What is a prophylaxis (cleaning)?
What is root planing and scaling?
What is periodontal dIsease?
What is periodontal maintenance?
What is a periodontal maintenance procedure?
How often do I need to have my teeth cleaned?
Why doesn't my insurance cover all the costs for my dental treatment?
Why does my insurance only pay the least expensive alternative treatment?
If my insurance goes into effect next month, why won't my dentist do my treatment
today but submit the claim nest month so the insurance will pay?
Why doesn't my dentist participate in my dental benefits network plan?
Prophylaxis [Back to top]
A prophylaxis is also called a "cleaning". It is the removal of "plaque", "calculus" and stains
from tooth structures not affected by bone loss. (typically the crowns of the teeth.)
- Plaque is a soft, Is a soft, sticky substance that forms on teeth, regardless of what types of foods are eaten,
which is composed of bacteria and bacterial by-products.
- Calculus is also known as "tartar" and is a hard, mineralized deposit, somewhat like cement, that is formed from the
plaque in the mouth and the minerals in a person's saliva.
A regular cleaning is recommended for persons who do not have any bone loss, periodontal disease, or infection around their teeth.
There should also be no bleeding, mobility of teeth, receded areas where the gums have pulled away from the teeth, or gaps where the
spaces around the roots of the teeth are exposed. In other words, the mouth should be healthy, with no gum and bone problems.
[Back to top]
Root planing and scaling [Back to top]
Root planing and scaling are therapeutic (healing), meticulous and time consuming treatments designed to remove
toxins and bacteria from the root surfaces of the teeth, thereby allowing the body's immune system to begin the healing process.
Calculus (tartar), diseased cementum and/or dentin are scaled away. (Cementum is the hard tissue that covers the tooth root.
Dentin is that part of the tooth that is underneath the cementum.) These procedures are used as a complete treatment in some stages
of periodontal disease, and as part of preparing the mouth for surgery in others. Several appointments, treating sections of the mouth,
and local anesthesia may be required. Your local dental hygienist or dentist may provide the service. The American Academy of
Periodontology considers scaling the root surface to be a critical element in establishing periodontal health. In addition, studies
now show a relationship between gum and bone health and certain heart conditions, premature, low birth-weight babies and various
systemic diseases.
[Back to top]
Periodontal disease [Back to top]
Periodontal disease can be described as an inflammation and/or infection of the gums and bone which support the teeth. Bacterial plaque,
and its toxic by-products, plus calculus and roughened root surfaces can overwhelm the mouth's defenses. Typically, unhealthy gum tissue
covers eroded bone, resulting in abnormal "pockets" around the roots. Left untreated, periodontal disease can result in loss of teeth.
It is a common, and sometimes silent, condition in many adults.
[Back to top]
Periodontal maintenance [Back to top]
If you have periodontal disease, you may require root planning to remove diseased deposits from the roots of your teeth. Other treatment,
including surgery, may be required. After the disease process is under control, a regular cleaning is not appropriate anymore. Instead,
you will require special on-going gum and bone care treatments, also known as periodontal maintenance procedure to keep your
mouth healthy.
[Back to top]
Periodontal maintenance procedure [Back to top]
Periodontal maintenance is a procedure performed following periodontal therapy (surgery or root planing) which continues at varying
intervals, determined by the clinical evaluation of the dentist, for the life of the teeth and/or implants. Includes the removal of
plaque and calculus that may form either below or above the gum line.
Periodontal maintenance is not the same as a cleaning (Prophylaxis) even though a hygienist may perform both services. Periodontal
maintenance includes but may not be limited to:
- An update of your medical and dental history.
- X-ray review.
- Mouth/face examination inside and outside including cheeks, lips, tongue, gums and throat.
- Tooth examination by the dentist. (This is separate from the periodontal maintenance and billed seperately as well)
- Gum and bone examination. (Probing around each tooth to check for bone loss)
- Review of home care.
- Scaling and root planing as needed.
- Polishing of teeth as needed.
- Gums and pocket irrigation with medicine as needed.
Typically an interval of three months between appointments is effective, but more frequent appointments may be needed. As in many
other chronic conditions, successful long-term control of the disease and prevention of tooth loss depends on continual, and possibly
life-time maintenance.
[Back to top]
How often to get your teeth cleaned [Back to top]
The old system of everyone having their teeth cleaned only twice a year has fallen out of favor. In fact, many believe that the idea
actually came from the recommendations of a 1940 toothpaste advertisement.
While some people may be able to maintain their dental health with semi-annual cleanings, many patients find that their mouths and teeth
stay in better shape when they have their teeth cleaned more frequently. Many dentists and hygienist are now setting up a patient's
cleaning schedule based on their personal needs. This may be as often as four times a year.
[Back to top]
Why insurance doesn't cover all costs for dental treatment [Back to top]
Dental insurance isn't really insurance (a payment to cover the cost of a loss) at all. It is actually a money benefit typically provided
by an employer to help their employees pay for routine dental treatment.
The employer usually buys a plan based on the amount of the benefit and how much the premium costs per month. Most benefit plans are only
designed to cover a portion of the total cost.
[Back to top]
Why my insurance only pays the least expensive alternative treatment [Back to top]
To save money, many dental plans allow a benefit only for the least expensive method of treatment. For example, your dentist may
recommend a crown, with your insurance only offering a benefit towards a filling.
This does not mean that you have to accept the filling. The good news is that some benefit will be paid; the bad news is that more of
the fee will be your responsibility. Remember that your dentist's responsibility is to prescribe what is best for you. The insurance
carrier's responsibility is to control payments.
[Back to top]
Why dentsits will not do treatment today and submit claim next month [Back to top]
State laws regulate these issues. It is insurance fraud to change the dates of service on a claim. Both the patient and the dentist
can be prosecuted.
[Back to top]
Why dentists will not participate in a network plan [Back to top]
Some plans require that the network dentists observe certain restrictions to treatment. Many dentists are not comfortable with this.
[Back to top]
