A recent article in Forbes (November 16, 2009) described the difference between dental insurance and dental discount plans. It made some great points that I would like to mention here.
According to this article, “the average individual dental insurance plan costs $554 – and that’s for a limited network of providers… Even using one of these plan’s chosen (i.e., cheapie) dentists, you’ll have a 20% copay for routine fillings and a 50% copay for crowns and bridges.” Your benefit is 2 free cleanings per year and an exam. Reading the fine print you will quickly realize that the yearly treatment cap ranges between $1000 and $1350, and implants usually are not covered. The waiting periods are usually long, some as long as 18 months prior to getting basic coverage for exams, x-rays and extractions.
Many years ago I decided that there is a better way. Why plan for failure? Dentistry is not much different that the crisis in today’s health care system. Too much emphasis is put on a magic pill that will cure all ailments. We eat too much (and mostly bad stuff), exercise too little, and then wonder why diabetes, heart disease and every other illness is on the rise. So we look to pills, plastic surgery, and any means possible to cure our “resulting” condition with very little emphasis on WHY we got there in the first place! This is a formula for disaster that we are all experiencing right now in the USA.
We are solely responsible for our body’s health. With a few exceptions such as genetic disorders there-alike, most health issues are preventable! The same goes for the mouth. I explain this to my patients as the DENTAL CYCLE. For some odd reason it was accepted that you get decay, you will need lots of fillings, then crowns, root canals, extractions, and eventually dentures. It was the natural progression of a mouth. Well, it is not.
Dental Insurance has mostly focused on the resulting mess neglect has caused. Fillings to remove cavities, crowns to fix broken teeth, and extractions for gum disease. These are but a few examples. Why did you need that filling in the first place? Why do you have gum disease? What, your insurance will only pay for 2 cleanings a year but your dentist and hygienist say you really need 3-4? Who do most patients listen to? Yes, you guessed it, the insurance company. So, don’t be surprised if in a few years of “supervised neglect” by your dentist you now have active gum disease, bone loss, and now you need “deep cleanings”. Teeth get looser, root surfaces get exposed and become sensitive, tissue recedes and reveals “longer teeth” with black spaces between them. Now you wonder how you got there? All along you had the “cavities” fixed, right?! Wrong. It is not about fixing the resulting issues but fixing the reason behind the issues. And that happened years ago now when your dentist said you needed to be seen 3-4 times a year but your insurance only paid for.
2. Follow me?
For this reason I do not allow insurance companies to run my practice or tell me what to do. I work for my patients, nobody else. My sole goal as a dentist is to inform you about your personal oral health, why you are where you are and how you can improve your situation and hopefully keep your teeth and gums healthy for the rest of your life. Period. Many years ago I fired the insurance companies and decided that to be able to provide Ideal Dentistry I need to focus on providing the best dental care system, not just fill and bill.
At Ideal Dentistry we do very few root canals, have very few emergencies, and do even fewer extractions, yet we are a highly successful practice with a great pool of patients that is growing daily. Why do you think that is? Simple, I focus on your individual situation and help you step out of the dental cycle as soon as possible!
So, now to answer the question that started this thread, Is Dental Insurance Worth The Premium? Not in my opinion, especially if you are young and have well taken care of teeth. All you really should need on a yearly basis is 2-4 cleanings and an exam with x-rays. That alone is significantly less than most premiums, even at the best dental practice. So what if you have an accident and break your 4 front teeth off? Won’t insurance pay for that? Nope, they protect themselves from paying by having a ridiculously low yearly max towards treatment. You would still end up paying most of it out of pocket.
For years you paid into this insurance, padded their pockets, and then when you need them most they say sorry. What if you had seen a dentist that helped you avoid gum disease, cavities and tooth wear and put all that money that you would have given to insurance companies into a savings account? Yes, you would have plenty saved up for emergencies as well as maybe a nice vacation. Furthermore, you would have healthy teeth and a resulting healthier body since you learned how important it is to avoid gum disease and decay in the first place. You would probably have many less fillings and saved many hours in dental office visits.
What this country needs is a class on prevention of disease, bad habits, and quick fixes. I for one have chosen a different approach to dentistry that I feel has benefited my patients significantly.
If you want to step out of the dental cycle, feel free to contact me with questions or just come in and experience the difference yourself!
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