Do I have to have x-rays?
What are sealants and does my child need them?
My insurance says they pay 80% on fillings. Why did they only pay 75% on mine?
Do I have to have a crown on my root canal treated tooth?
What is an implant and how is it different from a bridge?
What should I do if my tooth is knocked out?
Why do I need scaling and root planing? How is that different from a simple cleaning?
Dental x-rays are a very important part of a dentist’s comprehensive exam. Many times cavities that grow between teeth or under fillings cannot be detected without the help of x-rays. X-rays are not only used by a dentist to help diagnose tooth decay, but they are also critical in examining the bone and tissues which surround your teeth. They also aid in detecting periodontal disease, determining the presence and extent of infection, and, in some cases, diagnosing oral cancer. X-rays are a very important part of maintaining good dental health and are necessary for a proper diagnosis.
Sealants are placed on the chewing surfaces of teeth to help prevent tooth decay. Teeth with deep grooves and fissures on their chewing surface are usually good candidates for sealants. The sealant is a plastic-like resin material which starts out in liquid form. After the tooth is cleaned, the sealant material is applied into the grooves. It is then hardened with a special ultraviolet light. Sealing the grooves prevents penetration of bacteria thereby preventing tooth decay. Anesthetic is not needed to place sealants, and they can usually be applied in just a few minutes. With proper care they may last many years. Of course, regular brushing and flossing is essential to preventing tooth decay, but sealants may provide a good head start.
Dental insurance is one of the most beneficial and most misunderstood areas in dental treatment today. This explanation will attempt to clear up many common misconceptions about dental insurance. Dental insurance is a contract between the EMPLOYER and the PATIENT. It has NO CONNECTION at all to the dentist who is providing the dental treatment. The extent of coverage varies greatly from company to company, and sometimes even within a company. It has absolutely NOTHING to do with the level of service provided by the dentist and the fee charged for these services. An often misunderstood term used by many insurance companies is “UCR” or usual and customary. This “usual and customary” number is the maximum amount that a particular insurance company will pay for a specific procedure. It has nothing to do with the fee charged, but with the level of coverage negotiated by your employer. For this reason, estimates of a patient’s portion for any given procedure may not be exact because often there are variations in the amount that the insurance company is willing to pay based on your particular policy. For example, if a dentist charges $100 for a filling and the coverage is listed at 80%, the patient may assume that their insurance company will pay $80 toward this filling. However, if your policy only ALLOWS $90 for a filling and your policy ALLOWS 80% coverage of this amount, then the insurance company will ACTUALLY pay $72 toward the service, not $80. So instead of the patient paying $20 out of pocket, they will actually be paying $28 (the remainder of the dentist’s $100 fee). This is a common point of confusion, because the percentages given by the insurance company are not of the DENTIST’S FEE but are percentages of the ALLOWANCE of the insurance policy. Summit Dental Care’s policy on dental insurance is as follows: Our office makes every effort possible to assist you with your particular insurance coverage. Although it is not required, we will prepare and submit your insurance forms free of charge as a courtesy. We will also provide an estimate that will show expected insurance reimbursement and patient share for each procedure. Our office can only ESTIMATE what the insurance company will cover because most insurance companies will not disclose their exact ALLOWANCES. The patient’s estimated share will be due at the time of treatment. Should our estimate of the patient’s share be too high, a credit will be issued to the account or refunded to the patient if requested. Likewise, if the estimate was low, the remainder of the balance will be due at the time that the insurance payment is received. Should no insurance payment be made within 60 days of a submitted claim, the fee will become the sole responsibility of the patient who may choose to take it up with their insurance company at that time.
Most teeth that have undergone root canal therapy will require a crown. There are several reasons for this. First, the root canal procedure involves making a large opening in the top of the tooth to access the internal portion of the roots. This, along with the fact that a significant portion of the tooth is usually compromised to begin with, weakens the tooth making it more likely to fracture. A crown covers the tooth and prevents this from occurring. On rare occasions, usually in front teeth, there may be instances where the opening in the tooth is small enough that the crown is not required. One should note, however, that most root canal treated teeth darken over time so it may be desirable to crown the tooth for cosmetic purposes. The placement of a crown over a root canal treated tooth also serves to seal off the root canal system and prevent the penetration of bacteria into the tooth thereby preventing contamination. For whatever reason, the placement of a crown over a root canal treated tooth increases the longevity of a tooth, allowing it to function without the risk of fracture.
Both an implant and a bridge are used to replace missing teeth. An implant is a titanium fixture that is placed into the space where a natural tooth has been lost. It fits down into the bone and extends to about the level of the gumline. The fixture integrates solidly into the bone and, after about 3 months of healing, a crown can be placed on top of it. Implants can replace single or multiple teeth and are an ideal long-term treatment option. Because the implant is metal, tooth decay cannot form around its edges. An implant crown can be easily cleaned by the patient and functions like a natural tooth. Because the fixture is all metal, no anesthetic is required for the fabrication of the crown which takes only a few minutes as compared to a traditional crown which can take much longer. A bridge also replaces missing teeth, but requires that two natural teeth be present on either side of the space. This differs from an implant which is independent and does not require the presence of other teeth.
The best treatment for a tooth that has been knocked out is to replace the tooth in the socket as soon as possible. The best situation is for the patient to immediately replant the tooth himself/herself and then contact a dentist so the tooth and be examined and splinted into place. If the tooth is covered in debris, it must NOT be scrubbed clean before replanting but GENTLY rinsed under running water. A tetanus vaccination as well as antibiotics may be recommended by the dentist upon patient examination. If the tooth cannot be properly positioned into the socket by the patient, then the tooth must be kept moist by storing it ideally in a cup of milk, saline (i.e. contact lens solution) or at least in water. Contact a dentist as soon as possible— the greatest chance to save the tooth is if it can be replanted within 2 hours of its displacement. Replanted teeth almost always require root canal therapy. Other possible complications including infection, root resorption and ankylosis (fusion to bone) can sometimes occur. The younger the patient, the greater the chance that replanting a tooth will be successful. However, only permanent teeth (not baby teeth) should be replanted.
Scaling and root planing (SC/RP) is a more advanced type of dental cleaning than a simple cleaning or prophy which consists of the superficial removal of tartar (ABOVE THE GUMLINE) in a patient with healthy gums. SC/RP is the initial therapy in the treatment of gum disease (periodontitis). Although there is no cure for periodontitis, it can be managed with thorough tooth brushing and flossing by the patient as well as maintaining regular dental visits. This therapy is needed when deposits of tartar have accumulated on the roots of teeth (BELOW THE GUMLINE). These deposits of tartar are filled with bacteria that are very damaging to the bone and gum tissues that support the teeth. If the deposits are not removed, the destruction of the supporting bone will lead to loosening and ultimately complete loss of the diseased tooth. The procedure is performed under local anesthetic to maximize patient comfort. This treatment can be very effective in patients who follow their recommended oral hygiene regimen prescribed by their dentist.