Understanding Your Dental Insurance To Optimize Your Oral Health



On today's episode we talk all things dental insurance, some important stories from the news, and dentistry fact or fiction!  Join us as we start Talkin' Teeth.


Speaker 1:                          A smile says it all.If your teeth could talk, what would they say? Find out today on Talkin' Teeth with Dr. Kyle Bogan.

Dr. Kyle Bogan:                 Happy New Year and welcome to the first episode of Talkin' Teeth. My name is Dr. Kyle Bogan of North Orange Family Dentistry, right here in Lewis Center, Ohio, and every two weeks, I'm going to bring you need-to-know topics and tips for your mouth that you can put into action right away. We're also going to spend time discussing another one of my passions, how service impacts our local and global communities through the lens of oral health. In the end, my goal is to keep you connected to your oral health and to the community around us.

Dr. Kyle Bogan:                 Our first show is going to be focused around one of the biggest questions that I get every day in the office and the question that my staff deals with the most is helping people understand dental insurance. It's such a vital part of what we do and I want to make sure that everyone out there can kind of understand the nuts and bolts of how everything works. And we're going to kind of jump right into that right off the bat. So if you've ever had questions about dental insurance, you do not want to miss this upcoming segment, Understanding Your Dental Insurance to Optimize Your Oral Health.

Dr. Kyle Bogan:                 We're going to dive into topics like what's the difference between a DMO and a PPO. What is a deductible? What's co-insurance? And what is a waiting period? These are all things that are necessary to understand so that you can maximize the use of your benefits that you pay for so that you can have the best oral health possible. But first, let's start with one of our recurring segments, Dentistry in the News.

Speaker 3:                          Dentistry in the News.

Dr. Kyle Bogan:                 Dentistry is in the news all the time, whether it's for lighthearted, funny-type anecdotal stories or whether it's kind of hard-hitting topics that really hit close to home with our families. We're going to start with one of those hard-hitting stories and we're going to take a look at the epidemic of opioid abuse ... Really, it's nationwide, but specifically right here in Ohio. I was privileged recently to sit down with Mindy and Mikaela on News Radio 610 WTVN on their show, What Matters with Mindy and Mikaela to really discuss this topic and both how it's affecting the role that dentistry plays in it as far as our teenagers and their exposure to opioids at that age that wisdom teeth come out and that sort of thing.

Dr. Kyle Bogan:                 And really, what that means for families and how we can kind of curb that and specifically,what's been done in Ohio to kind of combat this opioid epidemic and how dentistry in particular has really taken a leading role in helping to address this and find alternative methods, so I'm actually going to play for you a segment of their show when I was on. We had a great discussion and I'll let you hear that.

Mindy:                                 We are so fortunate every week to have so many wonderful sponsors, part of What Matters with Mindy and Mikaela and today we talk about something that really can affect an entire family.

Mikaela:                             Yeah, it's what matters. That's the name of the show and that's what we're talking about today with the sponsor that we have. And we're fortunate to have Dr. Kyle Bogan with North Orange Family Dentistry.

Mindy:                                 First of all,happy wedding anniversary. I can't believe you're in here on your actual wedding anniversary, 12 years.

Dr. Kyle Bogan:                 I know, right? And I did it with permission, so I'm not in the dog house or anything.

Mindy:                                 Is she listening right now?

Dr. Kyle Bogan:                 She is. Absolutely.

Mindy:                                 Happy anniversary, Kate. Thanks for allowing us to give up your hubby.

Mikaela:                             Kate, happy anniversary, yes. We're so glad that he's in and we hear you're having a delicious meal tonight

Dr. Kyle Bogan:                 We are. Absolutely.

Mikaela:                             So that's good. So you're here to talk about something important and again, we're glad you're here.

Dr. Kyle Bogan:                 Absolutely.

Mikaela:                             So we were talking earlier this week and we didn't know this was going to come up and then we thought it would be a good subject to talk about because opioid addiction is such a huge issue here in the state of Ohio. As a matter of fact, I think Governor-elect DeWine is going to be on 60 Minutes tonight talking about the issue. I think I've seen some things on social media about that or some of his spokespeople over the weekend. But in the dental world, there was this study that came out ... I don't know, was it the beginning of this week or the end of last week?

