What is my
dental insurance all about?
Dental
insurance is all about paying for some portion of some
procedures.
Some
procedures are not covered. During a calendar year
there is limited total coverage. Most procedures carry
a co-payment.
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Why didn’t
my dental insurance pay for everything?
The
only source I’ve known to proclaim that dental insurance
“pays for everything” is the insurance salesman. To get
a better idea of what your prescribed treatment will
cost, the dental office can process an insurance
estimation called a pre-determination.
Pre-determination may be unreliable when dual coverage
occurs. The insurance industry is uncooperative in
relaying information for dual coverage situations.
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What is
prevention?
Dental
prevention is action taken so that dental diseases do
not start. Thorough tooth brushing teeth three times a
day for about three minutes each time is the primary
vital action targeting elements of microbial dental
diseases. Flossing once a day additionally constitutes
good at-home participation. More ideal prevention
includes professional cleanings by a dental hygienist
twice a year.
Oral
bacterial diseases are progressive and cumulative and
become more complex over time. Therefore, prevention
also is action taken to minimize disease in progress.
Brushing and flossing are still essential but a dentist
will need to diagnose and treat existing conditions. An
example of this is the eradication of a small area of
decay before the decay becomes extensive.
A
third level of prevention is early treatment undertaken
to intercept incipient disease. An example is
interceptive orthodontics, which is undertaken before
adult teeth have erupted. Another example is the
treatment of the cause of cracked teeth.
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What is
occlusal disease and what causes it?
Occlusal
disease is a number of conditions that occur when the
upper teeth position to or contact to the lower teeth in
a dysfunctional or harmful way. This can be called
functional malocclusion. Malocclusion then is more than
just crooked teeth, crowded teeth or overbite. Occlusal
disease may be associated with cracked, drifting, worn,
loose or sensitive teeth; with muscle or joint pain or
headache; with restricted jaw movement; or with the
perception that the teeth close together in an
uncoordinated or unnatural manner.
Clenching
and excessive tooth grinding or bruxism is the most
common destructive parafunctional habit. Other harmful
habits like biting on objects and intense gum chewing
can be damaging. Occlusal trauma is another condition
and it happens when tooth surfaces meet stressfully even
during regular function.
The
condition called temporomandibular dysfunction is
multifaceted in nature and may have a psychological
overlay. The beginning stage usually involves
inflammation of muscles that move the lower jaw.
Progressive degeneration can lead to irreversible
structural and functional changes.
The
understanding and treatment of occlusal disease and
malocclusion uniquely differentiates dentistry from all
other healing professions. Treatment can sometimes be
accomplished with a conservative removable appliance.
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What is
gum disease and what causes it?
Gum
disease is the dental disease known as periodontal
disease or pyoria. It causes destruction of the jawbone
that anchors and roots teeth. Gum disease is
preventable, but most adults show signs of it.
Toxins
(poisons) produced by bacteria promote the damage to
jawbone. In advanced stages teeth loosen and drift,
gums bleed and swell, and foul odor occurs. Pain may
not be present.
Brushing
thoroughly three times a day removes the harmful
bacteria. Flossing removes plaque (complex sticky
bacteria) missed by brushing alone. One should floss
every day. Proper brushing and flossing is the best
prevention for gum disease.
Identification
of periodontal disease is done with x-ray, inspection
and observation. If the infection and inflammation of
gum disease gets too deep, teeth may require removal.
Early stage deep cleaning treatment preliminarily can
halt the disease, but bone loss is lasting.
Periodontal
disease can be subtle. It can occur in isolated areas.
It can disappear and reappear. It can be subject to
nutrition, to stress and to an uncoordinated biting
pattern. Some forms are contagious. To diagnose this
disease see a dentist every six months for professional
cleaning and checkup.
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What is
decay and what can be done about it?
Tooth
decay is the dental disease known as caries or
cavities. Caries causes destruction of tooth enamel and
root surface. Cavities are preventable and affect young
or old. This condition is the single most common
chronic childhood disease.
Cavities
are formed by acid, produced by bacteria, which
dissolves and destroys tooth structure. This is how
holes (cavities) are produced in teeth. Sugars and
starches (carbohydrates) left on the teeth allow the
bacteria to thrive. Residual candy, soda pop, deserts
and snack foods are most offensive.
Brushing
thoroughly three times a day removes the bacteria and
carbohydrates. Flossing removes plaque (bacteria plus
carbohydrates) missed by brushing alone. One should
floss every day. Proper brushing and flossing is the
best prevention for cavities. Chewing gum or using a
fluid jet device is no substitute for brushing and
flossing.
