Cosmetic & Family Dentistry
To assist our patients, unlike many dental offices, we bill many dental insurance plans for dental treatment. We are a “provider” for some P.P.O.’s , which gets the patients a discount on their fees, while we receive payment from others without a discount to the patients. The patient is responsible for the balance.
For patients under 20, a first-time appointment will be scheduled with our hygienist. She will do the cleaning and Dr. Parker will do an exam. Fluoride will be applied at the appropriate ages. If it is deemed that a child is too young for fluoride (they try to swallow it) we will not do it until they are older. Many dental insurance plans cover fluoride only until a specific age. It is the parent’s responsibility to decide if they want the fluoride treatment and to be aware of the age cut-off for fluoride with children on their insurances. Dental x-rays will be taken at the age appropriate times. Just like an adult, if a child has had previous x-rays that are timely, we would ask the parent to obtain copies of those x-rays when we schedule the appointment. Most dental insurances will cover “bite wing” x-rays every six months but the coverage time period for a “panoramic” x-ray may be three, five or six years. If a parents allows a panoramic x-ray to be taken and does not come with a previous panoramic x-ray for the child, it is the parent’s responsibility to pay for the panoramic x-ray if the dental insurance does not pay for it.
The first appointment in our office for those over 20 years old, is with Dr. Parker for a complete exam of your teeth and your gums and a complete x-ray of the entire mouth. When the appointment is scheduled, patients who have had x-rays taken previously of all of their teeth ,are told to call their previous dentist and get a copy of the x-rays to bring with them to Dr. Parker’s office on their first visit. Many of our patients have never had their gums checked and are startled to discover that they have gum problems. They may have experienced bleeding gums or bad breath but didn’t realize that they had a gum disease problem. Dr. Parker will explain everything to the patient once he does an exam and reviews the x-rays. Then a written treatment plan will be mailed to both the patient and the dental insurance. This is called a “pre-authorization“.
This allows us to find out what dental care is “covered” by an insurance and what the out-of-pocket expenses for the patient will be for each type of treatment that they need.
Please be aware that a panoramic x-ray gives an overall picture of the teeth but does not give the detail needed
in all situations. When an adult returns for their cleaning appointment, we usually take bite-wing x-rays which show the back teeth with more detail. If there is another tooth that Dr. Parker wants to see in more detail, we will take a single x-ray, a periapical. The dental insurance may or may not cover the additional x-rays. Be aware that your dental insurance policy is to assist you in receiving your dental care by paying for some care but will not cover everything necessary.
When a “pre-authorization” is mailed to a dental insurance and specific treatment is denied, it does not mean that you do not need the treatment or that it is not the correct treatment. It means that the treatment is not a covered benefit on your plan. Dentists do not give care according to the guidelines of an insurance plan. We will always strive to assist our patients in making the most of their insurance, however, if needed treatment is not a covered benefit and the patient continues with their care, the patient is responsible for the payment for the treatment at the time of their appointment.
There is now a dental treatment for staining called Microabrasion, which involves removing the surface layer of stain or discoloration from a tooth.
The success of Microabrasion depends on several factors, especially the type and extent of the discoloration of the teeth.
Some teeth may have a deep, irreversible stain or discoloration caused by a trauma, root canal or a medication. These stains are usually not improved my Microabrasion.
Some teeth may have a "speckled" appearance showing a lot of white spots all over the tooth. These teeth may be improved by Microabrasion. Children can have discoloration of teeth due to medications or trauma to a tooth.
Sometimes, poor dental hygiene while in braces, leaves a young patient with "mottled" looking teeth. Microabrasion can be considered to change the appearance of the teeth.
Microabrasion is a safe, minimal treatment for discolored teeth. Other treatment for discolored teeth would include porcelain veneers or porcelain crowns.
Dr. Parker can evaluate your teeth and discuss with you the probably success of the Microabrasion for you.
Because this is a cosmetic procedure, microabrasion would not be covered by a dental insurance plan.
Recent studies suggest that gum disease may contribute to or be warning signs of potentially life threatening conditions such as:
**Heart Disease and Stroke - Studies suggest that gingivitis may increase the risk of heart disease and stroke because of the high levels of bacteria around in infected areas of the mouth. As the level of periodontal (gum) disease increases, the risk of cardiovascular (heart) disease may increase. Other studies have suggested that the inflammation in the gums may create a chronic inflammation response in other parts of the body which has also been implicated in increasing the risk of heart disease and stroke.
**Diabetes - People with diabetes often have some form of gum disease, likely caused by high blood glucose, according to the CDC. People with diabetes need to take extra care to ensure proper brushing and flossing techniques are used to prevent the gum disease from getting worse. Regular visits with Dr. Parker every 6 months, or more often if Dr. Parker feels your situation warrants 3 or 4 month cleanings, would be helpful.
**Chronic Kidney Disease - A study, conducted by Case Western Reserve University, suggests that people without any natural teeth, which is called being "edentulous", are more likely to have chronic kidney disease than people with their natural teeth. The chronic kidney disease affects blood pressure potentially causing heart disease, contributes to kidney failure and can affect bone health.
As a note, when women are pregnant, they may experience a flare up of gum disease symptoms. They need to have excellent dental hygiene during the pregnancy to avoid any future dental issues.
Often, people become lazy about brushing and flossing their teeth and that is when problems can occur. It has been estimated that 75% of Americans have some form of gum disease which have been linked to more serious health complications.
Gingivitis - This is the beginning stage of gum disease and is often undetected. This stage is reversible with proper dental hygiene.