Dr. Kyle Bogan:                 I think it was maybe the end of last week.

Mikaela:                             Very end of last week.

Dr. Kyle Bogan:                 Yeah, I think so.

Mikaela:                             Journal of American Medicine talking about this connection between prescription painkillers andteenagers after they have their wisdom teeth out.

Mindy:                                 And that's something, really, that we wouldn't even think of. A lot of us, it wouldn't even cross our minds that that can be a form of addiction because it's something that you have to have done. You have to have your wisdom teeth out.You would never think that it would lead to something, such a serious problem.

Dr. Kyle Bogan:                 Absolutely. And so when you think of teenagers, the increased risk of addiction is actually something that's physical and so when you look at ... I'm a dentist, so I know the basics here, but if you look at brain development, the prefrontal cortex,which is responsible for judgment, the impulse control, that really doesn't develop until the early to mid-twenties.

Mikaela:                             Oh Mindy, she's that right now with her teenagers.

Mindy:                                 You better believe it.

Mikaela:                             Yeah and I've heard that many a time. So their judgment isn't what it is, what you and I and what all of us have right now.

Dr. Kyle Bogan:                 Exactly. And so,you know, looking at that whole article, my take on the whole thing is that both as a parent and as a medical professional, I think taking a step back and evaluating every possible exposure to opioids that our children, our teenagers have, especially with the state of things in Ohio right now, is really a good thing to do.

Mikaela:                             They were saying in this study, so nearly 6% of almost 15,000 people between 16 and 25 years old who received that initial opioid prescription from dentists in 2015, nearly 6%were diagnosed with opioid abuse within a year.

Mindy:                                 That's really scary.

Mikaela:                             Within a year. And in comparison, and this is what I'm curious about too, it's scary, and when you think about this though Mindy, .4% in a similar group who didn't get dental opioids were diagnosed with opioid abuse during the same period. So .4% from kids who were diagnosed and ... Or given, I should say, ibuprofen and other medicine like that, compared to 6%. So with that, do we need to be talking, i four kids are going in to get their wisdom teeth pulled, what conversations do we need to be having with their dentists?

Dr. Kyle Bogan:                 Yeah, I really do think that because if you look at research ... I mean, there's a new study that just came out that said that you can actually get the same, if not better, pain control using a combination of ibuprofen and acetaminophen than you can using an opioid prescription.

Mindy:                                 So how do you combat it, then? What's the best thing you can do as a dentist?

Dr. Kyle Bogan:                 As a dentist, I can say personally, me, I haven't written a prescription of opioids in a while.Maybe a year or two.

Mindy:                                 Do you have the freedom to do that, though?

Dr. Kyle Bogan:                 I do.

Mindy:                                 And you just choose not to because you know how serious it is.

Dr. Kyle Bogan:                 It is and one of the things as a dentist that's my utmost importance and concern for me is pain after the procedure. So we're taking out teeth, we're placing dental implants and obviously, we want to be able to control the pain after the procedure. But what I've found is that combo works just as good or better so I haven't really needed to go that route.

Mikaela:                             I talked to a mom who's involved with a group called One Day Moms here in town. Some of you who live in the central Ohio area may know about it. She's very passionate. She's a friend of mine ... About the opioid epidemic and what's happening to our children and to adults as well. And she was saying that when her son was younger, they kind of fought her when he got his wisdom teeth out about using.They wouldn't give him an ibuprofen prescription for like 600 or 800 milligrams. They really wanted him on the painkillers.

Dr. Kyle Bogan:                 Yeah, and I'll say... Being this is a national story, but I can tell you here in Ohio, we have done ... I think dentistry, especially in Ohio, is kind of ahead of the game addressing this issue. And to that point, the Ohio Dental Association,representing the majority of dentists, actually worked with the Ohio State Dental Board to come up with a list of prescribing guidelines that put limits on the amount that you can actually prescribe now, so that dentists can have that in the back of their head. But they still have the ability to use the medication when needed. But again, it's not as commonplace anymore. I think we're starting to-

Mikaela:                             See a turn.

Dr. Kyle Bogan:                 ... See that turn and we're starting to address that issue.

Mindy:                                 What other major surgeries would you have to use these type of painkillers or something else other than wisdom teeth?

