Why Dental Care Matters
You know many tips to stay healthy, such as eating fruits and vegetables, exercising regularly, and getting enough sleep, but did you know that practicing proper preventive dental care can also dramatically impact your overall health? Healthy dental hygiene can reduce your risk of developing dental problems, which can be associated with additional health issues.
Take, for example, gum disease, which has been linked to oral cancer, heart disease, diabetes, respiratory ailments, preterm birth, skin diseases, thyroid problems, and leukemia (1). Preventive dental services and routine dental care are critical components in helping to prevent serious health issues. A recent study conducted by Dominion Dental Services found that preventive dental care can be associated with reduced emergency room visits and hospitalizations for people with chronic medical conditions (2).
Preventive Dental Care
Preventive dental care includes semi-annual dental checks-ups and routine dental care. At the dentist's office, preventive care usually includes teeth cleanings, oral exams, X-rays and fluoride treatments for children. Some insurance plans offer members incentives to encourage wellness, help prevent future costly restorative work, and lower out-of-pocket costs. For example, Dominion Dental Services’ standard and high plans offer a Prevention Rewards Program, in which each family member who receives two cleanings during the plan year from a participating Dominion network dentist receives a $20 office copay reimbursement.
At home, preventive dental care consists of daily brushing, flossing, and eating a balanced diet. It’s essential to brush your teeth twice a day for two minutes and floss daily to prevent cavities and gum disease. Additionally, a balanced diet can protect your teeth by providing them with nutrients. Limiting your sugar intake and drinking plenty of water also helps to prevent cavities and promote healthy teeth.
While brushing teeth twice a day and flossing daily assist in the prevention of dental problems, semiannual dentist visits are also necessary as they promote early detection of dental issues that cannot be spotted at home. Early detection allows for timely treatment, which can help to avoid more serious and costly issues that could arise the longer a problem goes undetected. Dental insurance can encourage preventive dental care, and research suggests that people with dental coverage are twice as likely to visit a dentist than those without dental insurance (3).
Preventive dental care is especially critical for at-risk populations, which includes people with diabetes and expectant mothers. For example, diabetics are at a higher risk for gum disease, and other oral health issues such as thrush and dry mouth, which can cause soreness, ulcers, infection and cavities (4). Additionally, it is estimated that up to 50% of pregnant women develop pregnancy gingivitis and dentists may recommend an additional cleaning to help manage it (5). Due to the higher risk for these populations, some dental plans such as Dominion Dental Services, provide these groups with an extra cleaning. If you are a diabetic or expectant mother, you may want to select a dental plan that covers an additional cleaning.
Coverage for Non-Preventive Dental Care
While most dental plans cover preventive care at no charge, calculating out-of-pocket costs for non-preventive dental services differs depending on plan type.
A Dental Health Maintenance Organization (DHMO) plan includes predictable, pre-determined fees designed for transparency. In a DHMO plan, there are specific co-payments listed for each covered service. If you know the dental procedures you need to have completed, you will know exactly how much you will pay for your dental care before you even go to the dentist.
A Preferred Provider Organization (PPO) plan covers procedures at a co-insurance percentage. With a PPO plan, your out-of-pocket costs may not be immediately evident. For example, a major service like a crown may be covered at 50 percent. To calculate your actual cost, you will need to determine how much your dentist will charge you for that procedure under the contracted arrangement with the dental plan. It is also important to understand your plan’s annual maximum as your plan will only cover up to that amount each year. Dominion’s DHMO plans have no annual maximum limit to the number of services you receive each year.
Many dental carriers provide a comparison tool that will allow you to compare features and your cost for specific procedures. Compare costs and co-pays for standard and high Dominion Dental Services plans here.
2020 Open Enrollment
This year’s open enrollment season for choosing a dental plan runs from November 11, 2019, through midnight EST December 9, 2019, for coverage effective January 1, 2020. Retirees who are currently enrolled in a Federal Employees Dental and Vision Insurance Program (FEDVIP) plan will automatically continue enrollment into 2020. If you want to cancel or change your dental plan in any way, you must contact BENEFEDS during open enrollment.
Keep Up with Changes to Tricare and Your Other Benefits
1. According to the American Dental Hygienists’ Association (2008) and Gust in, K.M. (2006, Dec.). Discussing ; ; Dental. National Provisioner. 220(12). 26-29.
2. Dominion Dental Services, Capital BlueCross and Geneia Medical/Dental Integration Study, July 2015-June 2017.
3. National Association of Dental Plan. The Haves and Have-nots: Consumer With and Without Dental Benefits. February 2009.
4. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes, Gum Disease, & Other Dental Problems, 2019, niddk.nih.gov/health-information/diabetes/overview/preventing-problems/gum-disease-dental-problems.
5. American Dental Association. Pregnant? 9 Questions You May Have About Your Dental Health, 2019, mouthhealthy.org/an/pregnancy-slideshow.