Monday, May 23, 2016

Dental Insurance 101

Believe or not, insurance is the aspect of dentistry we hear the most questions about. Insurances can be very confusing, and sometimes not very easy to deal with. Our front desk is very experienced and can answer just about any question you have. In this post we hope to answer some general questions. If you have a specific question, or one that isn’t addressed here, please write to us. If we don't know the answer, we will find it for you.

One of the trickiest things about insurance is the whole network thing. Unless a plan is particularly restrictive, most patients can choose their own dentist. We participate in most Delta Dental and Blue Cross Blue Shield networks. A dentist being in-network or out-of-network affects how much of the payment the patient is responsible for; most out-of-network plans will still pay a portion of each procedure, but your portion may be higher. If you have questions about whether we are in your network, your human resources department should be able to tell you for sure.

Every employer chooses what plans to offer its employees, and sometimes one employer will offer different options based on your job within the company. You can’t assume anything about dental insurance; you and your neighbor could both have Delta Dental, but your job might offer one level of coverage and your neighbor’s coverage might be completely different. Most human resource departments will give you a booklet that breaks down what and how much is covered. It’s important to familiarize yourself with your specific insurance plan.

If your insurance allows you to visit us, we’ll figure out exactly what your plan covers. Each insurance policy has different coverage levels and stipulations, so there is no general answer. A quick call to your insurance company will give us a breakdown of your benefits.  This will tell us in broad terms what will be covered and allow us to estimate how much of our fee the plan will cover. We like to have this breakdown before you visit us, so we can accurately explain the financial side of proposed treatment plans. We’ll also review financial options available for work that is not covered by the insurance plan.

If there is a question about whether a specific procedure is covered, or if you’d like to know exactly how much of the fee insurance will cover, we can submit a pre-estimate for you. The insurance company processes the pre-estimate like a claim, and tells us exactly what they will reimburse. It it the only way to guarantee what your coverage will be before you come in. Any other fees we quote you are estimates. A pre-estimate doesn’t force you to complete the treatment plan, but the coverage is guaranteed for a year.

Our office will submit all claims to your insurance for you. One less thing you have to worry about! We also follow-up on any outstanding claims in our system. We take care of as much as we can on our end, but occasionally we do need your help. For example, the insurance company might send a letter to you requesting more information, such as whether you have any other coverage. It’s important to fill out and return these forms to the insurance company, as they often won’t resolve your claim until you do.

As a final thought: You always want to maximize your insurance benefits; you are paying for them! But keep in mind dental insurance companies are not on your side. They occasionally deny necessary or cost-effective treatment based on a black-and-white policy or obscure stipulation. It's important to remember this when you and your dentist look at treatment options. Make the best choice for you. Maximize your insurance, but don't let it tell you what to do!

Monday, May 2, 2016

This One's for the Kids

Some of our most frequently asked questions regard children’s dentistry. Home health care habits should be established at a young age, and should adapt as the child matures. ​With the advances in dental technology (fluoride, sealants, digital x-rays) over the last two decades, we've been able to cut childhood tooth decay in half. Our goal is to keep that stat up and help your children build strong dental habits early in life to keep their smiles bright and healthy. Here are some tips to guide you.

  • Infancy
    • Some infants are born with teeth, but most are not. Even if the baby has no teeth it’s important to create an oral healthcare routine. After each feeding, take a wet infant cloth and rub it along the baby’s gums. This will clean any food debris from the mouth, as well as stimulate the gum tissue.
    • Once the baby has teeth, it’s time to find a dental home. The American Academy of Pediatric Dentistry and the American Dental Association recommend bringing a child to the first dental appointment 6 months after the first tooth comes in (“erupts”), or by their first birthday, whichever comes first. This helps the child acclimate to the dental routine in a way that's not overwhelming. Early visits also serve as consultation sessions with the parents to address any concerns or questions they might have. Research shows that kids who get this type of early start tend to get fewer cavities.
    • Based on these visits, the dentist will recommend when to schedule the child’s cleaning. Every child is different. One child may sit for the hygienist at 2 or 3 years old, while another child may have a hard time with that. We understand that children mature at different rates and we don’t force the issue.

A woman's oral health can change based on hormone levels. That's why it's important for women to keep up with regular dental cleanings if they’re pregnant or trying.

  • Childhood
    • Use a kid’s toothpaste until the first baby teeth fall out. Then “graduate” to an adult toothpaste. By that point the child is old enough not to accidentally swallow the toothpaste. Adult toothpaste has stronger agents to prevent tartar buildup and staining.
    • Children tend to bite the toothbrush, causing the bristles to wear out sooner. A child's toothbrush will often need to be replaced more frequently than an adult's. When the bristles start to wear and fray, it’s time for a replacement.
    • As a general rule of thumb, parents should help with teeth brushing until the children are old enough to tie their shoes by themselves.
    • It’s also important for children to see parents brushing their own teeth. And also to see the clean, shiny smiles parents come home with after their own dental cleanings. When led by example, children are taught to appreciate healthy habits and will be more likely to keep up those habits into adulthood.
    • Definitely talk about the dentist with youngsters. Answer any questions they might have, in an honest but age-appropriate way. If they express fear or anxiety, let them know we are their friends. But please be careful of the words used. Words like "pain" or "hurt" or "needle" will do more harm than good.

If you as a parent have any questions or concerns about your child’s dental health at any time, please call us and set up a consultation visit.

  • School
    • If the school allows it, children should keep toothbrush and toothpaste in their desks or lockers so they can brush after lunch.
    • If it’s not allowed, or the child doesn’t have time to brush, give them “detergent foods” (apples, carrots, celery, etc) for lunch. They are slightly abrasive, not sticky, and have a high water content - natural cleaners that stimulate saliva! Foods like these should be eaten last to wash away excess food particles and protect teeth against decay-causing acid.
    • Another trick is to rinse with a little water after eating. Doing a little swish will help dislodge food particles so they don’t stick to the teeth and create cavities. It’s not the same as brushing but it’s a decent substitute.
    • Kids love to snack, but since snacking doesn’t produce as much saliva as eating a full meal, bits of food can stick to teeth longer, increasing the risk of decay. Dairy acts as a buffer to the acids bacteria produce. Drinking milk or eating cheese during or after snacking can help reduce tooth decay.
    • Student athletes are at a higher risk for tooth decay and erosion because breathing through the mouth during intense training causes dry mouth (saliva protects your teeth from tooth decay). Also, athletes tend to use acidic sports drinks and sugary carbohydrates to refuel. (Acid erodes enamel and sugar causes decay.) Athletes should practice excellent home care habits, and try to drink water over sports drinks.
    • Athletes of high contact sports are also at a high risk for dental injuries. Mouth guards should always be worn during practices and games. We can create custom-made mouth guards for athletes of all ages.
    • When children graduate to college, we tend to see a rise in the patient’s tooth decay. We understand how busy college life can be, but it is important that good home care habits are still practiced. Encourage students to brush and floss, and to schedule dental cleanings around school breaks. We will do our best to accommodate their schedules.

We know how busy life is, especially with kids! That's why we have evening and Saturday hours, appointment reminders, easy parking, diaper changing stations, and of course....the sticker drawer! If you have any questions about this post or wish to add your own tips, please feel free to leave a comment.