Dental and Medical Insurance for Extracting Wisdom Teeth

Dental and Medical Insurance for Extracting Wisdom Teeth

People must go to maxillofacial surgeons for removing their wisdom teeth but removing them can be expensive (“Is wisdom tooth removal covered by health insurance?” 2017). While not everyone needs the procedure, other people’s wisdom teeth, depending on the teeth’s condition and location in the mouth, can lead to “pain, damage to other teeth, misalignment of other teeth, damage to the jaw, [increased] tooth decay, gum inflammation, or sinus issues” (Nowak 2019). Simple extractions for a wisdom tooth that is fully erupted, has simple roots, and is positioned naturally, can range from $75 to at least $500, but simple extractions for four wisdom teeth can range from $300 to at least $1200 (Nowak 2019). However, wisdom teeth that are impacted can cost much higher. For instance, extracting a soft-tissue-impacted wisdom tooth “still partially encased in gum tissue” can range between $225 to at least $600, but extracting four of these teeth can range between $800 to $1500 (Nowak 2019). The surgery for a bony impacted wisdom tooth “still encased in the jaw bone” can range from $275 to at least $900, but extracting four of them can range from $1000 to at least $3000 (Nowak 2019). Along with the surgery, people have to consider the costs of exams, x-rays, nitrous oxide or anesthesia for the surgery, aftercare, prescriptions, etc. (Nowak 2019). People could utilize their dental and medical insurance to pay for the procedures.

Dental insurance has caveats for covering wisdom teeth extractions. It may cover a simple wisdom tooth extraction as a basic service for 50% to 80% of the cost (Staff Dentist). It may cover a “‘surgical’” extraction as a major service for an impacted wisdom tooth for 50% of the price or less (Staff Dentist). Unfortunately, beneficiaries may have to go through a waiting period of three to six months before receiving coverage on basic services or six months to one year before receiving coverage on major services (Araujo 2019). The annual limits also affect the amount of their coverage, but beneficiaries could “[divide their] procedure across two calendar years” (Nowak 2019).

Medical insurance also has some caveats for covering wisdom teeth extraction. The surgery has to be considered medically necessary by the health insurance company for the patient to get coverage (“Is wisdom tooth removal covered by health insurance?” 2017). For instance, extracting impacted wisdom teeth is medically necessary in order to prevent “[infection] and damage to surrounding teeth and bone” (“Is wisdom tooth removal covered by health insurance?” 2017). Extracting soft-tissue-impacted teeth is medically necessary because food and germs can get stuck under the gums and then cause swelling and pain (“Is wisdom tooth removal covered by health insurance?” 2017). Unfortunately, people that that go through the procedure in order to avoid any long-term problems would not get health coverage due to the lack of present medical necessity (“Is wisdom tooth removal covered by health insurance?” 2017).

Although extracting wisdom teeth can be expensive, dental and medical insurance could help people pay for the extractions.

Works Cited

Araujo, Mila. “Dental Insurance Waiting Period.” the balance. Last modified January 13, 2019.
https://www.thebalance.com/dental-insurance-waiting-period-2645722.
“Is wisdom tooth removal covered by health insurance?” Health Insurance Providers, February
26, 2017. https://www.healthinsuranceproviders.com/is-wisdom-tooth-extraction-covered-by-health-insurance/.
Nowak, Simon. “How Much Does Wisdom Teeth Removal Cost?” Authority Dental, January 28,
  1. https://www.authoritydental.org/wisdom-teeth-removal-costs.
Staff Dentist. “Insurance ‘dental services’ – Preventive, Basic, Major.” Animated-Teeth.com.
Accessed February 7, 2019. https://www.animated-teeth.com/dental_insurance/a-dental-insurance-plans-major.htm.
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