Symptoms
of caries can be subtle and can occur without immediate
pain. Cavities can be found on the top, sides or root
surface of a tooth. The latter occurs especially in the
elderly. Caries can also occur around aging dental
work. Left without treatment, caries can cause the
tooth to become unable to be restored.
Identification
of caries is done during the dental exam by using x-ray,
laser and observation. Treatment is done by removal of
damaged tooth structure followed by restoration with
porcelain, plastic or metal. Modern pain control
measures are used throughout.
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Are
there high tech solutions for dental decay?
Identification
of certain decay has entered the high-tech world. It
can now be done without taking an x-ray, without having
to pick and prod, without drilling to excavate for
depth, without exploratory tooth abrasion. It is done
with a great deal of accuracy. We can find out when to
restore. We can discover if just extra brushing is
necessary. With digital accuracy, the dentist can judge
if a restoration or a sealant is the best choice for
intervention. This is all being done in the privacy of
the dental office. The process is safe and
non-invasive. No medication, anesthetic or sedation is
required. A laser is used and it takes a matter of
seconds.
Restoration
of damaged or decayed teeth has also been
revolutionized. Wouldn’t it be nice to restore a
damaged or decayed tooth with a choice of materials?
Wouldn’t it be nice to be able to choose plastic,
porcelain or gold for restoration? Gold would be for
superior protection against a strong bite. Gold has
always been an ideally biocompatible material.
Porcelains and plastics are used in the aesthetic
zones. In addition, porcelain layered on gold is for
strength, biocompatibility and beauty.
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What is
this controversy on dental amalgam and mercury?
Patients
are asking more questions of their doctors. Consumers
are demanding to be more involved in their own health
care decisions. The same thing is happening in
dentistry.
Some
dental patients are concerned about the dental material
used in their mouths. Metals, plastics, chemical
compounds, disinfecting agents and mixtures of naturally
occurring substances can all be used during a single
dental visit.
The
dental material under the microscope these days is
dental amalgam. This is the technical name for what is
usually referred to as a silver filling. “It contains a
mixture of metals such as silver, copper and tin, in
addition to mercury, which chemically binds these
components into a hard, stable and safe substance.” ADA
It
is the mercury component that has some worried. Mercury
is a metal element that is a liquid at room
temperature. In this state it is very toxic. But
mercury is changed from its liquid form just before the
dentist uses the silver filling mixture.
Hundreds
of millions of these restorations have been placed over
the last one hundred and fifty years. The American
Dental Association claims that, “there is no scientific
evidence that exposure to mercury from amalgam
restorations poses a serious health risk in humans,
except for the exceeding small number of allergic
reactions.”
Crusaders
against amalgam are concentrated in Sweden and Canada.
They claim harmful mercury in amalgam liberates with
wear in sufficient quality to cause harm. According to
them, dental amalgam may be associated with
gastrointestinal changes, central nervous system effects
and other pathology.
The
controversy is likely to continue for years to come.
Proof is hard to determine because testing on human
subjects is impossible. Yet many patients are
requesting dentists to remove their serviceable amalgam
fillings just to “play it safe.”
There
are considerations in replacing existing amalgam
restorations. First, a dentist cannot promise improved
health or promise future disease prevention. Second,
the financial cost of replacing restorations may be
high. Third, a question arises whether the new
restoration is any more biocompatible than the one it
replaced. Last, the replacing process may damage or
injure previously asymptomatic teeth.
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Why does
the doctor need x-rays?
Dental
x-rays help the dentist do his job. The dentist’s basic
duty is to detect, disclose and correct diseases of the
mouth. The human eye cannot detect what x-rays detect.
Therefore, without dental x-rays, disease may go
untreated.
There
are two prevalent infectious oral diseases. Gum disease
is one of the most common diseases of man. It causes
teeth to loosen and eventually fall out. Pain, bleeding
gums or foul breath may indicate gum disease. Those who
don’t visit a dentist at least once a year almost
certainly are prime suspects for developing gum disease.
Tooth
decay or cavities is the other widespread condition. If
untreated cavities grow in size and eventually cause
tooth pulp inflammation, infection or death. Early
warning signs for tooth decay or gum disease may not
appear. So waiting, “till it hurts,” or “until I have a
problem,” usually invites bigger costs.
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Why do I
have to get my teeth cleaned?
Professional
teeth cleaning at a dental office removes deposits on
teeth that can’t be removed. These deposits cause gum
disease.
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