We know it can be frustrating and sometimes complicated to understand, what is and is not covered under your particular insurance plan. If you do not understand the reimbursement levels on your bill you’re not alone. We are providing the following information to answer some of our patients questions about their insurance coverage.

What is dental insurance?

A dental benefit plan helps you pay for the cost of your dental care. It is a contract between your employer, or plan sponsor and a third party (insurance company) These contracts vary widely. You need to know how your dental plan is designed and it’s limitations. It may not cover the total cost of your bill. Most plans cover between 50 to 80 percent of dental services.

What is a UCR program?

“Usual, Customary and Reasonable” (UCR) programs usually allow patients to go to the dentist of their choice. These plans pay a set percentage of the dentist’s fee or the plan administrator’s “reasonable” or “customary” fee limit, whichever is less. Although these limits are called “customary,” they may or may not accurately reflect the fees that area dentists charge.

There is no regulation as to how insurance companies determine reimbursement levels, resulting in wide fluctuation. So, on your bill the fee that your dentist has charged you may be higher than the reimbursement levels of your UCR plan. This does not mean your dentist is overcharging you.

Factors that influence your reimbursement levels

• Annual maximums-Your plan purchaser makes the final decision on “maximum levels” of reimbursement through the contract with the insurance company. Even though the cost of dental care has significantly increased over the years, the maximum levels of insurance reimbursements have remained the same since the late 1960’s. Many plans offer higher maximums that are comparable to rising dental care costs. Check with your purchaser.

• Preferred providers-Your plan may want you to choose your dentist from a list of their preferred providers. Whether or not you choose your dental care from this defined group can affect your levels of reimbursement.

• Least expensive alternative treatments-Your dental plan may only allow benefits for the least expensive treatment for a condition. For example, your dentist may recommend a crown, but your insurance may only offer reimbursement for a large filling. As with other choices in life -such as purchasing medical or automobile insurance, or buying a home-the least expensive alternative is not always the best option.

• Preexisting conditions-Just like your medical insurance, your dental plan may not cover conditions that existed before you enrolled in the plan. Even though your plan may not cover conditions, treatment may still be necessary.

• Treatment exclusions-Your dental plan may not cover certain procedures or preventative treatments, such as sealants, that can save you money later. This does not mean these treatments are unnecessary. Your dentist  can help you decide what type of treatment is best for you.

If you have further questions about dental insurance or any other aspects of cosmetic dentistry please write them in the comments portion of this blog. We will be using this forum to answer our patient’s questions and keep our clients up-to-date on cosmetic dentistry procedures.

Our goal is to provide our clients with  quality and caring cosmetic dentistry services. We look forward to collaborating with you for your dental health.

WE all know how important a beautiful smile is in giving a great first impression. But did you know that the differences in the lengths of your teeth convey certain meanings to others? And that their impression of you is influenced by these psychological factors?

When making any changes to your smile you should consider carefully what kind of psychological messages different smile designs convey. In cosmetic dentistry there are basically 3 smile designs:

• Sexy-features variations in the length of the teeth. In this design the central incisors are longer than the lateral ones and draw the eye to the center of the face. We mentally associate longer, prominent, unworn incisors with youth so this design conveys sexiness, boldness and warmth.

• Sophisticated-in this design the teeth make a straight horizontal line and emphasize the width of the lower face. Because of tooth wear our teeth become more uniform in length as we age so this design mentally conveys maturity and intelligence.

• Sporty-this design is in-between sexy and sophisticated. The central incisors are only a little longer than the lateral ones so it’s not quite as serious looking as the sophisticated smile but a little more mature than the sexy smile. It conveys casualness, informality and warmth.

Within these 3 basic designs are many variations, so you can see that it is very important that you work closely with your cosmetic dentist to plan the right design for you and for the impression you wish to convey. Some factors to consider in your smile design are:

• Facial shape-your teeth can either balance or emphasize certain features

• Your desires-what impression do you want to make on others

• Age-how young or mature would you like to appear

A cosmetic dentist is different than your usual family dentist in that he understands the psychological aspects of smile design along with the technical ability to realize that design. He can help you to make the right choices in designing your new smile.

If you are considering a smile makeover please call our office for a consultation. Together, we can design the smile of your dreams.

Did you know that if you are a woman you are twice as likely to suffer from the pain caused by TMD? You might know it as TMJ syndrome. Temporomandibular joint disease is a painful condition affecting the jaw and soft tissues that allow you to use your mouth to speak, bite and chew. The pain can range from a mild ache to being chronically debilitating.

Other symptoms are:

• Headaches-Migraines especially can be associated with TMD

• Jaw, neck, or ear pain

• Clicking or popping noises when you chew

• Sensitive teeth or vague tooth soreness

• Jaw locking opened or closed

Our team is focused on giving you the best care possible. To accomplish this we regularly attend continuing education courses that help us add to our skills and knowledge. Our most recent course dealt with TMD diagnosis and treatment. Diagnosis involves three steps:

1. Joint Vibration Analysis (JVA) uses headphones to discern what is going on in the jaw bone as it functions. This diagnostic tool is much more affordable and definitely less time consuming than an MRI which was usually used in the past.

2. Jaw tracker (JT) helps discern the point of dysfunction in the jaw in a non- invasive way.

3. Tech scan-to measure occlusion (bite) has the patient bite down on a special sensor which can make an instant diagnosis of occlusion problems.

These evaluations provide enough information to locate the pain or jaw problem, make a diagnosis and to start treatment. Simple, conservative treatment is usually all that is needed.

If you are experiencing any of the symptoms mentioned above please call our office for a consultation. Working together we can find the right solution for your problem.