Dr. Kyle Bogan:                 So wisdom teeth,any tooth extraction, a surgical type extraction, root end surgeries, root canals. Root end surgery is a root canal that you may keep having to retreat and they're going in a different way. It's called an apicoectomy. So any type of surgical procedure like that could have the potential to need that sort of pain medication but there's other ways to address the pain issue.

Mindy:                                 What's the most popular? A lot of people I know try Vicodin.

Dr. Kyle Bogan:                 Yeah, I would say that's probably ... You know, when I used to write opioid prescriptions more regularly, that's kind of the one ... We didn't go up into the other tiers of opioid pain medications.

Mindy:                                 You know what,though? Some people really like Vicodin.

Mikaela:                             And some people hate it.

Mindy:                                 And some people say it really makes them feel woozy and just not themselves, really.

Mikaela:                             Mark is just one of them. Mark has had shoulder surgery.

Mindy:                                 I remember when he did that.

Mikaela:                             And he did not want to have to take his painkiller prescription because it made him feel nauseous.

Dr. Kyle Bogan:                 And that's what I'm finding with patients that we're using this on is maybe they've taken that in the past and we're not doing it this time. And not being exposed to those side effects is actually ... They're perceiving that as a benefit because everybody hates feeling that way.

Mindy:                                 This is such a great conversation. We always want to open it up to our callers as well. If you have a question, a dentistry question for Dr. Bogan, please feel free to call at 614-821-WVTN, 614-821-9886. Maybe you have a toothache or something and I'm sure he can answer it.

Mikaela:                             He can and I wanted to talk about pain alternatives because I know, Dr. Bogan, you do have pain alternatives in your office for the procedures themselves as well. You have a pretty wide variety, if I am remembering correctly.

Dr. Kyle Bogan:                 Yeah, it's simple things like nitrous oxide, for example. That's something that you can have during the procedure and then it's done and there's no after effects. You can drive home from the office.

Mindy:                                 Is that laughing gas?

Dr. Kyle Bogan:                 Basically, yes.

Mindy:                                 Yeah, my daughter loves laughing gas.

Dr. Kyle Bogan:                 The other things we're doing to control pain and anxiety, noise-canceling headphones can be used during the procedure. We have televisions in the operatory so you can just take your mind off of it as far as anxiety during the procedure.

Mindy:                                 Does that really work?

Dr. Kyle Bogan:                 It does, actually.

Mindy:                                 Kind of mind over body?

Dr. Kyle Bogan:                 Yeah, mind, yeah.

Mindy:                                 Mind over matter.

Dr. Kyle Bogan:                 Transport your self to somewhere else while we do the work. Another thing as far as pain control goes is some of those surgical procedures where I'm expecting a little more pain, we actually have local anesthetics that are more long-acting. So we can actually numb you, say for 12 hours. So you can go home, get a good night's sleep. Give the Tylenol and ibuprofen time to work and that way, you're not feeling anything till the next day when you're kind of starting to feel a little bit more yourself.

Mindy:                                 That sounds pretty good.

Mikaela:                             And you do ...Yeah, it does, to have that option when you're in there getting that done and you do some laser procedures that also lessen pain.

Dr. Kyle Bogan:                 We do, yeah. So actually, laser can be used to stimulate healing and so in the same process, we can use it to cut tissue. It cuts it more gently. Sometimes, even for kids, we don't have to numb them anymore. So the shot in dentistry, sometimes is gone for kids and so they-

Mikaela:                             And that was the worst thing when I was kid, right? I had really great dental experiences but the shot was always the thing that I did not want to feel. I knew it was coming.

Dr. Kyle Bogan:                 Yeah. I hate that word. [crosstalk 00:11:02]

Mindy:                                 What do you do more than anything? What surgery do you do more than anything? What do you think is the most popular one that's common?

Dr. Kyle Bogan:                 Gosh, I would say extractions are common. Root canals are very common.

Mindy:                                 At what age is a root canal common?

Dr. Kyle Bogan:                 Oh gosh, I would say 30's, depending on ... Unless it's trauma.

Mindy:                                 Really? Okay.

Dr. Kyle Bogan:                 By that time-

Mikaela:                             Because our teeth are worn down, right?

