Understanding Dental Insurance Benefits

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We know how busy you are and how difficult dental insurance can be to understand. Therefore, we have listed some key words you need to understand when it comes to your benefits. Please feel free to contact our office with any questions you may have about your specific dental benefits.

 

Deductible – A deductible is the amount of money determined by your insurance plan that must be paid by you before your benefits begin each year. A typical dental deductible is 25, 50, or 75 dollars. Many plans waive this deductible for cleanings, exams, and x-rays.

Annual Maximum – Most insurance plans operate on a calendar year. The annual maximum is the amount of dental coverage a plan provides in a single year. A typical dental maximum can be 1,000, 1,500, and up to 2,000 dollars.

Percentages – The percentage an insurance company pays is often determined by the type of procedure you are having. Procedures are normally classified by the insurance company as preventive, basic, or major and the following are the percentages typically paid for each type of procedure.

Preventive 100% – Exams, X-rays, and Basic Cleanings

Basic 80% – Fillings, Deep Cleanings, and Root Canals (sometimes considered major)

Major 50% – Crowns, Bridges, Build-ups, and Dentures

Fee Schedule – Some plans’ coverage is determined by a fee schedule instead of a percentage method. When this is the case, insurance companies determine an amount they are willing to pay for each type of procedure instead of a percentage.

Exceptions – Most policies have some exceptions and we will try to explain some of the most common exceptions we see with insurance policies.

Frequencies – Insurance policies will usually only cover a procedure a certain amount of times during a specified time frame. For example, some bitewing x-rays are only covered once in a calendar year.

Waiting Periods – If your plan has a waiting period, you may have to wait 6-12 months before you are eligible for certain procedures.

Missing Tooth Clause – When this exception is included in your plan, coverage will not replace teeth that were missing before your policy began. For example, no benefits would be payable for a bridge that would replace a tooth that was missing before your policy began.

Usual and Customary – If your insurance benefits are based on percentages, then you may have an exception based on “usual and customary fees”. Insurance plans set a maximum fee for each procedure. For example, if a cleaning cost $80, but the insurance has a usual and customary fee they have set at $75, then even though the insurance states they pay 100% for cleanings, they will only pay $75.

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Effects of Thumb Sucking

ID-10057556Babies have an instinctive sucking reflex that aids them during feeding. This reflex causes babies to suck anything that reaches their mouth, and naturally one of the first things they are able to obtain is their own thumb. Thumb sucking provides a soothing and pleasurable sensation for babies, and sometimes the habit is hard to break. Furthermore, thumb sucking by infants may sometimes signal fatigue, hunger, teething, and shyness.

Thirty percent of preschool children continue the habit of thumb sucking. The ideal age to start breaking the habit is around 24 months. When children with permanent teeth continue to suck their thumb, it may cause problems with the development of the mouth and alignment of the teeth. It can also cause changes in the roof of the mouth. These are a few examples of the negative effects thumb sucking may have on the mouth:

  • An overbite or buck teeth, which can alter the shape of the face
  • Teeth that grow out of alignment and positioning
  • Upper teeth that flare out and tip upward
  • Lower teeth that move inward
  • A lisp that interferes with the correct formation of certain speech sounds

To help children stop sucking their thumb, experts suggest offering rewards, encouragement and distractions to prevent the harmful behavior.

Please contact our Marion dental office to schedule an appointment with Dr. Chamberlain if you are concerned about your child’s thumb sucking and what it means to his/her oral health.
“Image courtesy of David Castillo Dominici / FreeDigitalPhotos.net”.

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Oral Cancer

Did you kID-10038456now almost 42,000 Americans will be diagnosed with oral and throat cancers this year?

When oral and throat cancer is detected early it can be treated more effectively. Early stages of oral cancer is often painless and may go undetected. This is why at Dr. Dana Chamberlain’s office, we perform an oral cancer screening at every checkup. Regular visits to the dentist can improve the chances of detecting changes in your oral health and finding problems early. Between visits, it is important to be aware of any suspicious signs or symptoms and to visit your dentist as soon as you recognize a problem.

 

Some things to look for include:

  • a sore or irritation that doesn’t go away
  • red or white patches
  • pain, tenderness or numbness in mouth or lips
  • a lump, rough spot, crust, or small eroded area
  • difficulty chewing, swallowing, speaking, or moving your tongue or jaw
  • a change in the way your teeth fit together when you close your mouth

Research has identified a number of factors that contribute to the development of mouth and throat cancers. Smokers and excessive alcohol drinkers older than 50 are the most at risk. More recently the human papilloma virus (HPV), a sexually transmitted disease, has been associated with oral cancers.

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Rethink Your Drink

sodaIn parts of the country it’s called pop or soda, and here in the south we call it by a brand name.  Whatever name it goes by, you may want to rethink what your drinking.  Soft drinks wreak havoc on overall health, especially dental health.

When a soda is consumed it is like rinsing your mouth with sugar and acid.  Even diet sodas are very acidic.  The sugar and acid feeds the bacteria already in your mouth.  This bacteria then produces even more acid, which results in tooth decay and dissolves the enamel of the teeth.

Soft drinks are the most consumed food in America, and a two liter bottle contains 54 teaspoons of sugar.

The Good News

You can reduce your chance of decay by taking the following steps:

  • Substitute as much as possible for less sugary drinks like water or milk.
  • Try only having soda at meal times.  Sipping throughout the day is the quickest way to get decay.
  • Use a straw to help keep the liquid off of your teeth.
  • Rinse with water after having a soda to help remove the residue of the drink, which can sit on your teeth and extend the teeth’s exposure to acids.
  • Get a professionally applied fluoride treatment from your hygienist.

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Bleaching Special!!!

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Would you like whiter teeth for your summer vacation, wedding, family photos or just for you?  Our office is offering a complete Zoom Nite White bleaching kit with trays and all necessary appointments for just $270. Call our office at 783-8008 or come by the office to get your smile bright for the summer. This offer runs through July 31, 2014.

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Happy 30th Work Anniversary Tina!!

Tina_30yrsWe would like to thank and congratulate Tina for walking through this same door for the last 30 years.  As our practice manager, she is an invaluable asset to our office and in Dr. Chamberlain own words “Tina has been looking after us for 30 years and we would be lost without her!”  When asked about her first 30 years she said, ” I have enjoyed every year here and look forward to many more.  Dr. Chamberlain is a very easy going and tolerant employer.”  Next time you see Tina, join us in thanking her for dedicated service to our practice.

 

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Welcome To Our Blog!

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We are now offering a new and exciting way to keep our patients informed on the latest topics in the dental field and the life of our office. We hope you will find our new blog informative and fun. If you haven’t already, don’t forget to like us on Facebook to stay up to date with our blog and other events.

Feel free to contact our Marion, VA office with any question regarding our services, appointments, or a topic you would like to see featured on our blog.

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