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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!

Costumes Inspired by your Dental Office!

Not sure which costume to buy this year? Need some last minute inspiration? We’ve got you! No one else at the party will be wearing these!

Darla from Finding Nemo

Costume

Who could forget Darla the “Fish Killer” from Finding Nemo? She’s the niece of Dr. P. Sherman (42 Wallaby Way, Sydney) and with a Dentist for an Uncle you know she’s getting a deep discount on that headgear!

Toothbrush, Toothpaste, and Tooth

The classic trio. If you’re looking for group costumes, this is a combo that’s sure to stand out. You might even remind your friends to brush after all of that sticky candy you’ll be eating Halloween night.

Gag Teeth

Costume

Now this is crazy – kudos to the parents who spent the time to make this get-up. No one else in their class will have this costume.

The Tooth Fairy

Of course, you could go with the traditional beautiful woman in a tutu with wings and a tooth wand – but there’s something hilarious about a grown man in a leotard.

Your Dentist, of course!

Costume

This year a costume that already incorporates a mask is PERFECT.

And finally the scariest costume of all…

The Patient

Costume

She tells you she flosses everyday, but her gums say otherwise. Nothing is scarier to a hygienist than this patient!

 

Whatever you go as this Halloween, be safe, have fun, and give us a call if all the sweets give you a tooth ache!

 

Happy Halloween from Dr. Shahriary and Staff!

Iconic Teeth From Your Favourite Movies

Halloween is coming up – this year your costume can be instantly recognizable with some iconic teeth! Movies and TV shows use prosthetic teeth, natural imperfections in the actors teeth, and make up to give their characters a distinct look.

Winifred Sanderson, Hocus Pocus

The oldest of the Sanderson sisters was obsessed with beauty and youth so it makes sense that the costume designers gave her comically large teeth that don’t meet “conventional” beauty standards.

Austin Powers, The Austin Powers movies

Powers’ bad teeth were created by a dental technician named Gary Archer. Mike Myers came to Archer and told him, “I want bad British 1960s teeth”, based on a widely-held stereotype. Archer took pictures and made drawings of British patrons at an English pub that he often visited and the pictures became the inspiration for the final design Archer showed Myers, resulting in his iconic smile.

Lloyd Christmas, The Dumb and Dumber movies

When Jim Carrey was a child he got into a fight, resulting in the chip in his front tooth. The tooth was capped and Carrey had it temporarily removed to portray Lloyd Christmas.

The Mad Hatter, Alice in Wonderland

Johnny Depp has said the Mad Hatter’s iconic smile was inspired by comedian Terry Thomas’ diastema. In an interview Depp said, “the French call the teeth with the gap in the middle ‘les dents de bonheur’ – ‘the teeth of happiness’,”. A fitting inspiration for the (sometimes) jovial Mad Hatter.

Harry Lyme, Home Alone 1 and 2.

Harry’s gold tooth plays an important role in his identification. When he first enters the McCallister’s house impersonating a police officer, Kevin notices his gold tooth when he smiles. As a result when Kevin is almost hit by Harry and Marv’s van Harry smiles at him again and Kevin notices the gold tooth, blowing his cover as a police officer.

Stu Price, The Hangover

Did Ed Helms REALLY pull out his own tooth for a movie role?! Well, kind of! When Helms was a teenager he had a dental implant placed. Instead of blacking out a tooth for the movie he decided to talk to his dentist to see if he could have the 20 year old implant crown temporarily removed. His dentist agreed to remove it and the rest is movie history!

Belletrix Lestrange, Harry Potter Movies

Though Belletrix’s rotten teeth are never specified in J.K. Rowlings’ book, actress Helena Bohnam Carter felt the gnarly teeth would give her character a feral look. As Bellatrix had spent so much time in prison, Carter felt her teeth should look savage and deranged as she hoped to portray her as such.

Dracula – 1958 Starring Christopher Lee

Vampire fangs have an interesting history in Hollywood as most people associate fangs with Bela Lugosi’s popular 1931 portrayal. Lugosi, however, never wore fangs in his role as Dracula. In the era before microphones actors needed to enunciate for optimal clarity; prosthetic fangs impeded this greatly. Fangs were not popularized in vampire films until Christopher Lee’s iconic portrayal in 1958.

Let us clean up your “fangs”! Call today to book an appointment.

Pulling Baby Teeth – When and How?