Dr. Kyle Bogan:                 Yeah, they're worn down. Maybe you've had a cavity or two and it's gotten close to the nerve. And sometimes, the nerve just kind of waves the white flag and says it's done and you start to get that toothache.

Mikaela:                             After people use some of these pain alternatives or you try some of these in some of these procedures, popular or otherwise, what are their reactions? What do they say about how they feel post-procedure, once you have an alternative that you'reusing on them?

Dr. Kyle Bogan:                 Pretty much all the feedback we get is positive. We liked it because there weren't the major side effects. We were able to kind of be coherent during the procedure and not have to worry about what was going on. We were very informative during the procedure. But everything we've heard is good afterwards.

Mikaela:                             Good. So there's options out there and I think it's good to know that the State Dental Board in Ohio, we're being really proactive about on the opioid side of things. After the fact, that we're doing some things that are lessening the chances for our young people.

Dr. Kyle Bogan:                 Yeah, absolutely.It's gone to the point, too, where they're actually changing the curriculum for dental schools in Ohio where they actually have to address prescribing and addiction and things like that in the curriculum so that as people come through that educational program, they're getting that education about addiction.

Mindy:                                 We're coming into a new year. Do you have any new changes or things you're looking forward to, your office, in 2019?

Dr. Kyle Bogan:                 We do. We're actually opening a brand new office. We're focusing on kind of a digital patient experience and so-

Mindy:                                 What is that like, for example?

Dr. Kyle Bogan:                 We're looking at a completely integrated digital laboratory and so I really focus on being the one spot where we can treat the entire family. We have the services available to meet the needs of every age and the new facility is going to amplify that for us and let us take that to the next level.

Mikaela:                             And some of the things you can do same day because you're going to have a lab that creates things inside that facility.

Dr. Kyle Bogan:                 Yeah, exactly. As opposed to a more traditional dental office where we sent things out and the way we used to do some of our stuff as well, everything is going to be inside the office. So it will cut down procedure time, it'll cut down in between procedure time. Just make everything more streamlined- [crosstalk 00:13:12]

Mindy:                                 Well, that's exciting for you. When does that take place then? What month? Do you know?

Dr. Kyle Bogan:                 May, May 1st, we're supposed to be in.

Mikaela:                             They're building right now. I've been out there and I've seen it when I've been back there.

Mindy:                                 That's awesome.

Mikaela:                             So if people want to know how to get a hold of you, whether they want to know about pain alternatives or any of the other things that Mindy and I have discussed with you today, how do they do that, Kyle?

Dr. Kyle Bogan:                 They could give me a call at the office. The number is 740-548-1800 or they can check us out online at northorangefamilydentistry.com.

Mikaela:                             Northorangefamilydentistry.com. We've enjoyed having you in today. Thank you and again, perfect timing when it came to the stuff that came out.

Dr. Kyle Bogan:                 Super important topics.

Mindy:                                 And again,happy anniversary.

Dr. Kyle Bogan:                 Thank you very much.

Mindy:                                 You better go hurry up and go to dinner.

Dr. Kyle Bogan:                 I know, right?

Mindy:                                 Pick up your wife and go to dinner. And Merry Christmas. We probably won't see you till after Christmas.

Mikaela:                             Yeah, Merry Christmas to you. We'll see you in January.

Dr. Kyle Bogan:                 You know, I said it on the show and I'll say it again. There's really no more important job as both a parent and both me, as a medical professional as well, than to take a look at every possible exposure that our kids could possibly have to this sort of medication and really to determine is it necessary. So one of the questions that I got after that segment was what can parents do in the healthcare setting to help with this? What's their role?

Dr. Kyle Bogan:                 I think there's a few things. I think one is making sure you review your child's prescriptions and understand if they are being prescribed an opioid medication. Are they being prescribed a non-opioid medication? And are there over-the-counter options that would possibly work as well. So discussing that with your dentist or the oral surgeon or whoever is treating your child, if you are prescribed an opioid and you guys decide that that's kind of the best route and what's needed, based on the type of post-operative pain that's anticipated, keep track of your kid's medication.

