Orlando Harmon
Dental insurance can help lower the cost of dental care, which can be expensive for those without a plan. The type of dental plan chosen will determine the level of coverage for certain types of dental care, such as preventive, restorative, and orthodontic care. Restorative procedures include fillings, crowns, root canals, bridges, and dentures. Fillings are used to replace lost tooth structure with a suitable restorative material such as amalgam or composite. Amalgam fillings are typically covered by insurance, whereas composite fillings, which are more aesthetically pleasing, may not be covered or only be partially covered.
| Characteristics | Values |
|---|---|
| Cavity Filling | Composite, amalgam (silver) |
| Composite Filling | Tooth-coloured plastic, resin |
| Amalgam Filling | Silver |
| Composite Filling Coverage | Not covered by most insurance plans due to being more of a want based on aesthetic purposes |
| Amalgam Filling Coverage | Covered by most insurance plans |
| Composite Filling Cost | Patient pays |
| Amalgam Filling Cost | Covered by insurance |
| Composite Filling Benefits | More aesthetically pleasing, less tooth removal required |
| Amalgam Filling Benefits | Cheaper, easier to use, less technical work required |
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What You'll Learn
Composite fillings
The procedure for placing a composite filling typically involves removing the decayed portion of the tooth and applying an adhesive or bonding agent to the tooth. The composite material is then placed inside the tooth and hardened using a light curing unit.
While composite fillings are a popular choice for dental patients, they may not be covered by insurance plans. This is because composite fillings are often considered a want based on aesthetic purposes rather than a medical necessity. Amalgam (silver) fillings, which are traditionally used to fill cavities, are usually covered by insurance as they are cheaper and easier for dentists to use.
However, it is important to note that insurance coverage may vary depending on the plan and the insurance company. Patients should consult their insurance provider to understand their specific coverage and whether composite fillings are included.
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Amalgam fillings
To place an amalgam filling, a dentist first drills the tooth to remove decay and then shapes the tooth cavity for the placement of the amalgam filling. The dentist then mixes the encapsulated powdered alloy with the liquid mercury to form an amalgam putty, which is placed and shaped in the prepared cavity, where it rapidly hardens into a solid filling. Amalgam fillings are strong and long-lasting, making them less likely to break than some other types of fillings. They are also useful for patients with a high risk of tooth decay, large tooth preparations, and where moisture makes it difficult for other materials to establish a bond to the tooth.
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Insurance coverage
Dental fillings are a common procedure to repair a tooth after it has been damaged or decayed. Cavities are a common issue, with 92% of adults experiencing them and the associated tooth decay. The cost of a filling without insurance can range from $100 to $4000, with an average cost of $200 to $600 per tooth. With insurance, you can cover some of the costs associated with fillings, but the extent of coverage varies depending on the insurance provider and the specific plan. Some insurance companies may only cover amalgam fillings, which are functional but less aesthetically pleasing than composite fillings.
Amalgam fillings are made from silver alloy or other materials and are typically covered by insurance. They are functional and durable but may require more tooth removal than composite fillings. Composite fillings, on the other hand, are made from a tooth-coloured plastic or resin material that matches the patient's natural tooth shade, making them virtually invisible. While composite fillings are preferred by many patients due to their aesthetic value, they are often not covered by insurance because they are considered a "want" rather than a "need".
Insurance companies like Humana, Cigna, and Momentum offer various dental plans that may include coverage for fillings. These plans can range from budget-friendly monthly premiums to customized coverage for individuals and groups. Some insurance plans may also offer discounted fillings through specific dental clinics or providers. It is important to carefully review the terms and conditions of your insurance plan to understand what is covered and what is not.
Additionally, some insurance plans may have waiting periods for certain procedures, while others offer no waiting periods for fillings. This means that if you need a filling as soon as possible, you may be able to get it covered without having to wait. Some dentists also offer payment plans to help spread out the cost of a filling over several months, making it more affordable.
Overall, insurance coverage for cavity fillings varies depending on the insurance provider and the specific plan. While some plans may cover only amalgam fillings, others may offer partial or full coverage for composite fillings. It is important to review your insurance plan or contact your insurance provider to understand the extent of your coverage for cavity fillings.
