In the last couple of columns I discussed how dental insurance works. If you missed them you can read them at www.thetowncommon.com. In this column, I will discuss the best strategies to get the dental care you need.

I hope the message was clear – you are not missing much if you don’t have dental insurance. Because of the way dental “insurance” is set up, having it is equivalent to a discount on certain items at a store. Just because you don’t have it, doesn’t mean you can’t choose something that fulfills a need or desire. While there may be a few reasons to consider purchasing an “insurance” policy on your own, it usually does not make sense.

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Last week I explained how dental insurance works. This week I will break down the general differences between dental insurances, some things to consider when using your dental insurance, and when it makes sense to consider purchasing insurance if you don’t have it.

I get asked daily by patients who are either self-employed or are not offered insurance through their employer, “Should I consider getting dental insurance?” In most cases, in my opinion, it does not make sense to purchase dental insurance on your own. This goes back to last week’s column as to how dental “insurance” is set up to begin with.

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Most dental offices are bombarded daily with questions about dental insurance. “Do you take my plan? How much is covered? Why is dental insurance coverage so bad?” These are just a few of the questions we hear daily. So, why is dental insurance the way it is?

Dental insurance was first offered back in the early 1970’s. Back then, the first insurance companies offered a yearly maximum benefit level of $1000 per year per patient. In 2016, those insurance companies, and now many others, offer an average yearly benefit of $1000-1500 per year. Yes, you read that correctly; it has not changed much. However, back in the 70’s you could have gotten a lot more dentistry than you can today on that same $1000. Why hasn’t it changed?

There are many answers to this question. The bottom line is that raising the dental insurance limits would be extremely unprofitable for insurance companies. Here are some reasons why.

First is the “use” factor. Many patients who have dental insurance use their insurance right up to that yearly maximum. This is generally not the case with other types of insurance. In fact, the entire dental insurance model is based on a certain percentage of those insured not using their benefits at all. If the yearly benefit was higher, the premiums would need to be much higher for the insurance companies to make a profit. This would destroy the model and there would be many fewer patients signing up for those plans.

The second reason is pre-existing conditions. Many dental problems are often ignored for years and patients will often wait until they have “insurance” to take care of their problems. This is why many insurance companies have a “wait period” for certain dental procedures. When that patient finally has dental coverage and the dentist tells them they need three root canals and three crowns they are shocked to hear that their insurance will only cover a small percentage of the treatment. There is no dental insurance available to cover situations like this because it would be extremely unprofitable for the insurance companies.

Next is the fact that dental problems are much more common than many other health problems. This goes back to my first point of the “use” factor. Look at how expensive medical insurance is. For many people, they may go for routine check-ups to their doctor, but a much lower percentage of patients use their insurance for more costly procedures. However, we all need the health insurance in case of that catastrophic event that would otherwise bankrupt us. For dental insurance companies to remain profitable they have to charge a high enough rate to offset the “people using it” factor, but also a rate low enough for it to be “worth it” for the typical consumer.

And, when you think it couldn’t get any worse, it does. These same insurance companies are cutting reimbursements to dental offices that have participated for years. In addition, there are more and more “discount” plans available which appear more attractive to employers. This continues to brainwash the public that dental insurance is the answer.

Next week I will expand on this with a discussion of the difference between the different kinds of dental insurance available: those you can go to whomever you want and those where you have to pick a dentist from a list. The final column of this series will give you suggestions for getting the dental health you need regardless of insurance.

I have written before on the benefits of Xylitol, the sugar substitute that possesses 40 percent fewer calories than sugar and has been shown to decrease the amount of cavities that people get. It can be found in specifically formulated things like gum and mints. However, it is important to know that xylitol, even in small quantities, is toxic to dogs.

The dental benefits of xylitol have been known since the 1970’s. Xylitol is not metabolized by the decay-causing bacteria Streptococcus mutans (S. mutans), making it nonacidogenic and thus noncariogenic (not decay causing). Studies have also indicated xylitol decreases the levels of S. mutans in both plaque and saliva. As a result, patients who use xylitol have demonstrated a reduction in decay.

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A quality run can do so much good for a person, not just physically, but mentally as well. You can feel accomplished even after the most relaxed of days, or blow off steam from a stressful one. Time seems to stand still and all is right with the world for those few miles. Running has helped you stay fit for years, and you wish fixing your smile could be as simple and long-lasting. There so many different things wrong with your teeth, you don’t know how you could fix everything. Dr. J. Peter St. Clair and Dr. Leonard Strauss can give you that perfect, enduring smile with porcelain veneers in Rowley. (more…)