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Nov 11 / Susan

Guide to Cosmetic Dentistry and Insurance Coverage

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Despite its booming popularity, cosmetic dentistry is often surrounded by questions and uncertainty. Some people associate it with fake smiles and Hollywood dentists, while some find out that fixing their chipped tooth might actually fit under the cosmetic category for their dental plan. What exactly is cosmetic dentistry anyway, and how do you know if dental insurance will cover it?

What Is Cosmetic Dentistry?

There tends to be some general confusion about how to define cosmetic dentistry. The generally accepted definition for cosmetic dentistry is the use of dental treatments and procedures to improve the appearance of the teeth and mouth. This simply means that cosmetic dentistry typically deals with personal preferences, not health issues. However, some procedures may fix an existing health issue as well as correct the appearance. Procedures like this can help correct alignment, color, arrangement or shape.

Which Procedures Are Considered Cosmetic?

When using the above definition of cosmetic dentistry, you may be surprised at which procedures are actually included. Some procedures can even be considered both cosmetic and general dentistry depending on the circumstance. Here are some of the most common cosmetic procedures and what they include:

Teeth Whitening/Bleaching

Teeth whitening is performed when the patient wants a brighter and whiter smile. This procedure can be performed whether they would like to reduce staining and discoloration or simply improve the teeth based on their personal preferences. Numerous options for teeth whitening go from in-office bleaching from your dentist to other less expensive options like whitening trays, gels, strips and toothpastes. This is entirely cosmetic dental work.

Bonding

Bonding uses a composite resin material to repair broken or chipped teeth and even build up the edges of crooked teeth to make them look straighter. Dentists often use a similar material to fill cavities, and because it is more visually appealing than the longer-lasting metal amalgam, many insurance companies will not cover as much of the cost. It is almost invisible, so if you need to repair a scratch or chip, it blends in with your other teeth. This is often used for non-cosmetic procedures too.

Onlays/Inlays

Onlays and inlays are suggested when there is structural damage to a tooth. An onlay or inlay is a cross between a crown and filling. It fulfills the purpose of a filling, to prevent future decay and cavities, and fits over the tooth like a crown (though it doesn’t completely cover the tooth). Onlays and inlays are more structurally secure than regular fillings and are used when someone has a cavity so large that it would endanger the tooth structure to use a softer substance like metal amalgam or resin composite. They are made of porcelain in a laboratory exactly pertaining to the specific damage on the tooth rather than being created directly against the tooth. After receiving them from the laboratory, the dentist bonds them to the damaged area. Unless made out of gold instead of porcelain, the onlay or inlay is invisible and appears no different from the rest of the teeth. This could occasionally be considered cosmetic.

Veneers

Veneers are thin shells bonded to the front surface of the teeth in order to change the appearance and make it more pleasing. These can be made of porcelain or composite resin materials depending on preference. Veneers can cover teeth that are discolored, worn down, chipped or broken, uneven or misaligned, have gaps or are irregularly shaped. One major advantage of getting veneers is that they have a natural tooth appearance (unless you go overboard on wanting perfection – nobody’s teeth are that white). These are very rarely considered a necessary procedure for the health of the patient.

Tooth Implants

Implants are titanium replacement tooth roots that are screwed into the jawbone to support a false tooth. Their main purpose is to replace missing teeth and prevent jawbone deterioration. In addition to providing a more stable false tooth than bridges or dentures, dental implants also function to trick the jawbone into believing that the tooth is still there, preventing future bone loss in the jaw. Due to increasing success rates, implants are beginning to replace bridges and partial dentures when dealing with tooth loss. Despite the proven health benefits, some insurance plans still consider it a luxury and may not cover much of the procedure.

Tooth Caps

Caps, also known as crowns, may be necessary when the exposed part of the tooth is damaged but the roots are structurally sound. Many things can cause damage to the surface of the tooth, such as grinding, aging, an improper bite, old fillings or tooth decay. Adding a cap on top of the damaged tooth can help provide the durability and strength that was otherwise missing and give it a seamless, healthy appearance. Crowns are sometimes considered cosmetic if you use them simply to cover up an unshapely tooth and make it look nicer, but they are usually not considered cosmetic if the tooth is falling apart or they need to cover the open space left by a root canal procedure.

Orthodontics

Orthodontics generally refers to the use of braces in order to improve the bite or create a more attractive smile by slowly straightening the teeth. There are several types of braces, including metal braces, “invisible” braces, lingual braces, self-ligating brackets and ceramic brackets.