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Restorative procedures
Restorative dental procedures are performed to repair or replace damaged or missing teeth, with the primary goal of improving oral health and chewing function. These procedures often also improve a patient's smile. Restorative dentistry is performed by general dentists and is ideal for patients with cavities, tooth decay, damaged or broken teeth, or missing teeth.
Dental fillings are a type of direct restorative procedure, where the filling is applied directly to the teeth to restore the best version of the teeth or gums. Composite fillings, made of tooth-coloured plastic, are the most common type of filling. They are used to repair teeth and are usually performed on a tooth in the front of the mouth. Composite fillings are strong resin materials that come in a wide variety of natural tooth shades, allowing them to be almost completely undetectable. However, most insurance plans do not cover composite fillings because they are not necessary and are more of a want based on aesthetic purposes. Amalgam (silver) fillings, on the other hand, are typically covered by insurance plans as they are cheaper and easier to use.
Dental crowns, sometimes called "caps", are another common restorative procedure. Crowns are protective covers made from various materials such as porcelain, gold, metal, or zirconia, and are used to repair large cavities, broken teeth, or otherwise compromised teeth. They fit over an existing tooth, and the dentist removes some natural tooth enamel through shaving before placing the crown. Crowns are also used to restore teeth after a root canal to prevent future loss.
Dental bridges are used to fill the gaps caused by multiple missing teeth. They are made from artificial teeth that are matched in size, shape, and colour to the surrounding teeth. Once placed, the surrounding teeth are prevented from sliding out of position, maintaining the overall tooth structure.
Dental implants are metallic teeth placed as a substitute for missing teeth, usually after root canal procedures. They are implanted when the roots of crooked teeth are fully infected.
Dentures are a form of teeth replacement used when teeth cannot be restored through less invasive procedures. They are made from plastic, metal, or porcelain, and can be either full, replacing an entire arch of teeth, or partial, replacing several missing teeth.
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Preventative care
Preventative fillings, also known as "pit and fissure sealants", are intended to fill a tooth before a cavity has formed. They are recommended when you have deep grooves, fissures, or pits in your molars. These anatomical features help to crush and grind food, but they can also be prone to cavities. Food particles, bacteria, and acid can build up and lead to cavities in the rear teeth. Preventative fillings can seal up these pits and grooves, ensuring that your tooth is easy to clean and avoiding decay. They are particularly useful if you have a history of cavities or genetically weak enamel.
Preventative fillings differ from traditional fillings because no tooth material is removed, and no decay is present. They also differ from dental sealants because the entire tooth isn't coated with sealant material. Only the pits and grooves within the tooth are filled.
Dental sealants are another preventative measure. Sealants are designed for healthy teeth that have not yet developed cavities. They are usually placed on permanent molars in children, shortly after they come in, typically around the ages of 6 and 12. However, adults can also get sealants if their childhood sealants have come off or if they are starting to develop cavities in other teeth for the first time. Sealants are a thin coating that is painted on teeth to protect them from cavities. They are a quick and affordable option to prevent cavities and tooth fillings.
In terms of insurance coverage, your dental plan may cover you fully for preventive care, depending on the type of dental plan you have. You will need to check with your insurance company to see what your plan covers. Most insurance plans have an annual and/or lifetime dollar maximum. The patient is responsible for paying costs above the plan maximum. Some dental plans will apply the deductible to preventive treatments, and others will not.
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Frequently asked questions
A cavity filling is a restorative procedure that involves replacing lost tooth structure with a suitable restorative material such as amalgam or composite.
Cavity fillings are typically referred to as "restorative procedures" or simply fillings in insurance plans. They fall under the category of restorative care, which also includes tooth extractions, root canals, crowns, bridges, and dentures.
It depends on the specific insurance plan. While most dental plans cover preventive care at no additional cost, the coverage for restorative procedures like fillings may vary. Some plans may fully or partially cover fillings, while others may not cover them at all.
Composite fillings, also known as tooth-colored or aesthetic fillings, are not considered medically necessary by insurance companies. They are often chosen for aesthetic purposes, as they can be matched to the patient's natural tooth shade. Amalgam fillings, on the other hand, are cheaper and easier for dentists to use.
Review your insurance plan booklet or contact your insurance provider to understand the specifics of your coverage. Different plans have varying levels of coverage for preventive, restorative, and other types of dental care. By reviewing the details of your plan or speaking with a representative, you can determine if cavity fillings are covered and to what extent.
