Navigating the World of Dental Insurance Terminology
December 24th, 2014
Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.
A Basic Glossary
Annual Maximum–The maximum amount your policy will pay per year for care at Kenneth Sloane, DDS. It is often divided into costs per individual, and (if you are on a family plan) per family
Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care
Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract
Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures
Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Dr. Kenneth Sloane, X-rays, and evaluations
In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”
- If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.
Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)
- This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.
Limitations/Exclusions– A list of all the procedures an insurance policy does not cover
- Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.
Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan
Provider– Dr. Kenneth Sloane or other oral health specialist who provides treatment
Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier
There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Closter, NJ office.
Don’t procrastinate about dental work!
December 17th, 2014
When you have dental issues or just need routine care, you may try to put off making an appointment at Kenneth Sloane, DDS. Common reasons for procrastination are not having the time or fear of pain. Avoiding Dr. Kenneth Sloane is not a good idea, though. Putting off dental care can turn small problems into large ones. Short appointments turn into long ones with significantly more work and expense.
What happens when you wait?
The small cavity that could have been filled easily has turned into a large cavity. The larger the cavity, the more work required to fill it. However, this is only a minor problem compared to more advanced issues. The minor toothache you are trying to ignore could be a small fracture or an abscess. Small fractures can sometimes be repaired, but if you wait and the fracture increases, you may need to get a crown.
An abscess can be treated in the early stages. Ignoring an abscessed tooth may lead to root damage and the need for a root canal. Infection can spread to other teeth, which multiplies the damage. These treatments will require more of your time than you would have spent taking care of the problem early.
Perhaps you are just putting off a routine cleaning. Even if you brush, rinse, and floss the way you are supposed to, you need a professional cleaning at Kenneth Sloane, DDS. Plaque that is left behind hardens into calculus or tartar that you cannot remove by yourself. A build-up of calculus can also lead to gum disease.
Unfortunately, avoiding appointments due to a lack of time may mean that you have to give up substantially more time later on. You also can experience needless pain from tooth problems. It’s always best to visit Dr. Kenneth Sloane for regularly scheduled cleanings and exams to ensure your smile stays healthy and beautiful.
How do I pick the right toothpaste for my needs?
December 10th, 2014
With so many toothpastes available in so many price ranges, it can be difficult to be sure you are selecting the right one for your needs. You need a product that not only protects against tooth decay, but also addresses any special concerns that Dr. Kenneth Sloane and our team have raised. Look for the American Dental Association seal and do some research to find the toothpaste that best meets your needs.
Choose a Product Approved by the American Dental Association
The American Dental Association approves dental products such as toothbrushes, dentures, mouthwashes, dental floss, and toothpastes when they meet certain quality standards. Before products can display the seal, the American Dental Association must verify that the product does what it claims to do. Look for the American Dental Association seal on the toothpaste package before you buy it. Also, check to make sure that the toothpaste contains fluoride, which helps protect against decay.
Consider Special Needs
You may be depending on your toothpaste to perform extra tasks beyond cleaning your teeth. These are some common concerns that the right toothpaste can address.
- Bad breath (halitosis)
- Sensitive teeth
- Plaque or gingivitis
- Tartar
- Yellowing teeth
The American Dental Association’s website has a tool that lets users input their requirements and view a list of the toothpastes that carry the American Dental Association’s seal and address those particular oral health needs.
Make Your Children’s Tooth-Brushing Experience Fun
If you select toothpaste that contains fluoride and has the American Dental Association seal, most types of toothpaste will be fine for your children as long as they have no special needs. Allowing your kids to select fun toothpaste can encourage them to enjoy the brushing experience more, so that they brush more frequently and do a better job.
The following toothpaste characteristics can make brushing more fun for children.
- Fun flavors, such as bubble gum, berry, and watermelon
- Sparkles and swirls that make the toothpaste appear more attractive
- Toothpaste that comes in a pump
- Toothpaste with a container decorated with superheroes
Osteoporosis and Oral Health
December 3rd, 2014
Today, Dr. Kenneth Sloane and our team at Kenneth Sloane, DDS thought we would examine the relationship between osteoporosis and oral health, since 40 million Americans have osteoporosis or are at high risk. Osteoporosis entails less density in bones, so they become easier to fracture. Research suggests a link between osteoporosis and bone loss in the jaw, which supports and anchors the teeth. Tooth loss affects one third of adults 65 and older.
Bone density and dental concerns
- Women with osteoporosis are three times more likely to experience tooth loss than those without it.
- Low bone density results in other dental issues.
- Osteoporosis is linked to less positive outcomes from oral surgery.
Ill-fitting dentures in post-menopausal women
Studies indicate that women over 50 with osteoporosis need new dentures up to three times more often than women who don’t have the disease. It can be so severe that it becomes impossible to fit dentures correctly, leading to nutritive losses.
Role of dental X-rays in osteoporosis
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) released research that suggest dental X-rays may be used as a screening tool for osteoporosis. Researchers found that dental X-rays could separate people with osteoporosis from those with normal bone density. As dental professionals, our team at Kenneth Sloane, DDS are in a unique position to screen people and refer them to the appropriate doctor for specialized care.
Effects of osteoporosis medications on oral health
A recent study showed that a rare disease, osteonecrosis, is caused by biophosphenates, a drug taken by people for treatment of osteoporosis. In most cases, the cause was linked to those who take IV biophosphenates for treatment of cancer, but in six percent of cases, the cause was oral biophosphenates. If you are taking a biophosphenate drug, let Dr. Kenneth Sloane know.
Symptoms of osteonecrosis
Some symptoms you may see are pain, swelling, or infection of the gums or jaw. Additionally, injured or recently treated gums may not heal: teeth will be loose, jaws may feel heavy and numb, or there may be exposed bone. Some of the steps you can take for healthy bones are to eat a healthy diet rich in calcium and vitamin D, regular physical exercise with weight-bearing activities, no smoking and limited use of alcohol, and report problems with teeth to our office, such as teeth that are loose, receding gums or detached gums, and dentures that don’t fit properly.
For more information about the connection between osteoporosis and oral health, or to schedule an appointment with Dr. Kenneth Sloane, please give us a call at our convenient Closter, NJ office!