Insurance and Preventive Dentistry

Dentistry Today


Some medical insurance companies are expanding their coverage to include various preventive dental procedures based on the increase in knowledge linking systemic disease to oral healthcare. Some of these services are an additional dental prophylaxis yearly to pregnant women, diabetics, and patients with heart disease, and may also include coverage for prescription mouthwashes. These additional covered services come as employers look at ways to decrease medical costs overall. Aetna, Blue Cross Blue Shield of Michigan, and Cigna are offering options that will reduce medical costs to high-risk populations. Within these plans, nurses were asked to contact employees with heart disease and diabetes, as well as pregnant women, inviting them to visit the dentist; 36% of the 2,200 contacted actually were seen by their dentist. Michigan Blue Cross, Washington Dental, and MetLife offer these coverages at no additional cost. Reduction in overall costs were achieved when some services were shifted, ie, x-ray coverage from every 6 months to annually. Other insurers expect that reduction in medical treatment costs will compensate for the increase in preventive care. In a 2-year study of 116,306 insured patients, earlier periodontal services were “associated with reduced retrospective risk scores for diabetes mellitus, coronary artery disease and cerebrovascular disease.” In addition, by allowing unused dental allowances to roll over at year end, Guardian, Cigna, and Principal Financial Group are now covering implants as an alternative to bridges, since studies indicate that implants last longer than bridgework. Many more insurance companies cover implants at 50%, reports the American Academy of Implant Dentistry. Some plans cover composite restorations over amalgam.

(Source: The Oral Care Report, Colgate Professional, Volume 16, Number 4, 2006)