Dr. Kyle Bogan:                 Dispense the tablets as prescribed and make sure that you just don't leave the bottle sitting and if they don't finish the prescription, don't leave it in the medicine cabinet. Drop it off at a local pharmacy for disposal. There's different areas or different places where you can drop those off. When that medication is in the house, just make sure you keep track of it. You can also start an open conversation with your child. Talk to them about their risks of opioid addiction and let them know that they can turn to you without fear if they experience a drug misuse, have witnessed a drug misuse, just really keeping those lines of communication open is another thing that can really help this whole issue moving forward.

Dr. Kyle Bogan:                 The next story,we're going to talk about something that isn't very appetizing. We're going to talk about sharing toothbrushes with people in your house. There are people out there who seem to be unfazed by using their family member's toothbrush, whether it's a one-time thing or if it happens a lot. And there are those who are totally repulsed by the idea. That's a no-no in our house. Everyone has their own toothbrush. It's in their own separate container. It's just kind of gross to think about sharing that toothbrush.

Dr. Kyle Bogan:                 So no matter which camp you fall in, sharing really isn't the answer when it comes to toothbrushes. But if you are someone that likes to borrow a family member's toothbrush, you're actually not alone. Match.com, funny enough, surveyed more than 1,100 members and they found that 22% of the participants admitted to doing it and 76% of them never told their family member about that encounter.So they used their toothbrush, they put it back in the holder, and just went on their merry way and didn't even tell them.

Dr. Kyle Bogan:                 One of the most common defenses of sharing toothbrushes, especially among family members, is if you tend to drink after one another that the saliva ... You're sharing saliva and all that, but there's a little bit more to it with a toothbrush because when you're sharing drinks, obviously there's saliva there but the actual purpose of a toothbrush is to mechanically remove plaque and bacteria from the teeth. So, in effect, if you're borrowing someone's toothbrush, you're taking the plaque and bacteria colonies that they've removed from their teeth that are on their toothbrush and transferring that bacteria directly to your mouth. Like I said at the beginning, a little bit gross.

Dr. Kyle Bogan:                 Our mouth is actually home to hundreds of different species of bacteria and some viruses can also live in there as well. And they can be transferred from person to person through a toothbrush and these include the culprits for the cold, the flu, and even periodontal disease. So, we definitely don't recommend that you pick up the plaque and bacteria off of someone else's teeth and scrub your own with it because you're risking illness and also transferring their possibly cariogenic bacteria to your mouth that can cause cavities and gum disease and all that stuff.

Dr. Kyle Bogan:                 The other thing that we don't quite think about is that toothbrushes, while they look clean,they really aren't, which, that's part of the recommendation when we ask you to change your toothbrushes every three to four months. Because we know, even when they look clean, a used toothbrush harbors bacteria deep down in the bristles that are invisible to the naked eye. The recommendation is if you're in a pinch and you don't have your own toothbrush or the dog ate it, or if you have kids and they scrubbed the sink with it and you don't want to use it, use your finger with some toothpaste. Rub it around for the time being. That will get you through the morning and grab one on your way home. Or if you're coming into the office, we have plenty. So just remember, sharing drinks is one thing,sharing a toothbrush is quite another.

Speaker 6:                          And now ...

Dr. Kyle Bogan:                 All right. Now we're at the topic of the day, Understanding Your Dental Insurance To OptimizeYour Oral Health. So there's no greater area of confusion, I feel like, in all of healthcare but specifically we're going to talk about dentistry today,  benefits, understanding your insurance company, what those benefits are, how your employer plays into that, coverages and everything that kind of wraps up into your coverage. We're going to kind of dissect that today as much as we can.

Dr. Kyle Bogan:                 We're going to start and really talk about the two main types of dental insurance. We are starting to see employers offer a choice. One's obviously a little cheaper than the other and there's reasons for that. But the two main types of dental insurances out there are what are called DMO insurance policies and PPO insurance policies. So DMO stands for Dental Maintenance Organization. PPO stands for Preferred Provider Organization. That's a bit of a tongue twister.We'll try that again. PPO is Preferred Provider Organization. The main difference between the two is that in a DMO insurance model, you're assigned to a dental provider. In that provider, either you're assigned to one or they're given a very limited network of participating providers that you are able to choose from.

