Don’t Let Dental Insurance be Your Decision-Maker, it Didn’t go to Dental School

The greatest failure of dental “insurance” is the mistaken belief dental benefits cover all our necessary oral health care needs, and anything that is not covered by the benefit is not necessary to maintain our oral health.


This is a real frustration for both dental practitioners and patients. For example, say you show up for your 6 month check-up and your dentist finds 4 new cavities and periodontal (gum) disease. In order to get your oral disease under control, the standard protocol for treatment includes all areas of decay being removed and filled, periodontal therapy performed, and antibacterial caries therapy started. But, when the office checks your dental coverage, your plan will only cover 2 of the 4 necessary fillings and a deep cleaning or scaling and root planing for the gum disease at your next visit. There is no coverage for the medication required to kill the bacteria causing the decay, AND no coverage on the removal and filling of the other 2 areas of active disease.


To the dentist, waiting to treat the disease in those areas is like only removing ½ of a tumor. If part of it is left in the body, it will not get better—it needs total removal and the disease needs systemic treatment. Without it, the tumor will continue to grow. You can see then how frustrating it is when dental “insurance” is the decision-maker of oral disease. When you focus on your coverage you will not get better.


Instead we need to start thinking about our dental coverage as providing a discount or partial payment. It will cover 2 of the cavities, which will bring your cost down, but you still need to take care of the rest of the treatment if you don’t want to be in the same place (or worse) 6 months from now. Often dental offices know the financial burden of treatment is too much for a full payment up front, so they have options like low-interest financing or an in-office membership plan to give you further discounts.


Understanding the real role of dental insurance is important as you make decisions about your oral health. A product purchased by an employer has no skin in the game when it comes to your health and well-being, so don’t let it decide how you take care of your body.

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