How Dental Costs Can Add Up – Even With Dental Insurance

dental cost can add up, even if you have insurance. In fact, a bad year for the typical American can easily cost more than their annual dental plan deductible.

Overhead includes rent or mortgage payments, payroll for hygienists and office staff, health insurance, supplies and business taxes. Some local community health centers and medical insurance programs may also provide low-cost care.

Preventive care

Preventive care helps keep your oral health in the best possible condition, reducing your risk of more extensive restorative procedures down the road. It includes services like teeth cleanings, fluoride treatments and limited x-rays.

Almost all dental insurance plans include preventive care to some extent. However, most have co-insurance and annual maximums that determine how much of a treatment is covered after you’ve met your deductible.

The most affordable options tend to be PPOs with a wide provider network and dental HMOs with flat-fee copays. Check each plan’s annual maximum and deductible rates, as well as any waiting periods for specific types of treatment. This can make a big difference in how much you pay for your dental coverage. Indemnity plans offer more flexibility in choosing a dentist, but may require higher out-of-pocket costs than those with provider networks.

Routine cleanings

Routine cleanings are the foundation of good oral health. They remove plaque, tartar and biofilm (a thin film of bacteria that can’t be removed with brushing alone) from teeth and the gum line. They also catch early stages of tooth decay or gum disease and provide patients with a head-start on improving their overall oral health.

Dental cleanings are quick and relatively pain free, although some patients may experience sensitivity or sore gums afterward. These symptoms are normal and should subside within a few days.

If you have dental insurance, routine cleanings will usually cost nothing out of pocket. However, if you haven’t been to the dentist for a while and have excessive build-up you will likely need a deep cleaning procedure, which can add an extra $100 or more to the total bill.

Fillings

In most cases, fillings are considered a medical necessity and thus largely or fully covered by your dental insurance service provider. This is especially true for those who have a preventative dental plan in place.

The type of filling material used is one of the biggest factors that impact the cost of the procedure. Silver fillings (amalgams) are the most affordable and tend to last a little longer than composite resin or porcelain fillings.

Porcelain and cast-gold fillings, on the other hand, are made in a lab, bonded to the tooth, and are more resistant to staining. These are the most expensive types of fillings and can run from $250 to $4,500 per filling. They’re usually reserved for molar teeth where cavities are harder to reach with other procedures.

Crowns

Crowns are tooth-shaped caps that cover and protect damaged or decayed teeth. They can also replace a missing tooth. Dental insurance covers most of the cost of crowns that are deemed medically necessary, but the exact amount depends on your plan and type of crown.

Typically, a dentist will need to schedule several appointments to complete the crown procedure. However, some dentists offer same-day crowns by using digital pictures and scans to build the crown in the office as the patient waits.

Crowns can be made from porcelain, porcelain fused to metal, gold, and a new material called zirconia. The most expensive are the porcelain ones, but they look more natural and have better durability than metal crowns. Crowns for cosmetic reasons are usually not covered by dental insurance.

Bridges

If you have missing teeth, dental bridges are a great solution to restore your smile and prevent further damage to your mouth. However, it’s important to understand the benefits and challenges of both bridges and implants before deciding which treatment is best for you.

A conventional bridge uses two anchoring teeth (abutment teeth) to support a false tooth, called a pontic. These abutment teeth need to be healthy enough to support the bridge, and can weaken over time due to future dental procedures.

The cost of a bridge can vary depending on the type of bridge, materials used and location of the dental practice. Bridges may also be partially covered by insurance. On average, bridges cost $1,000-$5,000 per artificial tooth. This can be a significant investment for those without insurance.

Implants

Dental implants are an excellent alternative to bridges and dentures. However, they can be expensive. Dental insurance usually does not cover them, but there are ways to reduce the cost.

Your dentist will need to determine whether you are a candidate for implants. This will involve a comprehensive exam, including X-rays and dental CT scans of the jawbone and gums. He or she may also need to perform a bone graft, which will require additional surgery.

The cost of dental implants depends on several factors, including the type and complexity of the procedure. The implant material, the number of implants required, and the need for a bone graft will all influence the price. The price of a single implant can range from $3,000 to $4,500.

Orthodontics

Dental insurance typically has a maximum out-of-pocket limit that applies to individual services. These limits vary by plan type and insurer. For example, Marketplace plans typically have annual maximums of $1,000 to $2,000.

Most dental insurance plans require deductibles, copayments and waiting periods. Depending on the plan, these fees can add up quickly.

Copays are fixed fees that you pay for procedures after reaching your deductible. These fees are usually low, such as $20 or $30. Most plans also include a schedule of benefits, which lists the amounts that the insurance company will cover for each procedure. These fees are based on a variety of factors, including your area’s cost of living, average prices at other dentist offices and the materials used for treatment.