Dental Health FAQ

What is Periodontal Disease?
Periodontal (gum) disease is the major cause of tooth loss in adults. It affects 75% of the adult population over the age of 35. More than 50% of the adults over age 18 already have periodontal disease in its early stages. This inflammatory disease causes swelling and redness, and attacks the gums, bone, and other supporting structures of the teeth. Periodontal disease is chronic, meaning that left untreated it can persist and worsen over time.

Recent studies are showing a relationship between gum and bone health and certain heart conditions and other systemic diseases.

What is the difference between Gingivitis and Periodontitis?
Gingivitis is the earliest form of periodontal disease. It occurs when plaque (a sticky film of bacteria and other substances) accumulates on the teeth near the gums. The gums become inflamed, causing redness and swelling around the teeth. As the disease progresses, the gums tend to bleed easily. If detected and treated at this stage, the gingival tissues will return to normal.

If left untreated, gingivitis becomes periodontitis. As the plaque hardens into calculus, it extends from the gumline down onto the root. The gums gradually detach from the tooth and forms a pocket. These pockets create room for more bacterial activity and accumulation. As the disease worsens, the bone supporting the tooth is destroyed, resulting in bone loss.

What is a regular cleaning or prophylaxis?

The American Dental Association labels a prophylaxis as a scaling and polishing procedures to remove coronal plaque, calculus, and stains. This type of cleaning is recommended for persons who do not have any periodontal disease, bone loss, or infection around their teeth. There also should not be bleeding, mobile teeth, or recession of the gums where it has pulled away from the teeth and exposed the root surface.

What is a deep cleaning or a scaling-root planing procedure?

A deep cleaning removes bacteria, tartar, and diseased deposits from under the gums. This type of meticulous and therapeutic cleaning is one of the first steps to treating gum and bone disease (periodontal disease). Scaling is required the full length of the root surface, down to where the root, gum and bone meet. Periodontal treatment promotes healing of the gum tissue and its reattachment to the teeth.

What is a Periodontal Maintenance?

If you have periodontal disease, you may require root planing to removed diseased deposits from the roots of your teeth. Other treatment, including surgery, may be required. After the disease process is under control, a regular cleaning is no longer appropriate. Instead, you will require special on-going gum and bone care procedures known as periodontal maintenance to keep your mouth healthy. Typically, an interval of 3-4 months between appointments is effective for maintaining periodontal health. Intervals longer than this between each maintenance appointment would allow for toxins to accumulate and irreversible bone loss and damage to occur.

My insurance plan only pays for Periodontal Maintenance twice a year, why should I have it done more often?

Most benefit plans are only designed to cover a portion of the total cost of a person’s necessary dental treatment. Insurance typically pays a minimum regardless of what you might need as an individual. It is a mistake to let benefits be your sole consideration when you make decisions regarding your health. People who have lost their teeth often say they would pay any amount of money to get them back. Your teeth, smile, attractiveness, ability to chew and enjoy food, and general sense of well being are dependent on your dental health. It is worth the extra time and expense to keep your teeth for a lifetime.

Which type of toothbrush should I use?

The brand of the toothbrush is not as critical as the type of bristle and the size of the head. A soft toothbrush with a small head is recommended because medium and hard brushes tend to cause irritation and contribute to recession of the gums, and a small head allows you to get around each tooth more completely and is less likely to injure your gums.

Is one toothpaste better than others?

Generally, no. However, it’s advisable to use a fluoride containing toothpaste to decrease the incidence of dental decay. For patients with sensitive teeth, we recommend patients use a toothpaste that contains the soothing effects of potassium nitrate.

How often should I floss?

Flossing of the teeth once per day helps to prevent cavities from forming between the teeth where your toothbrush can’t reach. Flossing also helps to keep your gums healthy.

What is the difference between a "crown" and a "cap"?

These are restorations to repair a severely broken tooth by covering all or most of the tooth after removing old fillings, fractured tooth structure, and all decay. The restoration material is made of gold, porcelain, composites, or even stainless steel. Dentists refer to all of these restorations as “crowns”. However, patients often refer to the tooth-colored ones as “caps” and the gold or stainless steel ones as “crowns”.

What is the difference between a "bridge" and a "partial denture"?

Both bridges and partial dentures replace missing teeth. A bridge is permanently attached to abutment teeth or, in some cases, implants. A partial denture is attached by clasps to the teeth and is easily removed by the patient. Patients are usually more satisfied with bridges than with partial dentures.

