Dental insurance is a benefit that not a lot of Americans have. In 2016, roughly 74 million Americans did not have dental insurance. While dental insurance can be an important avenue to care for most Americans, there are flaws in its system that can prevent you from getting the proper dental service that you require.

Origins of Dental Insurance

Whereas medical insurance has existed in the US since the 1850s, dental insurance started in the 1950s as an additional perk for employees. Medical insurance companies treated it as a separate package because dental care was less about emergency care. However, this is not true. Over 50,000 people are diagnosed with oral cancer a year, according to the American Cancer Society. Furthermore, roughly 2 million people go to the emergency room for dental pain each year and may be hospitalized with a life-threatening tooth infection

Dental Insurance Benefits Are Often Not Enough

Generally, dental insurance covers standard preventative care like cleanings, and then only a percentage of basic restorative and major care like crowns. According to the CDC, 47% of those above 30 suffer from periodontal disease. This likely means that an insurance company’s idea of “standard preventative care” isn’t enough to serve the needs of its customers.
Additionally, rather than looking at the real frequency of when patients need care, insurance companies look at coverage schedules regardless of what you, the individual patient may need. As a result, many individuals do not get the true care they require for proper oral health.

Coverage Allowances Have Barely Changed Since the 1960s

Yearly benefits for dental coverage have barely raised since before the Vietnam War. Back in the 50s and 60s when dental insurance was created, your yearly benefit allowance was about $1000. However, today, the same allowance is about $1,500. Is there anything you can buy today that costs the same as it did 60 years ago? If insurance kept up with both inflation and medical advances, the allowance would be $10,000. While dental insurance premiums continue to rise, the value of the coverage remains stagnant.

Dental Insurance Can Limit The Type of Care You Receive

Laser dental care, such as LANAP, is a huge advancement in dental care. These treatments can reduce pain, significantly shorten recovery time, and reduce complications. However, this is an example of a benefit that is not covered. So while your dentist may be able to provide faster, safer, less painful, and more efficient care to you; your insurance company may not agree. From laser treatments to the quality of the retainer your child receives, the insurance company simply sees its bottom line.

What Does This Mean For Patients?

Ultimately dental insurance coverage needs to be better. However, until that happens, you will likely still need to rely on your plan, along with the out-of-pocket expense, to maintain your dental health. So what can you do? Use your benefits every year to keep yourself healthy. Talk with your employers and union reps about alternatives like Health Savings Accounts (HASs) which allow you to use your money as you see fit and are not controlled by the insurance company. Be a wise consumer!

A Center for Dental Excellence does not provide medical or healthcare advice via articles. This material has been prepared for informational purposes only. It is not intended to provide, and should not be relied on for medical advice.
A Center for Dental Excellence provides expert dental care to the Brooklyn and Staten Island communities we serve. To schedule an appointment or consultation, contact us or call the office you would like to visit. (718) 232-8289 for Brooklyn, and (718) 980-9555 for Staten Island.