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Navigating the World of Dental Insurance Terminology

March 22nd, 2023

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at Haley Dental. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

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

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Dr. Richard Haley, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

  • If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

  • This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

  • Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Dr. Richard Haley 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; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Carrizo Springs office.

Courting Disaster

March 15th, 2023

When we think of sports and dental damage, we naturally think of hockey and football. But when it comes to the actual number of dental injuries suffered each year, vying for top seed is the game of basketball.

How is this possible? After all, football and hockey are categorized as “collision sports”! But along with the helmets, shin guards, and padding, these teams often require mouthguards—and this makes all the difference. Studies have shown that an increase in the number of players wearing mouthguards means a decrease in the number of oral traumas.

And while basketball isn’t considered a collision sport, it is a contact sport. Basketball is a combination of running, jumping, hard surfaces, and solid bodies. And elbows. We can’t forget elbows. So a broken or even a knocked out tooth isn’t, unfortunately, all that unusual when bodies in motion meet hard surfaces—or other players. But there are other dental dangers as well. Besides tooth injuries, oral injuries can involve:

  • The ligaments and bone structures holding teeth in place
  • Bones in the upper and lower jaw
  • Delicate gum, tongue, and mouth tissue.

You need a solid defensive strategy to reduce the severity of oral injuries or to prevent them from happening altogether. The best play in your playbook? Wearing a mouthguard!

Choosing the right guard is key. There are three common options, and you can choose the model which works best for you:

  • Stock guards, which are ready-made guards in pre-formed shapes and sizes. You can buy them over the counter in drug stores and sporting goods stores. Because these guards aren’t shaped to fit your teeth and mouth specifically, they can be less protective (and harder to speak around).
  • “Boil-and-bite” guards can also be purchased, and can provide a closer fit. After warming the guard in hot water as directed, you place it in your mouth and bite down firmly to mold it to your teeth.
  • Dr. Richard Haley can make you a mouthguard which is designed and crafted specifically for your use. Because this guard is custom-fitted, it provides better protection for your teeth and mouth. Patients often find custom guards much more comfortable and more durable as well.

Mouthguards are most effective when you wear them on the court and care for them off the court. This means avoiding a few flagrant fouls.

  • Dirty play

All those moist nooks and crannies inside your mouthguard are a perfect environment for bacteria, mold, and plaque buildup. You should clean your mouthguard carefully every time you wear it, and let it air dry before popping it back in the case. Ask Dr. Richard Haley for advice on getting your guard and its case their cleanest.

  • Failure to sub out in a timely fashion

Mouthguards don’t work if they’re damaged. If you notice any warping, breakage, or jagged or sharp edges, contact our Carrizo Springs office for a replacement. If a guard doesn’t fit you properly, it doesn’t protect you, and sharp edges can irritate or injure delicate mouth tissue.

  • Unnecessary roughness

Your mouthguard protects you, so don’t forget to protect it! Keep your guard in its case when you’re not wearing it to save it from dirt, damage, and disappearance.

If you know your basketball, you know your guard game can make all the difference. Even though a mouthguard might not be mandatory on your team, that doesn’t mean it’s not essential. Remember that basketball is a contact sport, and protect yourself with a mouthguard whenever you play.

What kind of toothbrush and toothpaste should my child use?

March 15th, 2023

Dr. Richard Haley and our team know that as a parent, you want your child to be as healthy as possible. By now, you probably know that your son or daughter’s oral health plays a huge role in overall health.

When there are so many toothpaste ads and different styles of brush to choose from, it can be difficult to know which will serve your child the best. We recommend you break down the decision process to make it simpler.

First, your child’s age and stage of development are vital to consider. Until about the age or 12, your youngster may not be prepared to brush or floss adequately alone, due to dexterity issues. If that’s the case, it can be easier to use a battery-powered toothbrush to improve the quality of brushing.

Next is to select the right size of toothbrush head to fit your child’s mouth. As a general rule, the head of the toothbrush should be a little larger than the upper portion of the child’s thumb.

