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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. Collins 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 Gentle Dental Care. 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. Collins, 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. Collins 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. Collins 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 Mundelein office.

Your gums are responsible for a large part of your overall oral health. So keeping them healthy and knowing how to detect gum disease is extremely important.

Since it’s often painless, gum disease may go unnoticed and can progress when left untreated. Understanding the causes of gum disease will give you the ability to keep your oral health in great shape:

• Bacteria and Plaque. Good hygiene helps remove bacteria and plaque from teeth. When plaque is not removed, it turns into a rock-like substance called tartar, which can only be removed by a dentist.
• Smoking and Tobacco. Smokers and tobacco users put themselves at a higher risk of developing gum disease. Tobacco use can also stain your teeth, give you bad breath, and increase the risk of oral cancer. It’s best to avoid using tobacco altogether.
• Certain Medications. Ironically, certain medications for other health conditions can increase your risk of developing gum disease. Talk with Dr. Collins if you have concerns about a medication you are taking. Steroids, anti-epilepsy drugs, certain cancer therapy medications, and oral contraceptives can be among the culprits.
• Medical Conditions. Certain medical conditions can also affect your gum health. Diabetics can have an increased risk of gum disease due to the inflammatory chemicals in their bodies. Talk to our team about your health condition so we can take that into account when treating you.

Luckily, there are actions you can take to prevent gum disease. You should make regular visits to our Mundelein office for regular cleanings. It’s also worthwhile to maintain good hygiene habits at home, such as flossing and brushing at least two times every day.

Good oral hygiene practice and visits to our Mundelein office can help you eliminate or reduce the risks of developing gum disease!

The community health awareness group Oral Health America has reported that 82 percent of adults are unaware of the role that infectious bacteria can play in tooth decay or cavities, and almost three out of five children aged 12 to 19 have tooth decay. Since June is National Smile Month, Dr. Collins and our team at Gentle Dental Care thought we’d remind our patients about the importance of good oral hygiene visits between office visits.

To keep your family’s smiles healthy and beautiful for years to come, be sure to:

• Brush at least twice a day with fluoride toothpaste
• Floss every day to clean between your teeth
• Eat a healthy, well-balanced diet
• Reduce your intake of sugary foods and drinks
• Visit Dr. Collins for scheduled appointments

If you want to know more about healthy home care habits, feel free to ask our team at your next appointment, or ask us on Facebook!

Many dentists and hygienists recommend fluoride treatments for their adult patients. You might ask yourself, “Do I really need a fluoride treatment? I thought those were just for my kids.” After all, most insurance plans cover fluoride treatments only up to the age of 18.

What you need to know as a dental consumer is that studies have shown topical fluoride applications performed by a dental professional create a significant benefit for adults who have moderate to high risk for cavities.

There are several circumstances that warrant extra fluoride protection among adults. Many prescription medications reduce saliva flow or otherwise create dry mouth. A reduction in saliva increases cavity risk.

Adults often experience gum recession, which exposes part of the root surface of teeth. These areas are softer than the hard enamel at the top of the tooth, which makes them more susceptible to decay.

In addition, adults often get restorative work such as crowns or bridges. Fluoride can help protect the margins of these restorations, ultimately protecting your investment.

Today many people opt for orthodontic treatment (braces) as adults. Braces make it more challenging for patients to maintain good oral hygiene. Just ask your kids! Fluoride can keep the teeth strong and cavity-free even with the obstacle of orthodontic appliances.

Have you had a restoration done within the last year due to new decay? If you have, that puts you at a higher risk for cavities. Fluoride treatments are a great way to prevent more cavities in patients who are already prone to them.

How is that flossing coming along? You know you should floss daily, but do you? If your oral hygiene is not ideal, fluoride could be just the thing to keep your neglect from leading to cavities between your teeth.

Fluoride can also help with the growing problem of sensitive teeth. Diets high in acidic foods and beverages, general gum recession, and increased use of whitening products all tend to produce sensitive teeth. Fluoride treatments re-mineralize tooth enamel and reduce that sensitivity.

Patients who undergo radiation treatment for cancer also benefit from topical fluoride applications. Radiation damages saliva glands, thus greatly reducing the flow of saliva. Saliva acts as a buffer against the foods we eat and beverages we drink. Once again, less saliva greatly increases the risk of cavities.

If one or more of these conditions applies to you, consider requesting a topical fluoride treatment. Be sure to ask Dr. Collins at your next appointment whether you might benefit from a topical fluoride application.