Dr. Kyle Bogan:                 If you contrast that with a Preferred Provider Organization type of insurance, there's a large wide cast network of providers that you're able to choose from and so it's the difference of choice. So you can choose a provider through a PPO type plan, or in a DMO (Dental Maintenance Organization type plan) you're really assigned by your employer based on your geographic location, to an office that participates in that particular plan. The reason there's such a limited choice of offices is there really are fewer dentists that choose to participate in those DMO type plans and so a lot of those are clinic type offices that you would be assigned to.

Dr. Kyle Bogan:                 One of the other issues or differences between DMOs and PPOs is that the DMO insurance will only cover procedures at that office that you're assigned to. So if you need to be seen at another office, you would essentially be paying out of pocket for those treatments. And for those of you that are more familiar with the medical,there's really no out of network benefits in a DMO plan. PPO insurances, like I mentioned earlier though, have a wide network of general dentists and specialists where you can receive coverage with an in-network provider, but you also have coverage if you want to go out of network. Your insurance will still pay that provider.

Dr. Kyle Bogan:                 Gr anted, you're saving money by seeing an in-network provider because you have those discounts on the fees as a result of the contract between the provider and the insurance company, but it gives you total freedom of who you want to see. Our office, in particular, tries to make our services accessible to everyone, so we are in network with basically, every PPO insurance out there. So we really support the freedom of choice of our patients so we want to be a member or a participant in basically every PPO insurance out there so that we can offer our service to the widest range of people and give them the choice. Both, especially when we need the services of a specialist, to be able to have that choice to pick theirprovider.

Dr. Kyle Bogan:                 Aside from the varying types of insurance, once you have your insurance, there's a lot of things and a lot of nomenclature and a lot of terminology that's really confusing. So I kind of want to take a second to digest that a little bit.We'll talk about what these various things mean. So the first thing, are plan year maximums. So every dental insurance has a  amount that the policy will pay during that policy year. So for most insurance companies in the dental space, the plan year starts January 1st and it runs through December 31st of that calendar year. So within that calendar year, most plans either have a$1,000 to $1,500 or $2,000 annual max. And that means, that's the most the insurance company will pay during that calendar year.

Dr. Kyle Bogan:                 So specifically,that includes pretty much everything: Your cleanings, exams and x-rays,insurance usually covers those at 100% but that comes out of that maximum. So a lot of times, we'll have patients that are having treatment done during the year. They have, maybe a cleaning, in the first quarter of the year. There's some treatment that's done and towards the end of the year, that cleaning that's supposed to be free, because the insurance will cover it at 100%, if that benefit's gone, then there ends up being an out of pocket expense. So we try to be very clear about those limits and update patients as the year goes on as to what those are.

Dr. Kyle Bogan:                 The other thing is called a deductible. So what a deductible is, similar to medical insurance, is that's the amount you have to pay out of pocket before the insurance policy will kick in and pay anything. So for dental insurances, the majority of deductibles are either $25 or $50. So that means if you're having a procedure done that is not covered at 100% or even if it is covered at 100% and subject to that deductible, the insurance company will make you pay that deductible before it pays anything. For example, if you're having, let's say, sealants.Sealants are one that sometimes are subject to a deductible.

Dr. Kyle Bogan:                 So let's say that your child is having four sealants done and let's just, for easy math, say they're $20 apiece before insurance would pay anything. So that's $80 and let's say your deductible is $50 and those sealants are subject to that deductible.So even though sealants are covered at 100%, your insurance company won't pay$80. You'll pay $50 and then the insurance will pay the remaining $30. But now if there's anything else that needs done that's subject to that deductible,that deductible has been met for the entire year. So you only have to pay that once per policy year.

Dr. Kyle Bogan:                 The other term that comes up a lot is co-insurance. So if you're having a procedure done that is not covered at 100% ... So let's say, a good example is like a filling. So the majority of insurances will cover fillings under basic services at 80%coverage. There are some insurance companies that call basic services 50%, but I'd say 90% of the insurance companies cover basic services, including fillings, at 80%. What that means is whatever the filling amount is, so for easy math, let's say a filling is $100. The insurance company will pay $80 and the co-insurance or the part that you're responsible to pay as a member, would be 20% or $20 for that particular service.

