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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!

Why water is the right choice for your oral health?

– Drinking water helps prevent cavities and staining

For drinking sugary drinks you need to know that the sugars combine with the bacteria in your mouth and form acids that make cavities in your teeth. Having the occasional soda or sports drink is OK, Just when you make sure that drinking water is a regular part of your day!

Also, when you are outside until you can get home to brush and floss, drinking a glass of water and swishing it around a little in your mouth after having food, definitely helps a lot.

– Drinking water fights bad breath

Do you know why so many of us get “morning breath”? it`s because of the Bactria which grows in Dry mouth. You can stop morning breath by keeping hydrated with water. This also helps to produce saliva to wash away any lingering food particles that could contribute to bad breath or tooth decay.

– Fluoridated water helps fight tooth decay and cavities, especially with children!

Fluoride strengthens the tooth structure, making the entire tooth more resistant to decay. It also can repair the early stages of tooth decay.

Don’t forget to visit your dentist every six months for a dental exam and cleaning to make sure your smile stays healthy and strong.

Baby Teeth – When do they come in?

The most common questions we are asked about Baby teeth are “when will they come in?” and “when will they fall out?”. While the answer can vary – we have a general timeline for when we expect these things to occur.

Baby Teeth

Most children will have all 20 of their primary teeth by the time they are 3 years old. By age 21 all of your child’s permanent teeth should have erupted (with the exception of wisdom teeth which may or may not fully erupt.)

Caring for baby teeth can be difficult for parents.

From 1 to 2 years  

  • Brush your child’s teeth daily (using non-fluoridated toothpaste).
  • Check for signs of early childhood tooth decay once a month. Lift your child’s upper lip and look for chalky-white or brown spots on the teeth or along the gum line. If you see any, take your child to a dentist as soon as possible. Your dentist may suggest you start using a small amount (the size of a grain of rice) of fluoridated toothpaste.
  • Switch to a regular cup for all drinks between 12 and 15 months.
  • Limit soother use to nap and bedtime.
From 3 to 4 years old
  • Teach your child “2 for 2,” which means brushing twice a day for 2 minutes each time.
  • Start using fluoride toothpaste, the amount of a green pea, and teach them to spit rather than swallow.  Supervise your child while he/she is brushing teeth.
  • Encourage your child to do some brushing with you completing the job, making sure that all tooth surfaces have been cleaned.
  • If your child continues to suck her thumb as permanent teeth begin to appear, talk to your doctor or dentist.
For all ages
  • Wash your hands before and after brushing teeth.
  • Rinse toothbrushes thoroughly after brushing and ensure that each one can dry without touching other toothbrushes.
  • Replace toothbrushes every few months, when the bristles become flattened with use.
  • Between meals, quench a child’s thirst with water. Do not offer candy, dried fruit (including raisins) and sugared drinks or juices.
  • Take your child for regular dental visits (every 6 months, unless otherwise suggested by your dentist).

To schedule your child’s next cleaning Contact us! (604) 936-1263

I Just Had a Filling – Why does my tooth still hurt?

So your dentist recommended you have a filling done, but now a tooth that didn’t bother you before is hurting! Yikes!

Before you start panicking there are a few reasons this could happen. Firstly – is the pain you are experiencing upon biting or chewing? or is it a constant ache?

Pain with biting/chewing

If the pain/sensitivity is with biting or chewing, chances are your filling needs a slight adjustment! When the dentist checks your bite after performing a filling, sometimes you’re so frozen it’s hard to get a good idea if your bite feels “normal” or not. Even the slightest bit of filling material being too high, or left over bonding agent can cause sensitivity with biting if you have a “tight” bite.

Typically, we can see you the same day for a quick appointment (that requires no freezing) to adjust the filling.

Constant Ache

If your pain is more of a constant ache there are two possible issues. Your pain may be associated with the injection site for the anesthetic. Some people are very sensitive to freezing and can experience and ache/bruised feeling in their jaw from the anesthetic – especially in the lower jaw. The best course of action is to wait a day or two to see if the ache gets better.

The other possibility with a constant ache is that the decay was much deeper than expected. While we always try our best to prevent a tooth from needing a root canal, sometimes the decay is so deep we have no choice. When Dr. Ross performs a filling where the decay is deep in the tooth, he will often place a medication to desensitize the tooth and help it “calm down”.  If this doesn’t work, a root canal may be the best course of treatment to fix the tooth.

