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Insurance Coverage – What you need to know.

Dental insurance can be extremely confusing, after all, our front desk staff had to complete a certification program to be able to deal with it! But here is some useful information about how plans work and the terms they use to help you navigate the world of dental coverage. Please remember to always read your benefits booklet at the start of a new plan to familiarize yourself with it’s limitations.

Benefit Year: Your plan benefits are payable each benefit year. Often this aligns with the calendar year (January 1 – December 31) but sometimes a benefit year can start at a different point in the year and run for 12 months. IE: July 1 – June 30. Your maximums will reset at the start of each benefit year.

Deductible: A deductible is a set amount of money you must pay upfront at the beginning of your benefit year. Your plan may have an individual deductible and a family deductible. For example, the individual deductible is $25 and the family deductible is $50. This means that the first 2 visits to the clinic by any family members will have $25 charged to them. Now the $50 family deductible has been paid and no other family members will have to pay $25 for this benefit year.

Dependant: Someone who has coverage under your plan, for example a spouse or child.

Basic Services: Basic services are procedures done in office like cleanings, exams, fillings, x-rays, and even root canals*

*some insurance companies will consider root canals, extractions, and other procedures as major services. But the listed procedures are most commonly considered basic services.

Major Services: Major services are more involved procedures such as crowns, bridgework, dentures, and gum surgery. These are often covered at a lower percentage than basic services.

Maximum: The maximum on your plan is the dollar amount your insurance will pay towards your dental work each benefit year. You may have a separate maximum for basic and major procedures. IE: Basic max: $1,000 per benefit year, Major max: $1,500 per benefit year. OR you might have a combined maximum meaning all procedures, whether basic or major are limited to the dollar amount detailed under your plan.

Units of time: Time units are often used when describing limitations on cleanings. 1 unit = 15 minutes of time. So your insurance company may limit you to 13 units of scaling and root planing (two types of cleaning your hygienist performs) per benefit year. This means your insurance will pay for 195 minutes of cleaning every benefit year. For people with mild-moderate tartar build up this equates to 4 cleanings. Included in the scaling and root planing time is oral hygiene instruction. If your hygienist spends 5 minutes “scraping” your teeth and 10 minutes explaining how to better brush or care for your mouth, this is considered a chargeable 1 unit (15 minutes) of time.

Predetermination: A predetermination is a request to do a procedure that will cost over $500. For example, we send a predetermination to your insurance company when we would like to place a crown in your mouth. We tell them how much our work costs and how much we think the lab work will cost. We attach x-rays and any information proving that the procedure is necessary. From there the company will decide if they will approve the work for payment. Due to privacy reasons, many insurance companies will provide their predetermination statement (with explanation of allowable payment) directly to the patient, and not to our office.

Cost differences: Occasionally your plan will pay alternate or less expensive procedures in place of the work we actually did. The most common example of this is when we do a white filling and your plan only covers amalgam (silver) fillings. Lets say the cost of a white filling is $200 and the cost of a silver filling is $180; there is a $20 cost difference. Even if you plan covers 100% of basic services there will be a $20 portion owing as they only covered 100% of the cost of a silver filling.

Fee guide: Each year in February the BC Dental Association issues a fee guide outlining the cost of each procedure. Most procedures increase in cost incrementally each year to keep up with the cost of supplies and overhead for the office. Some plans pay the previous year’s fee guide meaning there will always be a cost difference to you. Ministry plans follow a different fee guide, if you have a ministry plan, please contact our office to discuss your coverage.

Limits: Some procedures have limitations for how often they can be done. An example of this is your “recall” exam which accompanies a cleaning. Sometimes you are limited to 1 paid recall exam every 6 months, or it could even be once every 9 months or year.

Assignment of Benefits: This is one of the most confusing aspects of an insurance plan. While our office is happy to accept payment for your work on your behalf from the insurance company, not every plan allows this. This is called assignment of benefits. Some plans do not allow assignment of benefits and instead require the patient to pay for their work upfront to the dental office then submit claims and receipts. The company then reimburses you directly.

Regardless of your insurance plan, it is important to remember that as your health care provider we are here to serve what is best for your oral health, and not just what is “allowed” by your plan. We always try our best to work within your plan’s limitations but some of the work we recommend may not be covered by your insurance. We will provide an estimate to you and explain thoroughly why we feel the work is needed.

As always, we strive to provide caring and conscientious dental care.

Permanent Teeth, what you should know.

Here’s what you need to know about permanent teeth.

When do primary teeth come in?

Typically we see babies start teething around 6 months old. This is there first set of teeth called “primary” teeth, though often referred to as baby teeth. There are 20 primary teeth that continue to erupt until age 2-3. Besides helping kids chew their food, primary teeth have the important job of holding place in the jaw for their 32 permanent teeth.

When do permanent teeth come in?

Kids usually start losing their primary teeth around the time that school starts. As shown on the chart the permanent teeth erupt in the same order that their primary teeth did.  This often means that the first baby teeth to erupt are also the first to fall out and be replaced by adult teeth. Of course there are special cases in which this doesn’t apply. For example, when there is poor dental hygiene, trauma to the primary tooth, or a medical condition. By the age of 12-13 most kids have all of their permanent teeth.