Dr. Kyle Bogan:                 The co-insurance applies to a wide range of procedures. Preventative services, like cleanings,fluoride, most of the time, sealants, the majority of preventative services are covered at 100%, so that would mean your co-insurance would be zero. Basic services like fillings, we just talked about. Like I said, the majority of them are covered at 80%. Periodontal services, so if you have gum disease and need those types of services, the majority of insurances cover those at 80%. And again, when I say majority of insurances, that's what that means. There are differences among policies and sometimes there's differences among insurance companies and so our staff does an amazing job of keeping track of all that. We give all that information to our patients.

Dr. Kyle Bogan:                 But there's such a wide range, I just kind of ballpark it and that's kind of the majority of the policies. The other category is major services. These are things like crowns,bridges, dentures, and implants and those things like that. I would say the majority of insurances cover those at 50%, which will leave the co-insurance at 50%. So you pay half, the insurance pays half. Another issue or another thing that we see a lot with dental insurances are waiting periods. That's something to really be cognizant of when you're signing up for these insurance policies,whether it's individually or through your employer is that some policies come with a waiting period.

Dr. Kyle Bogan:                 And that means,say, the most popular waiting period would be in a major service category like crowns and bridges and those sorts of services, where the insurance companies can say you have to wait six months or 12 months before we'll cover anything.So that's really what a waiting period is. Now when we talk about optimizing your benefits, for you to get the most benefit for your insurance, one of the ways to do that is to really look at your plan year and where your insurance starts and where it ends. As the participator in the insurance policy, as the subscriber, you, through your employer, pay for the insurance. Some employers pay part of it; sometimes the employee pays all of it. Either way, it's your insurance policy.

Dr. Kyle Bogan:                 So we try to do our best for patients that need those oral health services, to educate and really make sure you're getting the most out of the policy that you pay for. So sometimes the way we do that is if you're getting close to the end of your policy year ... So, say it's November and there's a few services that need to be completed before the end of the year, one of the more popular ways to maximize your benefits is to ... Let's, for instance, say you have a root canal and a crown that needs to be completed. What you can a lot of times is have the root canal done at the end of the year and the crown done at the beginning of the year. So you take advantage and you're able to maximize your benefits by having part of it on the previous policy year and part of it on the new policy year.

Dr. Kyle Bogan:                 So there's various things like that, that once you really start to understand your coverage, and we do a great job of trying to help you with that, that you can really get the most out of the policy, like I said, that you're paying for. So that's really the basics of dental insurance and really, the policies can be so confusing.Employers sometimes will change policies without letting their employees know a whole lot what's going on, so part of our job is to educate you, both through vehicles like this podcast, but also in the office to double check your benefits and kind of give you that information as the year goes along.

Dr. Kyle Bogan:                 So in the end, you pay for that dental benefit annually and so with our help and hopefully, with some of the information you've gathered today from this segment, make sure to put it to work for the betterment of your oral health because that's really what we're all here for in the end.

Speaker 6:                          Fact or Fiction.

Dr. Kyle Bogan:                 As you've just heard,the last segment for this week's episode is Fact or Fiction. So just like in any healthcare, really any field at all, there's all kinds of myths and old wives' tales and all kinds of things out there. So I want to dedicate a segment every now and then to just taking one of these questions that I get all the time and we can discuss whether it's fact or fiction. I'll give you the answer right off the bat and then we can kind of dive in and discuss why.

Dr. Kyle Bogan:                 So the thing I want to talk about today is the statement that adults do not need fluoride applied to their teeth at a dental visit. With kids, we recommend, really, every six months having that professional fluoride applied to help prevent cavities and help strengthen the teeth, especially as they're developing. Then so the question comes up, well, adults have all their adult teeth, so why would they need fluoride? It's actually fiction that adults do not need fluoride. We, as a general rule, will recommend the same thing to adults that we do to children that they have that fluoride professionally applied at every visit for their six-month checkups. A lot of times ... We're talking about insurance today so a lot of times we get into this insurance mentality where fluoride is covered at 100%once a year for a kid and so that's why we get in that mentality of, “Okay,they should have it once a year because insurance pays for it.”