Periodontitis - Untreated gingivitis may lead to the next stage of gum disease. With many levels of periodontitis, the common outcome is chronic inflammatory response, a condition when the body breaks down the bone and tissue in the infected area of the
mouth, ultimately leading to tooth and bone loss.
**Red, bleeding and/or swollen gums?
**Movement of any teeth?
**Abscesses and swelling near the gum line?
HOW Can I Prevent Gum Disease?
Daily proper brushing and flossing, which Dr. Parker can go over with you, is the key to a healthy mouth.
You must remove the plaque and tartar and then see Dr. Parker on a regular basis to remove any hardened calculus from the tooth surface. Some people are surprised that after a dental cleaning, they can see space between their teeth and close to the gum line. That means the calculus was cleaned off the surfaces of the teeth.
The panoramic x-ray is a wonderful x-ray invention. It has much less radiation than taking a traditional Full Mouth Series of x-rays which can consist of up to 18 x-rays of the entire mouth.
The panoramic x-ray shows the dentist your nasal area, sinuses, jaw joints, teeth and the surrounding bone.
It can show cysts, tumors, problems with the bone and a jaw joint problem, usually caused by clenching and grinding.
The panoramic x-ray shows impacted teeth that are still buried deep inside the bone and not pushing up (erupting) normally. When you have an impacted tooth, the body may wall it off by creating a cyst around it. This is something that needs evaluation by an oral surgeon.
Some patients experiencing what seems like dental pain, actually have sinus infections. Dr. Parker can see your TMJ (jaw joint) and be able to tell if you
have a problem. If it is found that you have impacted teeth, teeth still in the bone, you will be
referred to an oral surgeon to have the situation evaluated further.
It is very important for Dr. Parker to have a panoramic x-ray to have a more complete picture of your dental needs.
Typically, Dr. Parker will take a panoramic x-ray during a patient's first visit. If you have recently had one taken, usually within the last three years, we will ask you to get a copy from your previous dentist.
Dental insurances typically cover the payment for a panoramic every three to five years.
A crown is a tooth shaped covering or what used to be called a "cap" that is placed over a tooth to restore it to its original shape and size, to strengthen it and to improve it's appearance. When completed and cemented in place, a crown covers the entire visible portion of the tooth that is above the gum line.
There are many reasons why crowns are needed on teeth and why Dr. Parker may recommend them for you. Sometimes a crown is used to strengthen a weak tooth or a tooth that is cracked. That is typically called "cracked tooth syndrome". A tooth may be broken or moderately worn down and need a crown to restore its appearance and function. Crowns are also recommended when a tooth has a large filling in it and not a lot of natural tooth structure left.
You may choose to have a crow placed if a tooth is misshapen or discolored.
A crown is also placed on top of a dental implant after the root is placed by an oral surgeon.
The most common need for a crown is after the tooth has had a root canal, especially on back teeth. A
tooth that has had a root canal will become brittle over time due to the loss of nerve and blood supply. That makes
the tooth very susceptible to fractures. When a crown is placed, it can strengthen the tooth. Having the crown is an excellent preventative measure.
"Permanent" crowns can be made of porcelain ceramic, or a combination of porcelain fused to metal. The strongest crowns are either all metal or the porcelain fused to metal. All porcelain (all ceramic) crowns are used on the front teeth due to the way they look. Porcelain crowns on front teeth can fracture but people usually choose them because they like the way they look because you cannot see any metal near the gum line. The porcelain ceramic on the outside of a crown is matched to the color of the surrounding teeth.
Some people falsely believe that once they get a crown on a tooth they can never get a cavity in that tooth. That is false. The tooth structure that supports the crown can decay, and very quickly, leading to the loss of the tooth.
It is very important for you to maintain good dental hygiene. Brush your teeth at least twice a day and
floss every day. See Dr. Parker twice a year for your periodic exams and cleanings.
Typically, if a dental insurance plan had "major" coverage, a crown will be covered at 50% of the allowed fee after any annual deductible. We do a written "pre-authorization" to see if the crown is covered before we prep the tooth for the crown. Sometimes. employers have chosen not to have
"major" coverage as part of their employees dental plan.
If that occurs, we can discuss payment plan options with you or options for your needed dental care.
Sometimes, we see patients in our office who have lost a number of teeth through the years for various reasons. Maybe they had a great deal of decay and the teeth were non-restorable by the time they saw a dentist or maybe they had gum disease and lost teeth due to bone loss. Either way, they usually ask why they should bother to replace missing teeth.
The most obvious reasons that people think of are improving the way they look and improving the way they chew. People missing many teeth will appear to have a more sunken face than if they had all of their teeth or had them replaced.
Another not so obvious reason is that the remaining teeth have a lot of extra stress placed on them in chewing and are more likely to break. Also, when there is no tooth opposing an opposite tooth, that tooth will "super-erupt", keep coming out of the gum until it can actually hit the tissue opposite it where the missing tooth should be. Also, the teeth around the open space can shift and if left long enough, can move into the open space enough to make it very difficult to replace the missing tooth.
Dr. Parker will discuss both removable and "fixed" options for replacing teeth. A removable partial denture can replace any missing teeth on an "arch", meaning on the upper or the lower. A dental implant can replace a missing tooth if a person has healthy gums and a good amount of bone to anchor the implant. A "fixed" bridge is also an option in some situations. Because a partial is the least expensive option, this is usually the one covered by insurance.
It is usually covered at 50%.
Dental implants are usually not covered an bridges tap out dental benefits for most people for the year without full coverage.