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Understanding Dental Insurance Terminology

December 7th, 2023

If you have a hard time understanding your dental insurance plan, particularly the treatments and services it covers, you’re not alone. That’s why Dr. Bill Whitley and our team have put together a cheat sheet to help you through them.

It’s common for patients to get lost in the morass of the terms and phrases that surface when you’re dealing with a dental insurance plan. Knowing the commonly used terms can help speed up the process and enable you to get the most out of your coverage.

Common Terms

Annual Maximum: The most your policy will pay per year for care at Whitley Family Dental. It is often divided into cost per individual or per family.

Co-payment: Typically, a small amount the patient has to pay at the time of service before receiving care, and before the insurance pays for any portion of it.

Covered Services: A list of all the treatments, services, and procedures the insurance policy will cover fully under your contract.

Deductible: An amount you must pay out of pocket each year before the insurance company will contribute for any treatments or procedures. The amount can vary according to your plan.

Diagnostic Services: A category of treatments or procedures that most insurance plans will cover before the deductible, which may mean services that occur during preventive appointments with Dr. Bill Whitley, including X-rays or general screenings.

Exclusions: Dental services not covered under a dental benefit program.

In-Network: An insurance company will usually cover a larger portion of the cost of the care if you see an in-network provider for treatment.

Out-of-Network: If you visit someone who is not a part of your provider’s network, the insurance company may pay for a portion of the care, but you will be responsible for a significantly larger share out of your pocket.

Lifetime Maximum: The most that an insurance plan will pay toward care for an individual or family over the entire life of the patient(s).

Limitations: A list of all the procedures the insurance policy does not cover. Coverage may limit the timing or frequency of a specific treatment or procedure, or exclude some treatments altogether.

Member/Insured/Covered Person/Beneficiary/Enrollee:  A person who is eligible to receive benefits under an insurance plan.

Premium: The regular fee charged by third-party insurers and used to fund the dental plan.

Provider: Dr. Bill Whitley or other oral-health specialist who provides treatment.

Waiting Period: A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments.

It’s essential to understand the various insurance options available to you. Knowing what your insurance covers can save you major costs in the future.

Dr. Bill Whitley and our dental staff hope this list of terms will help you understand your dental insurance plan better. Be sure to review your plan and ask any questions you may have about your policy the next time you visit our Dallas office.

Why should I have my child’s wisdom teeth removed?

November 29th, 2023

The wisdom teeth are the last of the permanent molars to emerge from the gums. This can occur as early as age 17 or as late as 21. Though some teens and young adults experience a completely normal tooth eruption with ideally aligned molars that pose no health threat, this is not the case for everyone.

According to the American Association of Oral and Maxillofacial Surgeons (AAOMS), wisdom teeth must meet specific criteria to avoid a required extraction. These guidelines include:

  • Completely erupted and non-impacted
  • Completely functional
  • Painless
  • Free of decay
  • Disease-free
  • Capable of being properly cleaned

If one or more of your child’s wisdom teeth do not meet these conditions, we recommend scheduling an appointment with Dr. Bill Whitley; an extraction may be necessary.

Impacted wisdom teeth

One of the most common reasons for extracting a wisdom tooth is due to impaction. An impacted wisdom tooth is one that has not erupted and will not fully erupt from the gums. Usually this occurs because there is not enough room for the tooth to emerge. Impaction can be painful and can also lead to infection if left untreated. According to the AAOMS, roughly 90 percent of the teen and adult population has at least one impacted tooth. Extracting an impacted wisdom tooth early can help prevent future complications, such as periodontal disease, infections, and damage to neighboring teeth.

Extracting fully erupted wisdom teeth

Even if your child’s wisdom teeth are fully erupted, Dr. Bill Whitley and our team at Whitley Family Dental may recommend removing them as a preventive measure. Fully-erupted third molars often interfere with a healthy bite. This can lead to problems with tooth and jaw alignment and may also contribute to the development of headaches. Your child’s wisdom teeth may also be more prone to tooth decay and gum disease, because their location in the back of the mouth makes them more difficult to reach for brushing and flossing.

To learn more about wisdom teeth, or to schedule an appointment with Dr. Bill Whitley, please give us a call at our convenient Dallas office!

Can children be at risk for periodontal disease?

November 22nd, 2023

You want to check all the boxes when you consider your child’s dental health. You make sure your child brushes twice daily to avoid cavities. You’ve made a plan for an orthodontic checkup just in case braces are needed. You insist on a mouthguard for dental protection during sports. One thing you might not have considered? Protecting your child from gum disease.