Flossers are great for children and easy to use. They have handles and a horseshoe shape on one end with floss in between. Your child can choose a color he or she likes as well as the handle size, shape, etc.

Not only are there many brands of toothpaste to choose from, there are also many different ingredients that offer varying benefits. Kids are at high risk for developing cavities so you want to make sure the following ingredients are in your child’s toothpaste if you wish to avoid problems later on.

Sodium fluoride is the standard ingredient for cavity prevention, while stannous fluoride is anti-bacterial and anti-cavity. Anti-sensitivity toothpastes often contain potassium nitrate, and triclosan can be found in one particular brand for anti-bacterial action.

Fluoride should not be ingested, so if your child can’t spit yet, use a toothpaste that contains xylitol. This is a natural sweetener and should be the first ingredient listed on the tube.

Now comes the fun part: choosing a flavor! Your little one may sample different flavors and select the one he or she likes the best. A youngster is more likely to adopt good brushing habits if the flavor is appealing.

Don’t hesitate to speak with Dr. Richard Haley if you need to make an appointment at our Carrizo Springs office, or if you have any questions about toothpastes or toothbrushes.

Wiggle Room

March 8th, 2023

When you’re pregnant, you expect physical changes. That’s part of the excitement of the journey! What isn’t expected—and not nearly as exciting—is when your familiar smile seems to be changing as well.

If you’ve noticed that your teeth feel loose, or that your regular tooth alignment has shifted, you might be experiencing one of the unexpected, but quite common, side effects of pregnancy—tooth mobility.

How is this “wiggle room” possible? After all, you’re making sure that you’re eating a diet rich in protein, vitamins, and minerals, including calcium, vitamin D, and all the other nutrients which keep teeth and gums healthy. You’re brushing and flossing regularly to prevent cavities and gum disease. You haven’t changed your healthy dental habits, so why are you seeing different results?

The answer lies in the hormonal changes which occur with pregnancy. Your body has significantly increased production of hormones such as estrogen, progesterone, and relaxin. One of the benefits of these higher hormonal levels is their relaxing effect on your ligaments and joints. Relaxed ligaments and joints help make pregnancy and childbirth easier.

But you can’t target hormones just where they’ll be most useful. An increase in hormones affects the ligaments and joints throughout your body. And while this explanation might seem unrelated to loose teeth, it is, in fact, the “root” of the matter.

A complex support system holds our teeth securely in their sockets. Instead of being rigidly fused to the jaw, each tooth root is surrounded by a periodontal ligament within the socket. This ligament is largely made of flexible connective tissue, and attaches to both the root of the tooth and the bone tissue of the jaw, holding the tooth in place. Its flexibility helps cushion your tooth from pressure and impact, and allows the tooth movement which makes orthodontic work possible.

The hormones which relax ligaments and joints throughout the body have that same relaxing effect on the flexible ligaments and joints in the mouth. So it’s not uncommon to find that your teeth feel a bit looser, or that your customary tooth alignment has shifted, or that you’re experiencing discomfort in your jaw joint, especially if you grind or clench your teeth.

Fortunately, while loose teeth are alarming, it’s most often only a temporary condition. Your teeth and ligaments should return to their normal, stable status after your baby is born. But because dental health can impact on your pregnancy, see us if you notice any changes in your smile. We want to rule out any other causes of tooth mobility, including gum disease, tooth abscesses, or other serious conditions.

Other proactive prenatal tips to keep your smile its healthiest?

  • Call us when you learn about your pregnancy. We can offer suggestions for caring for yourself and your dental health during this exciting time.
  • Keep up with your dental hygiene. Brushing and flossing are more important than ever to keep your gums healthy.
  • And, because your gums might be more prone to gingivitis now, extra cleanings as needed can keep plaque buildup from forming.
  • Don’t forget your regular appointments at our Carrizo Springs dental office for exams and cleanings. We want to help prevent any small problems from becoming larger ones.

Pregnancy is a time of many physical changes. Dr. Richard Haley will work with you to ensure that one thing which remains constant is your beautiful, healthy smile!

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