What about "silver" fillings versus "white" fillings?

Although the U.S. Public Health Service issued a report in 1993 stating there is no health reason not to use amalgam (silver fillings), more patients today are requesting “white” or tooth-colored composite fillings. We also prefer tooth-colored fillings because they “bond” to the tooth structure and therefore help strengthen a tooth weakened by decay. While fillings are also usually less sensitive to temperature, and they also look better. However, “white” fillings cannot be used in every situation, and if a tooth is very badly broken-down, a crown will usually be necessary and provide better overall satisfaction for the patient.

Do I need to have a root canal just because I have to have a crown?

No. While most teeth which have had root canal treatments do need crowns to strengthen the teeth and to return the teeth to normal form and function, not every tooth needing a crown also needs to have a root canal.

Insurance FAQ

In general, dental insurance differs from traditional insurance in that dental insurance is more of a supplemental plan that helps you pay for dental procedures. Unlike the medical insurance where if you reach your maximum deductible the insurance pays the rest up to its lifetime limit, dental insurance typically covers percentage of the cost of dental procedure until you reach your yearly maximum. Did you know that the yearly maximum averaged $1,000 in the 1970’s and has not really changed since.

Below are Frequently Asked Questions (FAQs) regarding dental insurance at Mukilteo Dental Center. If your question is not answered below, please feel free to contact us by phone or email. Also, you may want to refer an article at About.com regarding dental insurances.

Can I come to your office if you are not a preferred provider?

We accept payments from all dental insurances. The payment options and coverages vary greatly within the same company. At Mukilteo Dental Center, we contact your insurance company for you and get your coverage information. We take this information and help you understand your insurance coverage and the patient responsibility costs for your various treatment options.

What is a PPO? (Preferred Provider Organization)

A PPO is a dental insurance plan that allows you to see any dentist that you want. You may receive different benefits depending on if you see an In-network dentist or an Out-of network dentist. Mukilteo Dental Center is a preferred provider for Washington Dental Service Premier and PPO, Cigna, Premera, and Regence.

Why won’t my insurance company pay for the treatment that my dentist recommends?

At Mukilteo Dental Center, we will recommend the BEST treatment for you, based on our diagnosis and discussion with you. Your insurance company is going to pay for the LEAST costly treatment for them regardless of what is appropriate for your individual needs. We believe that insurance should not dictate treatment. Insurance is only one tool that patients can use to aid them in maintaining their dental health.

Why does my dental plan say it covers cleanings at 100% but my dentist sent me a bill?

If you see an out of network dentist and your insurance company pays 100% of UCR, you may receive a bill from your dentist. UCR means usual, customary and reasonable. This is a fee set by the insurance company and your employer and not a true reflection of fees in your area. If there is a difference between the UCR fee and your dentist’s fee, then you are responsible for the difference. Currently, there is a wide fluctuation between UCR’s of different insurance companies and different plans within each company. This does not mean that your dentist charges too much.

What does dual insurance coverage mean?

If you have dental insurance through your employer and your spouse has dental coverage for you through their employer, then you have dual insurance coverage. Your insurance is considered the primary insurance and your spouse’s is considered the secondary. If your secondary has a standard clause, they will pick up a percentage of what the primary doesn’t. If your secondary has a non-duplication clause, they will not pick up anything left over from the primary.

What is a pre-determination?

A pre-determination is a claim sent to your insurance company telling them what treatment needs to be done. Your insurance then sends back a list of what they would cover for those services. A pre-determination is a great tool to help you and your dentist estimate fees but it is NOT a guarantee of payment and should only be used as a guideline. Insurance companies will NEVER guarantee payment.

What is a DMO? (Dental Maintenance Organization)

A DMO is a dental insurance plan that requires the subscriber to sign up for a contracted dentist at the time of enrollment. This dentist must direct all of your dental care. If you don’t see this dentist, your insurance will not pay. Mukilteo Dental Center is not a DMO provider for any plans.

At Mukilteo Dental Center, we are more than happy to help you with any questions you may have regarding your dental insurance. We will submit claims on your behalf and help you understand and maximize your dental benefits. Should the need arise, we will assist you with the appeals process. Please feel free to call our office 425-347-4141 and discuss these or any other insurance questions that you may have.