Navigating the World of Dental Insurance Terminology

January 27th, 2016

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 Sidney D. Kelly, DMD Family and Cosmetic Dentistry. 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 Drs. Sidney and Jacob Kelly, 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– Drs. Sidney and Jacob Kelly 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 Roseville, CA office.

How do OTC whitening treatments compare to in-office whitening?

January 27th, 2016

If you are unhappy with the color of your teeth, teeth whitening may be an excellent choice for you. Many patients of Drs. Sidney and Jacob Kelly suffer from darkened teeth due to the natural aging process, regular consumption of coffee or tea, or nicotine staining from cigarettes.

Some people may have darkened teeth due to long-term use of medication. Certain medication-related stains on the teeth cannot be lightened, but virtually every other type of teeth stains can be effectively lightened using either professional dental whitening or at-home whitening.

While both types of whitening have benefits, at-home kits are less expensive and less effective overall. Professional teeth whitening is a highly effective option, but it requires a bit more of an investment. Here is the basic info on each type of whitening.

At-Home Whitening

At-home whitening is done in a number of different ways today. Some of the most popular options include:

  • Whitening strips that are applied to teeth and then removed after a specified period. These will typically be used once a day for at least a week.
  • Whitening gels or pastes that are placed in a one-size-fits-all plastic tray. These trays are worn, retainer style, for a set period of time once a day.
  • Whitening toothpaste, which is used daily, and whitening mouthwashes are also available today. These products require constant use to realize results.

In-Office Whitening

In-office whitening is the fastest way to achieve whiter teeth. If you want an almost immediate difference in the color of your teeth and their overall appearance, this is probably the option for you.

Drs. Sidney and Jacob Kelly will typically apply the whitening formula directly to your teeth. Following the application, we will have you relax in our office between half an hour and an hour.

Some office-whitening formulas are strengthened with the use of heat, specialized lighting, or laser application. Patients will usually notice whitening results after only one application, but it usually takes at least a few appointments at Sidney D. Kelly, DMD Family and Cosmetic Dentistry to notice a truly dramatic change in tooth color.

Quit Smoking to Save Your Smile

January 27th, 2016

You’ve likely heard that smoking increases risk of lung cancer and emphysema. But did you realize that your cigarette habit also has an impact on your smile? Chronic smokers suffer from increased dental problems that make their smiles unsightly. Understanding how smoking affects your oral health may provide the momentum you need to kick the habit for good.

Cosmetic Changes Associated with Smoking

Cigarettes contain more than 600 ingredients that, when lit, create in excess of 4,000 chemicals. Of these chemicals, many are known carcinogens while others have been shown to have serious negative effects on health. The nicotine and tar in tobacco products are absorbed by the enamel of your teeth. The result is yellowed teeth that look unsightly; with heavy smoking, your teeth may eventually turn nearly brown in color.

The chemicals in cigarettes and cigars also cause your teeth to become less clean. Smoking is associated with a build-up of tartar and plaque on the surface of your teeth. Over time, this increases your risk of developing cavities and other oral health problems. Furthermore, pursing your lips while smoking leads to wrinkles around your mouth, which detracts from your smile.

More Serious Dental Conditions

In addition to having unsightly teeth, smoking can cause serious health conditions. Because of the carcinogens in cigarettes, smoking is associated with an increased risk of oral cancer, which can be deadly. Smokers are also more likely to develop gum disease, which can lead to tooth loss. You may experience an increased loss of bone within your jaw, which will cause significant problems later in life.

Treatment for Smoking-Related Oral Health Problems

Drs. Sidney and Jacob Kelly and our team at Sidney D. Kelly, DMD Family and Cosmetic Dentistry will tell you that the best defense against smoking-related oral health problems is to ditch your nicotine habit. By decreasing the amount of nicotine and other chemicals you consume, you can decrease your risk of oral cancer and gum disease. Remember to mention your smoking habit when you’re at our Roseville, CA office. We frequently treat smokers and can recommend smoking cessation programs to help you quit. Drs. Sidney and Jacob Kelly can also advise you about whitening treatments and gum disease prevention activities that ensure you’ll have a beautiful smile for years to come.

Diabetes and Dental Care

January 20th, 2016

When most people think of complications of diabetes, they think of an increased risk of blindness, limb amputation, heart disease, and neuropathy. However, Drs. Sidney and Jacob Kelly and our team want you to know that emerging research is revealing a possible connection between uncontrolled diabetes and dental problems. Whether you have type 2 diabetes or type 1, uncontrolled high blood glucose level increases the risk of certain oral health conditions, including:

  • Cavities
  • Tooth decay
  • Gingivitis (early gum disease)
  • Periodontal disease (advanced gum disease)

Diabetes and proper dental care

If you have diabetes, it is more important than ever to take your dental care seriously and practice excellent oral hygiene. These recommendations will help:

  1. Manage your diabetes. First and foremost, it is vital to control your high blood sugar in accordance with your physician’s instructions — not only for the sake of your oral health, but your overall health. With properly controlled blood sugar, you reduce your risk of developing gingivitis and other oral health issues.
  2. Practice good at-home oral hygiene. This means brushing at least twice a day AND flossing. At a minimum, brush your teeth in the morning and at night, but after meals and snacks if you can. Use a soft toothbrush to avoid injuring your gums. Don’t neglect flossing, because it helps to remove plaque below the gumline and between teeth.
  3. Visit the dentist regularly. While it is important to see the dentist every six months even if you don’t have diabetes, it is even more crucial to have a professional teeth cleaning and dental exam if you have the disease. As dental professionals, our team at Sidney D. Kelly, DMD Family and Cosmetic Dentistry is able to detect early dental conditions before they develop into something more serious and costly.
  4. Tell your dentist that you have diabetes. If you were recently diagnosed with diabetes, be sure to let us know as soon as possible, and remind us at every appointment.
  5. Be conscientious about examining your own gums and teeth. By looking for early signs of gum disease, which can include bleeding gums, irritated gums, gums that are red (versus a healthy pink), or swelling, we can get started on treatment right away.

Managing diabetes takes effort, not only in watching your diet, exercising, monitoring your blood sugar levels, and taking your medication, but obtaining proper dental care.

To learn more about the link between diabetes and oral health, or to schedule an appointment with Drs. Sidney and Jacob Kelly, please give us a call at our convenient Roseville, CA office!

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