Whatever the problem may be – we’re here to help you fix it. Call or email us today! https://austindentalgroups.com/contact/

 

Sugar makes my teeth sensitive – Ouch!

For most of us a slice of cake or a TimBit sounds like a deliciously sweet treat. For some people the thought of a sugar-filled snack makes them cringe. If you’re cringing right now, you may be wondering why your teeth react this way to sugar and if you can get some relief. In short, your sensitivity is due to damage to your enamel. Fortunately, there are steps you can take and products to help reduce this sensitivity so that you can enjoy your favorite treats again!

Causes

Most people associate tooth sensitivity with exposing your teeth to burning hot or chilling cold, sweets can also trigger tooth sensitivity. Regardless of the cause, sensitivity can result from the loss of enamel on your teeth. The most common causes of enamel loss include brushing too hard and enjoying too many acidic foods. Both activities damage your enamel and can expose the sensitive inner layer of your teeth. When your outer layer of enamel is damaged, sugary foods, hot and cold treats, or other irritants have a more direct route to the nerve center of your teeth.

Preventing Sugar Sensitivity

If you can’t imagine living without your favorite sweets there are steps you can take to prevent sensitivity. Your best course of action is to take proper care of your teeth with an oral health routine and the right tools.

The first step is to use a soft-bristled toothbrush. A softer brush is not only better for your enamel, but it’s also gentler on already sensitive teeth. We always give our patients a soft-bristled brush in their patient “goody bag” at each cleaning appointment. Use a toothpaste designed to protect against sensitivity; the active ingredient you should look for is “stannous fluoride”. Finally, improve your brushing technique! Brushing too hard can cause serious damage to your enamel and gums, leading to tooth sensitivity. You can always ask your hygienist for proper oral hygiene instruction at your regularly scheduled cleaning appointment.

Contact us today to set up your next appointment! https://austindentalgroups.com/contact/

Oh Baby! Caring for your baby’s teeth and gums.

Dental health starts before there are any teeth to brush! Caring for your baby’s teeth early on develops good oral hygiene habits for the future.

Before your child has any teeth it is important to clean the gums after each feeding with a warm, wet washcloth. You can also buy “thimble” style rubber gum stimulators to brush your baby’s gums.

Teething is difficult, but there are a few things you can do to help. Rub your baby’s gums with a clean finger or a clean washcloth. Many babies find the applied pressure comforting. Keep their mouth cool with a cold washcloth, spoon, or chilled teething ring. If your child is already eating hard foods, offer them something to gnaw on like chilled cucumber or carrot. Keep close watch as they chew as any broken off pieces pose a choking hazard.

Baby teeth are important too. A common misconception in adults is that primary teeth do not need special care because they eventually fall out and are replaced by our permanent teeth. But these first teeth preserve the spacing for the permanent ones and help Baby chew and talk. If they’re not cared for properly they can decay, leading to a gum infection called gingivitis, which can affect the spacing of permanent teeth.

Put them to bed with water. The first sign of decay in your child’s teeth is discolouration and minor pitting. Putting your child to bed with milk or worse, juice, is notoriously bad for their teeth. This allows sugars to sit in their mouth and breed bad bacteria all night – water is the safest bedtime beverage.

For more tips on brushing and cleaning your child’s teeth see the Canadian Dental Association Website: http://www.cda-adc.ca/en/oral_health/cfyt/dental_care_children/cleaning.asp

To book your child’s first dental check-up, contact us today by phone (604) 936-1263, or email https://austindentalgroups.com/contact/

Why do I need Fluoride?

Anyone who has seen their Dentist for a regular cleaning and check up knows that a fluoride treatment will be offered at the end of the appointment, but why?

Fluoride reduces the ability of plaque bacteria to produce acid, and repairs tooth decay by building up the tooth in a process called remineralization. In fact, the occurrence of cavities has significantly dropped since the 1960’s after the American Dental Association approved the use of Crest’s first fluoridated toothpaste.

While it is important to use a fluoride toothpaste regularly, having a higher dose of concentrated fluoride treatment at your dental cleaning appointments is the most effective way to prevent decay.

If you have any questions about fluoride or you’re ready to schedule your next cleaning and check up, give us a call! Dr. Shahriary and his staff would be happy to help!

604-936-1263