Should you be pulling out baby teeth? How and when is the best time?

Youtube can show you countless creative ways to pull out baby teeth; from the “slamming door” method to newer techniques like the nerf gun. For some kids this is harmless fun, but for others it can be painful and scary.

It’s important to remember that teeth should only be pulled when they are loose enough to come out with very little pulling by the parent or child. Having a loose tooth can become uncomfortable as it can shift around and poke the gums affecting chewing. Remember that you want to make sure the tooth is not pulled out prematurely. Let your child be in control of the situation; this will ease anxiety and fear surrounding losing a tooth.

Your child will likely play with the tooth with their tongue throughout the day, gradually loosening it. If they are becoming anxious to lose the tooth offer crunchy snacks like apples to speed up the process.

When the tooth is truly ready to fall out organically there should be little or no blood, but have gauze ready to clean the area and rinse the mouth out to keep the site clean.

If your child has a loose tooth that is causing pain or keeping them up at night, call our office to make an appointment and we can assess if the tooth will need to be extracted in office.

(604) 936-1263 or email https://austindentalgroups.com/contact/

Don’t forget to read last week’s blog about the tooth fairy for more information!

 

 

Happy Holidays from Dr.Ross and Staff

Wishing you a sparkling holiday season 

May your smiles be Merry and White!

   

 

Snoring and dental problems

If you don`t have good oral health, it can be the reason for your Sleep Apnea.

You can sometimes find early signs of a sleep disorder by visiting your Dentist.

The first sign of having sleep apnea is tooth grinding  (bruxism). Grinding can cause tooth wear and breakage as well as inflamed and receding gums.

A spike in cavities can also be a sign of grinding.

Sometimes mouth`s anatomy and sinuses and Sometimes the eruption of the wisdom teeth can be the reason for snoring.

When the tooth has partially erupted, this causes a flap of tissue to become infected and swollen.

Because of this condition, patients may sleep with their mouth open, leading to snoring.

Snoring also can be caused by a number of factors like allergies, a cold, overweight, or alcohol consumption.

Other risk factors that contribute to what causes snoring include the following:

Being male, Being 40 years of age or older, Pregnancy and family history of snoring.

 

There are approved oral appliances available to help with snoring.

Your dentist can make you a custom snoring device, but only after you have been officially diagnosed with an oral problem. This oral appliance is a device that fits like a retainer and looks like a mouth guard. It supports your jaw and tongue to maintain an open upper airway.

 

There are several benefits to using a custom-made snoring device over store-bought ones, including:

– The device is much more effective than any prefabricated one because

it’s specially designed for your mouth.

– A custom snore guard will last definitely longer than that one you can get over the counter.

– They are portable, so you can take them with you while traveling.

–  Oral appliances are far more comfortable than wearing a mask!

 

How Smoking affects your dental health?

Smoking is already proven to be really bad for your oral health. It appears that smoking interferes with the normal function of gum tissue cells. This interference makes smokers more susceptible to infections. It causes severe periodontal (gum) disease, and once you have gum damage, smoking also makes it harder for your gums to heal. In general, smoking gives you bad breath, tooth discoloration and Increasing risk of bone and tooth loss.Further more, it has serious effects on developing oral cancers . Smoking can also lower success rate of dental implant procedures. Please If your have any signs and symptoms of gum disease like red,puffy,tender gum or bleeding while you are brushing do not hesitate to call us. We can book you a quick check up appointment with Dr.Shahriary.

Some tips for Thanksgiving

Next weekend, as your family celebrates Thanksgiving Day, it’s important to keep your oral health in mind. When preparing your holiday meal, include foods that are nutritious and beneficial for your teeth and gums. Turkey, Cheese, Greens and vegetables are packed with protein and phosphorous, Calcium, vitamins and minerals which are all good for  health and strength of your teeth and gum.

Cranberry sauce which is a tasty Thanksgiving tradition, pumpkin pie and desserts are the sweetest  part of our celebration. But you should consider that starchy foods are full of sugary carbohydrates, which build up bacteria in the mouth and can lead to cavities. Just make sure to have a few drinks of water afterward to wash away food debris from your mouth.

If you do notice tooth stains after Thanksgiving, contact us and also ask about our teeth whitening services. There’s no need to completely deprive you this Thanksgiving. But do keep in mind these suggestions  for your dental health.

Happy Thanksgiving in advance!