If your child has a loose tooth, see our blog about pulling baby teeth!

Why fix baby teeth if they’re just going to fall out?

We hear this question quite often. When a child has a cavity in their baby tooth it can be tempting to just leave it until it falls out. Untreated cavities in baby teeth can impact roots and spread bacteria to their permanent teeth potentially causing more cavities or gum disease. Additionally, they can become quite painful.

Hopefully these tidbits help you prepare for your child’s changing mouth. As always, please call us if you have any questions!

Gifts Your Teeth will Love

Give the gifts of beautiful teeth this holiday season. Dental products can make a great gift whether your budget is big or small!

Tooth brushes and tooth paste make great stocking stuffers. Especially for kiddos who are still learning how to brush. Bristles can become chewed up and ineffective faster when toddlers are just learning to brush.

Bigger kids may find their brushing technique more effective with a disposable electric brush. These do a better job of cleaning the teeth, even when your child’s brushing style is less than ideal.

Fun flavours of toothpaste encourage good oral hygiene habits and get kids excited to brush every day.

If you have a bigger budget for gifts, electric tooth brushes can greatly improve oral hygiene. Oral B electric toothbrushes have a round head and behave like a dental tooth would in our office – though the can be a touch loud, the brushing technique is highly effective. If the noise of an Oral B brush is too much for you we also recommend Philips Sonicare toothbrushes. They are quieter than the Oral B, though often more expensive.

Do you have a big event coming up in 2022 or do you want your smile to be glamorously white for your New Years Kiss? Treat your self to the gift of tooth whitening. Our office offers Opalescence Go (a more concentrated version of a white strip), Custom Trays made for your teeth that come with take home bleach syringes, or in-office whitening for the fastest results.

Not sure which gifts to pick? Call our office to discuss your specific dental needs!

School snacks for healthy teeth

With the return to school fast approaching our office sees the improvement in your child’s oral health. No more all-day summer snacking and slurping back sugary drinks.

The snacks you send in your child’s lunch can help keep their smile healthy all year long.

School Snacks, Dentist Approved:

  • Fresh fruit and crunchy vegetables. They’re high in fiber and will help fill up hungry tummies. Bonus: chewing crisp fruits and veggies can scrub away food particles and plaque.
    • While citrus fruits, such as oranges, and grapefruit are healthy and delicious,  citrus fruits contain citric acid which can cause enamel erosion. Moderation is important!
  • Unsalted and low-salt nuts, such as almonds or walnuts.
  • A lunch meat and cheese roll up.
  • Cottage cheese or low-sugar yogurt. Both are excellent sources of calcium and vitamin D, which promote healthy bones and teeth!
  • Peanut Butter (especially natural) is packed with fiber and protein. Spread on celery stalks, apple slices, or on wraps with bananas.
  • Small cubes of cheese. Especially cheddar, Monterey Jack, Swiss, and other aged cheeses. These cheeses trigger the flow of saliva which helps to wash food particles away from teeth.
  • Choose water instead of soda or juice!

Uh-Oh! School Snacks to Avoid:

  Dried fruit, fruit leathers and fruit snacks
Not only are they loaded with sugar, but these snacks are gooey and sticky and cling to the surface of teeth and gums.

  • Energy, protein or granola bars
    These may seem like a good choice, but they are very similar to candy bars in the amount of sugar and calories. Many contain sticky dried fruit that cling to teeth  long after the snack is eaten.
  • Cracker snacks
    White flour crackers like goldfish, graham crackers, and bagel chips also stick to teeth. These types of crackers contain carbohydrates that turn into sugar when broken down. Try healthier alternatives like whole grain crackers and triscuits.
  • Sports drinks
    Sports drinks contain extra calories and high levels of sugar, almost as much as soda. They are also  acidic and can contribute to enamel erosion.

Call today for your back-to-school cleaning!

Surprising Facts About Teeth!

Let’s explore some of the most surprising things you probably didn’t know about teeth!

Your Teeth:
  1. Your teeth’s enamel is the hardest substance in your body. Just don’t test in on bottle caps because…
  2. Teeth are the only part of your body that do not naturally heal.
  3. But on average, people only spend 48 seconds each time they brush – the standard recommendation is 2 minutes!
  4. So three out of every four Americans has some form of periodontal gum disease.
Other Creatures:

5. Some snails have more than 20, 000 teeth, even though their mouth’s are no bigger than a pinhead

6. An elephant’s tusks are actually teeth!

7. Giraffes have the same number of teeth as humans – 32

8. You can tell the age of a dolphin by counting the rings on its teeth – just like a tree

 Historically:

9. Barbers used to pull teeth – talk about a one-stop-shop

10. Most Americans did not brush their teeth every day until after World War 2. In WW2, the military required soldiers to brush their teeth twice a day, and they brought that habit home after the war.

11. Neolithic humans filled cavities in their teeth with beeswax

12. The cotton candy machine was co-created by a dentist who called it “Fairy Floss”. Now that’s surprising!

Your Dentist:

13. DDS vs. DMD – DDS means Doctor of Dental Surgery, DMD means Doctor of Dental Medicine. The degrees are the same as they have the same education but each practitioner can decide what their degree is called.

