Best dental equipment is so important to dentistry. While how about other things? You may want to provide emergent and urgent care so people do not have to miss as much work. The problem with only providing this kind of care is it does not encourage people to take responsibility for their preventative dental health.
If diagnostic care, emergent/urgent care and preventive care are covered at 100% of dentist’s fee, what’s next?
Usually it’s eliminating existing pathology: infected gums and bone around the teeth, abscessed teeth and large caries lesions (cavities). These become emergencies and urgencies that cause missed work.
The next thing an employer must consider is repair dentistry. The more repair dentistry covered by the insurance, the higher the premiums will be to the employer. This brings up the pleasing smile issue. Many dentists are doing repair dentistry today because of 1) extreme makeovers and 2) mercury silver amalgam fillings.
Most of us have seen the extreme makeover program where people with bad smiles have them made over. This has placed a huge strain on dental insurance because people are going to the dentist wanting their smiles recreated. Unfortunately, many of the materials used in makeovers do not last as long and can cause damage to the nerves of the tooth, leading to more expensive problems.
One of the hottest debates in dentistry today is whether silver amalgam fillings are safe because they contain mercury. Many fillings are being replaced for this reason, adding onto dental premiums. From a purely scientific standpoint, there is no basis for replacing fillings because of mercury. If they wear out they have to be replaced, but they have not been proven to be unsafe.
After diagnosis, emergent/urgent care, prevention and elimination of pathology, fillings should be covered. The
most cost-effective are, anterior (front) cosmetic fillings so people can smile, and posterior (back) amalgam fillings where people chew.
This leaves the replacement of missing teeth. Because these prosthetic devices usually last for a long time and can be financed outside of dental insurance as a way to conserve costs, they should be considered for payment last.
Most insurance sold today limit costs by annual dollar amount maximums, usually $1,000 or $1,500 per year, with deductibles, and with co-pays. The traditional plans cover diagnosis and prevention at 100% of the dentist’s usual and customary fee. Fillings, treatment or pathology at 70% or 80%, and replacement of missing teeth and crowns at 50%.