Dr. Kyle Bogan:                 What we really need to think about is the oral health benefits and why we're doing the fluoride application, not just because insurance pays for it. So like I said at the beginning, we recommend that fluoride application twice a year or every six months at the cleaning visits for kids, even though insurance only pays for it once, because it does a number of things for kids. So for kids, fluoride helps prevent decay. It strengthens the enamel. It actually, the fluoride actually gets incorporated into the enamel structure and helps really make it a stronger form of enamel. It can also, during the development years, we're drinking fluoridated water. That can also help while the teeth are forming.

Dr. Kyle Bogan:                 But really, that topical application throughout life actually helps continue to make the teeth strong. So we're talking about adults. Obviously, some of that anti-caries or cavity prevention benefit is good for kids as they're going through various stages in their life. Their diet's changing. Sometimes, in certain ages,they're taking in more sweets and so it definitely makes sense. When we're looking at adults, as we age and as we get older, sometimes the caries frequency or the frequency of cavity formation does kind of level off, but we do see spikes in that. And especially, as we get older, we start seeing more what are called root surface cavities.

Dr. Kyle Bogan:                 We start to get recession. That root structure isn't as strong and so just like fluoride prevents cavities in kids, it will also help prevent cavities in adults,especially as we get older and the areas that cavities forms change a little bit. Another thing that it really helps with in adults is sensitivity. I know I have sensitivity. Ice cream really ... There's a couple of teeth that ice cream really lights up for me.

Dr. Kyle Bogan:                 It's a common thing that I talk about with a lot of my adult patients is the various types of sensitivity: Hot, cold, sweets. We talk about desensitizing toothpaste and things like that, but also this fluoride varnish, the particular varnish that we apply actually helps stick to those root surfaces and it acts as not only a tooth strengthener and a cavity preventer, but it also acts as a desensitizer. So really, there's so many oral health benefits to fluoride, both as a kid and as an adult. We really, on a regular basis, discuss that with our patients and we really do recommend those treatments at all ages, regardless of insurance coverage.

Dr. Kyle Bogan:                 So unfortunately,we fall into the insurance cycle because we're so used to that. But just because insurance doesn't pay for it doesn't mean there isn't that clinical benefit to your oral health and to your teeth and to some of the symptoms that you may be having. So definitely have that discussion. Like I said, at our office, we recommend it all of the time. We definitely have that discussion and I think it's a great thing for people of all ages. So before we wrap up, I really hope you've enjoyed listening to Talkin' Teeth today. Our next episode will be released in two weeks. You'll get a new episode every two weeks here on Talkin' Teeth and we'd love to answer your questions.

Dr. Kyle Bogan:                 Whether those questions are from today's episode or whether you just have oral health or dental-related questions in general, please send them in. You can send them to info@northorangefamilydentistry.com. We'll take those questions and as part of our segment in two weeks we'll be answering those questions that you've sent in.What to expect next week: You can count on an update on our new building project. We're going to walk you through exactly what we have going on for our new office that's opening here in Lewis Center and the new technological advances that we are bringing to dentistry and to our patients. We're super excited about that. We're also going to have a segment on dental implants.

Dr. Kyle Bogan:                 So, if you've ever had questions or thoughts about, “Do I need a dental implant? Are dental implants right for me? Or even if I'm a candidate for dental implants?” then this is the episode for you. Quite honestly, if you don't even know what a dental implant is, please tune in in two weeks. We're going to really dive deep into what dental implants are, who's a candidate, what the benefits are, what the pros and the cons are and all of that. So we’re really looking forward to the next episode.

Dr. Kyle Bogan:                 Finally, if you are looking for a dental home, we would love to be that dental home for you and your family at North Orange Family Dentistry. You can reach us by phone. Our telephone number is 740-548-1800 or you can visit us online and you can even schedule an appointment online at northorangefamilydentistry.com. Thank you listening. It's been a great, great first episode. Looking forward to more fun to come, and have a wonderful day.

Speaker 1:                          Thanks for listening to Talkin' Teeth with Dr. Kyle Bogan. Be sure to visit northorangefamilydentistry.com. To join the conversation, access the show notes and discover our fantastic bonus content. Please remember this podcast is for educational purposes only. It is not intended or implied to be professional medical or dental advice or a substitute for professional care by a dentist or other qualified medical professional. Guests who speak in this podcast express their own opinions, experience and conclusions. And North Orange Family Dentistry and Dr. Kyle Bogan do not endorse or oppose any particular treatment option.

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