14. You can’t lie to your dentist – General dentists can tell a great deal about your habits, diet, and oral hygiene routine just by looking at your teeth. They can tell if you floss everyday or just for the days leading up to your appointment. They can also tell what types of foods you eat and whether you grind or clench your teeth.

15. Your dentist is an artist – Dentistry is an artistic as well as scientific profession. Dentists must have an artist’s aesthetic sense, an eye for detail and the manual dexterity to perform precise procedures in a small area.

Call today for your appointment https://austindentalgroups.com/contact/

Diabetes and Gum Disease

Those who are dealing with Diabetes should know that elevating blood sugars increases the risk of developing gum disease also can be more severe and take a longer time to heal.

Likewise, Gum disease and the body’s response to gum infections can make it harder to keep blood sugar levels in control. To keep your gums healthy, you need to brush after each meal and floss then rinse with an antiseptic mouthwash daily.

How can diabetes affect my mouth?

Glucose is present in your saliva diabetes is not controlled, high glucose levels in your saliva help harmful bacteria grow.

These bacteria combine with food to form a soft, sticky film, Plaque.  Some types of plaque cause tooth decay or cavities. Other types of plaque cause gum disease and bad breath.

On the other hand, Diabetes causes blood vessel changes. The thickened blood vessels can reduce the flow of nutrients and this reduced blood flow can weaken the gums and bone which puts them at a greater risk for infection.

Infections from untreated periodontal disease can cause the blood sugar to rise and make it harder to control diabetes. Some of the first signs of gum disease are swollen, tender,  or bleeding gums. Sometimes you won’t have any signs of gum disease. You may not know you have it until you have serious damage.

Your best defense is to see your dentist twice a year for a cleaning and checkup.

Things you should consider before Invisalign:

The first consideration is that you should be really  disciplined  in wearing your invisible aligners to get the best results

Invisalign must be worn almost 22 hours a day.  You usually need to remove them only when you eat and drink.

2- Your teeth may feel more sensitive

There may be a constant force while working around teeth movement, thus, making your teeth feel more sensitive.

3- Aligners can make the pain

As your teeth move to their proper positions, nerve ending in your gums are stretched as well. This may sometimes cause a stinging sensation in your gums.

4- You Shouldn`t smoke while wearing your Invisalign

Smoking with your aligners on can cause permanent discoloration.  If you wish to smoke, be sure to remove your aligners.

 5- Invisalign may affect your speech

Similar to metal braces, patients may feel that they have a lisp at the beginning of the treatment.

6- You need to remove your aligners whenever you eat

You have to make sure that food stuck in between your teeth and along your gum lines are removed.

So, this is important to brush your teeth and floss before putting your invisible aligners back in your mouth. 

7- Avoid sugary, colored, and acidic drinks

Coffee or breakfast tea can leave a stain on your aligners or may cause discoloration. If you want to drink while wearing Invisalign, enjoy drinking a glass of water instead.

8- You need to skip your lipstick for a while

Since Invisalign are clear plastic aligners, wearing lipstick can stain your aligners.  Try a colorless lip balm or other alternatives.

9- Be patient with the results

Remember that the duration of the treatment depends on the complexity of the misalignment of your teeth!

10- Invisalign should be cleaned regularly

Wearing Invisalign for about 22 hours a day and leaving them uncleaned can cause them to be discolored and smelly.

It would be great to wash them properly, soak them in a cleaning solution, and rinse them before using them again.

11- For Some Patients, Invisalign treatment may come with attachments

Attachments are tooth-colored buttons placed on certain teeth to allow the proper grip of the aligners 

12- The cost of Invisalign varies

The cost of Invisalign varies per patient. And some have insurances that may cover a portion of the cost.

13- You might need to use retainers after your Invisalign treatment

After your Invisalign treatment completed, your dentist might recommend that wear retainers when you sleep.

This is to ensure that you keep your teeth in place.

 

If you have any other concerns about your Invisalign treatment, Please contact Dr.Shahriary`s office to book a free consultation appointment.

What to pack for lunch – the best snacks for your teeth

Your oral health is important to your overall health and the first thing to decline when you eat a poor diet is your oral health. To ensure you’re choosing the best food for your teeth pick snacks that are rich in fiber, water, calcium, and protein. The top 7 foods as recommended by the American Dental Association are:

Cheese – Rich in calcium and protein, cheese also raises the pH in your mouth by increasing saliva production.

Yogurt – Like cheese, yogurt is high in protein and calcium. It also contains probiotics which are great for your gums as they block out the bad bacteria from forming

Leafy Greens – They’re full in vitamins, folic acid, and calcium which helps build your enamel!

Apples, Carrots, and Celery – High in fiber and water, they also help saliva production through the action required to chew them so thoroughly. Because they are so fibrous they also stimulate your gums in a similar way to brushing

Almonds – A great source of calcium and protein while being low in sugar

When it comes to beverages, the best choice is always water. Remember, a healthy smile is your first step towards better overall health.

Call or email today to book your next appointment!