Your oral health matters and dental coverage can help you achieve and maintain it. The reason may be greater than you think. Poor oral health doesn't just affect your mouth. Research suggests it may contribute to health conditions such as cardiovascular disease, kidney disease, diabetes, and cancer. In addition, many health conditions such as osteoporosis, Lyme disease, and eating disorders often show early signs in your mouth. Regular visits to the dentist can play a vital role in the early detection and management of these and many other health conditions.
While dental coverage won't make you go to the dentist, it helps address the number one reason why people don't go – cost. You may be well-intentioned, but chances are that you won't get the oral care you need if you don't have dental coverage. According to the National Institutes of Health's recent report on oral health, half of US adults with dental insurance have gone to the dentist at least once in the past 12 months. That percentage drops to 16% for those without dental coverage.1
In addition, dental plans often provide access to a network of dentists that may dramatically reduce their charges. When you visit one of these dentists, it may reduce your out-of-pocket cost significantly. In fact, if you need more expensive dental work, the savings can more than offset the cost of the dental coverage premium.
Many people are familiar with medical and prescription drug coverage, but they incorrectly assume that dental plans work the same way. As a result, they are disappointed when their dental plan covers less than they expect. It is important to understand why dental insurance is structured differently than other types of health insurance.
Medical and prescription drug plans play a vital role in protecting people from financial ruin. An emergency department visit can cost thousands of dollars, surgeries can cost tens of thousands, and major long-term conditions can exceed hundreds of thousands or more. Medications can be similarly expensive. Since healthcare costs are so high and medical and prescription plans often cover a significant portion of these costs, premiums for these plans are very expensive.
Dental plans work differently. The cost of dental treatment is not nearly as substantial as medical and prescription expenses. Also, dental disease is generally preventable with good oral healthcare practices.
With this in mind, dental plans typically cover most, if not all, of the cost for preventive and diagnostic services such as exams, X-rays, cleanings, fluoride treatments, and sealants. This strong level of coverage removes financial barriers to encourage regular preventive care. When dental problems arise and the participant has not yet approached their annual plan maximum, plans often cover a substantial portion of the cost of treating oral disease. This encourages prompt treatment to help avoid any disease from progressing. But for more costly dental treatment that is avoidable or is elective by nature dental coverage typically requires members to assume a greater portion of the cost. This encourages people to take responsibility for their oral health and ensures that individuals with better oral health are not burdened with higher premiums. This approach also encourages healthier individuals to continue to participate in dental coverage programs, which helps keep premiums lower for everyone over time.
1 National Institutes of Health: Oral Health in America: Advances and Challenges: Executive Summary, December 2021, pg. 12.