We often think about gum disease, or periodontitis, as an adult problem. In fact, children and teens can suffer from gingivitis and other gum disease as well. There are several possible reasons your child might develop gum disease:

  • Poor dental hygiene

Two minutes of brushing twice a day is the recommended amount of time to remove the bacteria and plaque that cause gingivitis (early gum disease). Flossing is also essential for removing bacteria and plaque from hard-to-reach areas around the teeth.

  • Puberty

The hormones that cause puberty can also lead to gums that become irritated more easily when exposed to plaque. This is a time to be especially proactive with dental health.

  • Medical conditions

Medical conditions such as diabetes can bring an increased risk of gum disease. Be sure to give us a complete picture of your child’s health, and we will let you know if there are potential complications for your child’s gums and teeth and how we can respond to and prevent them.

  • Periodontal diseases

More serious periodontal diseases, while relatively uncommon, can affect children and teens as well as adults. Aggressive periodontitis, for example, results in connective and bone tissue loss around the affected teeth, leading to loose teeth and even tooth loss. Let Dr. Bill Whitley know if you have a family history of gum disease, as that might be a factor in your child’s dental health, and tell us if you have noticed any symptoms of gum disease.

How can we help our children prevent gum disease? Here are some symptoms you should never ignore:

  • Bleeding gums
  • Redness or puffiness in the gums
  • Gums that are pulling away, or receding, from the teeth
  • Bad breath even after brushing

The best treatment for childhood gum disease is prevention. Careful brushing and flossing and regular visits to our Dallas office for a professional cleaning will stop gingivitis from developing and from becoming a more serious form of gum disease. We will take care to look for any signs of gum problems, and have suggestions for you if your child is at greater risk for periodontitis. Together, we can encourage gentle and proactive gum care, and check off one more goal accomplished on your child’s path to lifelong dental health!

Need Another Reason to Stop Biting Your Nails?

November 15th, 2023

Painful nails and cuticles, ruined manicures, reluctance to shake hands—there are so many good reasons to overcome the nail biting habit. But did you know that biting your nails is also bad for your dental health? Let’s look at a few more reasons to give our nails a break.

  • Bacteria Bonanza

It’s a vicious—and unhealthy—circle. Nail biting leads to injuries to the nails, cuticles, and skin surrounding the nails. These broken, jagged nails can now cause injury to delicate gum tissue. And to make things worse, fingernails harbor a lot of germs and bacteria, leading to the risk of illness and oral infections.  At the same time, bacteria from our mouths can get into the area around the injured nail, potentially leading to painful infections in the fingers.

  • Bruxism

Studies have indicated that nail biters have a greater risk of bruxism. Bruxism, better known as tooth grinding, can lead to a number of serious problems over time. Grinding and even clenching teeth on a regular basis can cause chronic headaches, worn enamel, fractured teeth, broken dental restorations, receding and inflamed gums, and loose teeth.

  • Breakage & Bad Bites

Your nails suffer obvious breakage, clearly, but your teeth are also at risk. The constant pressure of nail biting can lead to cracking, chipping, and erosion in the front teeth. Further, the pressure put on your teeth can even move them out of alignment, leading to bite problems. As you can imagine, nail biting has an even greater impact if you are wearing braces, because those teeth are already under pressure.

Why do we bite? Nail biting, or onychophagia, is a habit often started in childhood. Some people quit on their own as they reach adulthood, but for others, it can be a lifelong and painful habit. The explanations for nail biting are many: some researchers regard the habit as a form of compulsive behavior, others believe it to be a grooming impulse gone haywire, still others think it’s a way that we respond to anxiety or other stresses.

Whatever the cause, if you want to break the habit, you have options. There are over the counter polishes that use an unpleasant taste to deter biting. Learning to recognize triggers such as stress or boredom can help you choose a different response, such as snapping a rubber band around your wrist or gripping a stress ball. Dr. Bill Whitley can recommend some techniques for modifying this behavior. And finally, we can offer you suggestions for quitting, or even customize a mouthguard at our Dallas office to discourage nail biting and prevent the problems that come with bruxism.

It’s never too late to quit. If nail biting has become more than a cosmetic problem, let’s work on a solution. Healthy, attractive nails are a great goal to work toward, but nothing beats a beautiful, healthy smile!