Maximums

NO deductibles

NO claim forms

NO pre-authoriztion requirements

NO health questions

NO one will be denied coverage

No waiting periods (immediate eligibility)

FREE consultations

 

All of this for 62 cents a day. With the Custom Dental VIP Savings Plan Investment bankers and equity firms will no longer determine your care. Finally, you and your dentist are in control.

To find out more about the Custom Dental VIP Savings Plan call (469)535-2111.

I treat patients whose lives change dramatically from one day to the next solely because of dental implants.

Not only is there a great aesthetic advantage, but the improvement in your overall psychological and physical health is remarkable.  Here is a list of the top 10 benefits that can come from dental implants that I have personally heard from my patients and that are reported world wide: 

Ability to chew nutritious food and eat anything you like without pain or discomfort. An example of this would be a patient biting into an apple after years of not being able to do so. A wonderful patient of mine, who was also an employee of the company had struggled with failing teeth for years. She informed me about her avoidance of eating out with friends because she felt obliged to order soft foods to not show the discomfort she would display if she were to have ordered something harder like steak and vegetables. Over time, we were able to give her the gift of implants again and she was able to enjoy things that many of us may take for granted: like biting into an apple. 

Improving overall health because you are able to eat more solid and nutritious foods (fruits and vegetables). This same patient, and many other patients were able to eat foods like carrots, apples and meat for the first time in years. Expanding the variety in your diet once again is vital to improving the amount and quality of nutrients consumed.

Improvement of psychological health and well-being. In a world where we should be using our smile to change the world, we need to be mindful of how losing our smile can change us. I’m acutely aware of this every day when I go to work and meet patients with failing or missing teeth. Their confidence is deflated, and they cover their mouth when they smile. It is such a shame. However, once solutions are enacted to reverse these problems I literally see my patients change before my eyes. I've seen spouses cry when seeing their significant other with implants for the first time as they have not seem them smile in years! The radical improvement of confidence and increase in self esteem go hand in hand when receiving dental implants.

Instead of covering your mouth while laughing and smiling, you are eager to show off your new smile. This ties back into the psychological benefits we just discussed.

Dental Implants are more cost effective in the long run. It may seem that in the moment you are saving a lot more money on dentures and bridges, however you only have to change crowns about every 15 years and the dental implant itself could even last a lifetime.

You don’t have to have dentures or bridges fixed every five years anymore. Because of the constant deterioration of your bone and muscle loss that dentures and fixed bridges may cause, your bridges and dentures must be fixed to adjust to the form of your jaw. With dental implants this is not necessary because it STOPS this deterioration of bone and muscle loss leading to the next benefit.

Eliminating further bone loss and the “sinking in” of the jaw and stopping muscle atrophy of the mouth. This elimination is so detrimental as to why dental implants are the most superior missing or failing tooth replacement. Eliminating further bone and loss and muscle loss, literally stops the aging process from continuing and can even make you look ten years younger! Going from a sunken in jaw, to a jaw that is filled thick with healthy bone and muscle contributes to a far more youthful experience as demonstrated in the picture below. 

Not having to remove your temporary teeth every night. This is a given! Implants are permanent solutions that have a 99% success rate over a span of 10 years!

You are suddenly able to talk naturally, without concerns of “lisp like” sound or clicking of dentures. Many patients report a lack of confidence in their speaking abilities because of their dentures or missing teeth. Even when a dentures fits beautifully, it can still be daunting to learn how to speak again with a new structure in your mouth. Your body has adapted to the prior form of your jaw, so getting used to dentures can be a learning curve. Dentures cause your mouth to produce an extra amount of saliva and the excess saliva and the difficulty to control it causes lisps, gargling sounds, and whistling noises. Even when denture adhesive is applied correctly, they can slip causing quite an annoying clicking noise.

Reducing the risk of bad breath associated with dentures. If not brushed thoroughly twice a day, a film of lingering food can develop on the dentures causing the development of plaque and bacteria. This plaque buildup and bacteria can cause a very unpleasant smell that can become difficult to remove if not taken care of daily.

These are only eight of the benefits from dental implants that can be truly life changing. This process can transform our smiles which are often our signature, and a genuine smile carries through into the way we carry ourselves and even the spark in our eyes. It is a sign of friendliness, and kindness and is such an important factor in opening up opportunities for greater happiness and fulfillment.

Picture Citations: https://meadows-chiro.com/testimonios/happy-people/

https://implants-teeth-in-5days.com/blog/7-essential-things-you-should-know-about-dentures

https://pittsburghimplantsandperio.com/blog/all-on-four-dental-implants-cost/

Dental Implants are the absolute best solution to this date for failing and missing teeth.

With a 98% success rate, they are as close as you can get to the natural and beautiful teeth you were born with. With dental implants, patients are able to restore their ability to confidently eat nutritious foods, talk and pronounce words effectively, and show off a beautiful and full smile once again.

Imagine a dental implant as a small screw with a cosmetic crown on top. This screw is essentially what will replace the root of your original tooth, and is integrated flawlessly into your jawbone. The implant material and the bone in your jaw are compatible therefore the process of osseointegration will take place, a fancy word for the bonding of your implant and jaw bone. 

What are the parts of a dental implant?

1) The titanium implant itself (the screw).

2) The abutment or the “connector” of the implant and your crown.

3) The custom made crown itself (the ice cream on the cone).

The implant (or screw) is just one component of the cost of a total implant as the abutment and crown must be included as well.

What is the Implant made out of? 

Most dental implants are made out of titanium. The reason this particular metal is used over other metals, is that your bone and muscle do not reject it but rather respond to it, keeping the integrity of the surrounding tissue and bone.

This equates to the halt of bone loss and muscle atrophy, which is what causes your jaw and mouth to have a “sunk in” or older look. The halting of this process is truly what makes implants so special because your jaw is made to look fuller and younger once again.

History of Dental Implants: 

Even though Dental Implants are the most cutting edge tooth replacement technology these days, they are not a new concept. 

Documentation of dental implants goes back to the Ancient Egyptians where they used rocks, shells, and gold as dental implants: more than 3,000 years ago! 

Unfortunately the focus shifted from permanent solutions, to impermanent and less effective solutions like bridges and dentures for a long period of time, however, implants made their comeback in the 80’s. Initially, many people think that implants are exclusive to celebrities because of the high cost but with the ever improving development of dental technology and equipment dental implants have become much more affordable and attainable to anybody in this day and age.

Picture Citation: https://aspendds.com/content/dental-implants-alternative-dentures

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