Metal braces are the most common and usually take from one to four years to finish treatment. Metal brackets are bonded to the teeth with an arch wire threaded through them and rubber bands holding the wire in place. Invisible braces are a new system that allows teeth to straighten without the unappealing look of metal on your teeth, but it cannot be used for major changes. No matter the type, when braces are removed a retainer is typically used to help the teeth set permanently and not move out of place. Braces are a great way to straighten teeth and get the smile you always wanted, but they’re not always cosmetic. Crooked teeth can sometimes interfere with a person’s bite and cause serious dental problems if not treated.

Tooth Contouring/Reshaping

Contouring/reshaping is a quick treatment that can help correct mild cases of crooked, cracked, chipped or overlapping teeth. This procedure can sometimes have the same effect as braces simply by trimming a few millimeters off the tooth and, in some cases, replacing it with tooth-colored laminate. This can also help get rid of minor defects on your teeth to improve the appearance of your smile based on your preferences. One great advantage about this procedure is that it is painless and instantaneous. It can be completed in one appointment with a dentist without any anesthesia. This is a cosmetic procedure, in most cases, and can only be used if the problem to be corrected is minor.

Are These Procedures Expensive?

Cosmetic dental procedures can be very costly but have also become more widely available in the past few years. Increasingly high demand and advances in treatment processes have both contributed to the rise in popularity. Cost for these procedures varies as much as the procedures themselves. Many people look for insurance or discount dental plans to help lighten those prices. This often proves difficult, since many insurance options do not cover cosmetic procedures. Discount dental plans usually provide some discount on cosmetic procedures. Regardless of which route you take, an insurance or dental plan can definitely help take some of the pressure off the possibly expensive prices.

Insurance Plans

Some insurance plans do not cover many cosmetic procedures, if any, and most don’t include teeth whitening/bleaching. The ones that do tend to have higher premiums and deductibles, as they are the premier plans. Here are a few dental insurance plans that provide some coverage for cosmetic dentistry:

  • 1Dental Value, Classic and Premier Plans all cover braces for children and adults as well as several other cosmetic treatments. Many procedures not “covered” are still discounted for policyholders on these dental insurance plans. Depending on which of the three plans you prefer, these start at about $23 per month.
  • AARP Delta Dental Plan “A” offers coverage on basic procedures as well as many cosmetic procedures after one year of enrollment. Some of the cosmetic procedures it includes are crowns, prosthodontics and implants. Delta Dental will pay 50% of the procedure cost after the one-year waiting period. This plan usually costs around $50 a month for one individual.
  • Anthem Blue Cross Dental Blue Enhanced PPO is Anthem’s top dental PPO plan, and it appears to be their only one that covers major services. Some of the cosmetic procedures it includes after a 12-month waiting period are prosthodontics, implants, orthodontics and some savings on veneers. Orthodontics are only covered for children, and members receive a 50% payment for the cosmetic procedures. This plan usually costs around $50-$60 a month for one individual.
  • Assurant Health Dental Plus Plan is the company’s top dental plan and the only one that covers both basic and major services. This includes a number of cosmetic procedures like inlays/onlays, crowns and prosthodontics. After a six-month waiting period, policyholders may receive a 50% cash payment of the per-service benefit on major services. For the second year, the payment will be 100% of the pre-determined cash benefit until a specified maximum is reached. This plan appears to run around $35 a month for one individual.

Discount Dental Plans

Discount dental plans are becoming more prominent in the dental world. Here are a few that actually discount most cosmetic dental procedures:

  • Careington Care 500 and Point of Service (POS) plans both include discounts on all cosmetic procedures except, in some cases, teeth whitening and invisible braces. Discounts start right away and include braces for adults and children, implants, caps and crowns, veneers, etc. Cosmetic procedures can run from 20-60% off. The Care 500 plan tends to have slightly better discounts, and the POS plan tends to have a few more dentists in the network. Both the Care 500 Series and the POS plan cost around $75 per year for one individual.
  • Aetna Dental Access plan offers discounts on a variety of cosmetic procedures. Discounts range from 15-50% off, though most cosmetic procedures may lean more toward the 15% range. Members can use the discounts seven to ten business days after signing up. Membership with the Aetna dental plan is just over $75 per year for an individual.

Whether you need implants or you just want your teeth whitened, one of these dental plans may help keep your costs down. Whichever you choose, carefully examine their policy on cosmetic procedures to make sure that they cover or discount the procedures you would like. This can help you narrow down the daunting task of researching so you can make the best decision possible.

One Comment

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  1. Sharon Emery / Mar 10 2014

    This info seems to be very helpful. Will check into these options. I need teeth extracted, gums treated for disease and implants to prevent further bone deterioration.

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