23 Apr Dental Coverage for Sealants
If people neglect to take care of their teeth at home or visit the dentist regularly for preventive care, their teeth may develop conditions, like cavities or an infected pulp (“What’s the Difference between Dental Sealants and Dental Fillings?” 2018). However, sometimes, people cannot fully clean areas, such as the back teeth, by just brushing and flossing (“Dental Health: Sealants” 2018). For these teeth, people can choose to get sealants (“What Is the Difference Between a Dental Filling and a Dental Sealant?” 2013). Sealants can help people better care for their teeth, and fortunately, dental insurance can cover them.
Sealants can help protect the teeth from substances that could potentially damage them. Many people, including children, teenagers, and adults, can get sealants, which “is a thin, plastic coating painted on the chewing surfaces of teeth — usually the back teeth (the premolars and molars) — to prevent tooth decay. The sealant quickly bonds into the depressions and grooves of the teeth, forming a protective shield over the enamel of each tooth” (“Dental Health: Sealants” 2018). Due to the sealants, the teeth would be less susceptible to decay, since plaque and food would not get stuck in those areas (“Dental Health: Sealants” 2018). Regarding costs, people have pay for a sealant per tooth, and there is usually no price difference between sealants for baby teeth and permanent teeth (Staff Dentist 2019). Although sealants can last “up to 10 years,” people need to regularly visit the dentist who can examine their sealants “for chipping or wearing…” (“Dental Health: Sealants” 2018). People can inadvertently remove their sealants when eating or chewing sticky foods or damage their sealants when grinding their teeth (“What Is the Difference Between a Dental Filling and a Dental Sealant?” 2013). Dental practices may or may not require patients to pay for repairing or replacing their sealants (Staff Dentist 2019).
Dental insurance policies can cover sealants, but they can limit their coverage for them. They usually provide benefits for sealants because sealants can “reduce tooth decay, and thus fillings,” which are more expensive than sealants (Staff Dentist 2019). Consequently, dental insurance companies would not have to spend more money on pricier services, such as fillings (Staff Dentist 2019). However, policies usually just provide benefits for sealants to those under age 16 or 18 (“Dental Health: Sealants” 2018; Staff Dentist 2019). Furthermore, they would typically provide coverage for sealants applied to “1st and 2nd permanent molars,” but not “for primary (baby) teeth or permanent bicuspids (premolars)” (Staff Dentist 2019). Dental insurance companies may also deny coverage for sealants applied to teeth with “caries (tooth decay)” and to wisdom teeth (Summerford 2016). They may also limit benefits by covering a sealant on one tooth or covering sealants “once every 3 or 5 years” (Staff Dentist 2019).
Dental sealants can help mitigate tooth decay. While dental insurance policies may have some caveats for covering sealants, people can still enjoy some coverage for them.