Wednesday, December 7, 2011

Will Your Medical Insurance Ever Cover Dental Work?

These days, it's important to be educated about all of your options for cutting your health care costs. One option that people aren't often aware of is that in some cases you may be able to get selected dental services covered by your medical insurance. This is one way to help reduce your out-of-pocket costs and leave more of your dental benefits (which often have lower coverage limits) intact for routine services.

The Exception to the Rule

It's important to mention that most routine services like cleanings, fillings, and crowns are almost always excluded from medical insurance coverage. But if dental work is needed as a result of a chronic disease, performed to improve a medical condition or done to restore teeth following an accidental injury, you might have coverage. 

It's wonderful that medical insurance companies see the merit of covering some of these procedures for their subscribers. With training and some willingness to learn by trial-and-error a few dental offices are starting to get familiar with the process. Medical insurance is a whole different ballgame than dental insurance submission but you can help your office by collecting all your medical insurance information like your ID card, benefits paperwork, and contact information for your insurance plan. 

Some scenarios where you might qualify for medical coverage include:

1. You are diagnosed with sleep apnea and you end up hating your CPAP breathing machine so your doctor recommends a special mouthguard instead.
2. You are taking a medication for high blood pressure that sometimes has the side effect of causing extra gum tissue to grow over and even cover some of your teeth. Your dentist uses a LASER to remove some of this to improve the appearance of your teeth and make them easier to keep clean.
3. Your have a small sore on your tongue that won't go away so your dentist performs a biopsy to give you peace of mind and rule out something harmful like cancer.
4. You find out that you need a kidney transplant. Before your doctors will approve you for surgery they ask you to take care of any dental infection, like that broken molar in the back that has been bugging you on and off.
5. You are in a car accident and although thankfully you don't have any major injuries, the accident left you with two broken front teeth that need to be repaired with crowns. 

Worth a try?

Although medical coverage for dental treatment only applies to specific situations and varies widely among carriers, it's one more tool to stretch your healthcare dollars. It never hurts to ask, so the next time your dentist recommends a procedure that seems to be closely related to your general health, you might want to bring it up!

Wednesday, May 4, 2011

What's in a Brush?

     The first toothbrushes were most likely branches with small, sturdy foliage. Brushes sure have changed over the years but the concept remains the same: when sticky plaque builds up on teeth you need some kind of mechanical scrubbing action to get it off. When you combine a brush with something abrasive (enter toothpaste) then you really have an efficient combination for removing the gunk and junk that is left after meals.

     As a dentist, I get asked about toothbrushes all the time. As any trip to your local pharmacy will prove there are a dizzying array of choices available, from the tried-and-true manual brush to battery-operated spinning brushes as well as the high-end rechargeable power brushes. Many of these (especially the more expensive models) claim to be the best brush out there for keeping dental problems away. Is there a best brush? Despite all the ads, research doesn't give us a clear cut answer. What we do know is this: any brush out there can effectively remove decay-causing plaque from your teeth if it's used correctly. That means that with the right technique, the $2 model can be just as good as the $200 one.

     So what's the right technique? The dental profession has given names to all sorts of techniques over the years, and the current one that stands out right now is called the modified Bass technique: small, circular motions with the brush held at about a 45 degree angle so it's touching both tooth and gum at the same time. Move from tooth to tooth slowly, taking 2-3 minutes to do your whole mouth. Be sure to get the backs of all your molars, where food often collects after a meal.

     Is it really that simple? It can be. Where people run into problems is by speeding up the process (three minutes is actually a really long time when you're watching the clock) or by using too much force. While taking shortcuts will leave plaque on your teeth that can harden into tartar, using too much force gets your teeth too clean. Clean, smooth teeth are definitely what you want, but brushing too hard will wear away enamel and even gum tissue over time, creating large defects that can tarnish your smile and require fillings, crowns, or gum grafting to correct. The ideal pressure is just enough to remove food and no more. Realize that toothpaste is mostly pumice, so it doesn't take much force at all to scrub your teeth clean.

    So is there a place for electric brushes? While they aren't necessarily better, they can be more convenient. They take the guesswork out of the small circles, so they difference is sort of like a push lawnmower versus a walk-behind model. Also, the spinning action works well enough that little-to-no pressure is needed, so if you're prone to recession these brushes can be better for you. If you're concerned about the price tag, the $8-10 models that run on AA batteries or are disposable can be a great 'test-run' before you decide if you want to commit to one with more bells and whistles.

   A more expensive brush is not a guarantee of less dental problems, but it might be for you. If you're keeping problems at bay with the $2 model though, there might not be any advantage to switching. If you're wondering if what you're hearing is hype or not, your dental team can guide you in the right direction.

Thursday, January 20, 2011

What's the Best Toothbrush?

     Just before the holiday season last year I was fortunate to do a segment on our local ABC morning show that focused on this question. It was great to be invited and I had a really good time doing the piece. I've done some TV appearances before but despite my best efforts I usually get a little nervous when the lights come up and we're on live TV. This time though, I found I was a lot more relaxed. You could almost call me calm. At first I gave myself way too much credit and thought I had conquered the jitters that come with being on TV for someone who isn't used to doing it very often. But then it dawned on me: I was calm because this is a conversation I have several times a week in my own office with patients. It's probably the most common question that patients ask, along with 'what's the best toothpaste, floss, denture adhesive, etc...'. It's a question that many people want answered because they are overwhelmed with marketing messages that make all sorts of claims about oral health products. Because most people would like to avoid time in the chair treating decay or other dental problems, many people are interested in using a product if it can give them an edge and further reduce their chance of disease. But how do you sift through all this information? As a dentist, I can tell you the answer isn't one you would expect (but here's a hint: it's more about how you use what you buy than the name on the box; more on that later!).

     There are a lot of great products out there, from multi-setting high-powered brushes to the tried-and-true manual brush (which itself has transformed some over the years). In the next few posts we'll explore some different options and hopefully empower you to find the best combination of preventative products to keep you out of the dental chair for the dental problems you don't want to deal with while keeping your options open for any cosmetic work that you do want. Next up: 'All Your Brushing Options'.