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Navigating the World of Dental Insurance Terminology

August 11th, 2017

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at Elite Smiles Dental. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Dr. Dale Scharine and Dr. Alissa Edwards, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

  • If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

  • This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

  • Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Dr. Dale Scharine and Dr. Alissa Edwards or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Appleton, WI office.

Energy Drinks and Dental Health

August 4th, 2017

Are energy drinks bad for your teeth? Many of our patients at Elite Smiles Dental ask us this question, so here’s the scoop.

Energy drinks have been on the rise, taking up more and more space on grocery store shelves. Drinks such as Red Bull, 5-Hour Energy, Monster Assault, Rockstar, and the like promise to jump-start your day, give you more energy, and help you feel more alert. But they also do a lot more than that. Turns out, they do a pretty good job of stripping your teeth of enamel, which is a very bad thing.

Many of these energy drinks are loaded with a lot of citric acid. In addition, they are laden with preservatives (not to mention sugar), not only to enhance flavor, but extend shelf life. While enamel loss, tooth decay, teeth sensitivity, and cavities cannot be blamed entirely on energy drinks (improper oral hygiene at home and lack of professional dental care also play a role), they can wreak havoc on the health of your teeth and gums, especially when consumed in more than moderation. Over time, energy drinks can strip enamel, which is the outer layer that protects your teeth.

What can you do?

Although Dr. Dale Scharine and Dr. Alissa Edwards and our team aren't recommending you drink energy drinks at all, if you must drink one occasionally, there are a few things you can do to minimize the damage to your teeth.

  • Drink through a straw.
  • Don’t hold the drink in your mouth before swallowing.
  • Rinse your mouth with water immediately after drinking this kind of beverage. Water helps both to neutralize the acid and to increase the production of saliva.
  • Chew sugar-free gum immediately after, to increase saliva production.
  • Don’t brush your teeth right after drinking an energy drink. Wait at least an hour instead, because the combination of the acid and brushing will further damage tooth enamel.

The best advice is to refrain from drinking energy drinks altogether. One of the best hydrators is water. Water is a natural energy-booster and hydrator, and it doesn’t contain calories.

Give us a call today at our Appleton, WI  office if you have any questions or concerns about energy drinks and dental health. We can provide additional tips and a treatment plan to help reduce enamel loss, eliminate tooth sensitivity, and repair cavities and tooth decay as a result of drinking energy drinks.

Canker Sores and Stress

July 28th, 2017

Canker sores are painful lesions that form in the soft tissues of the mouth, usually along the inner lips, under the tongue, and along the cheek walls. They are usually small and round, and take on a white or yellow hue. Though most are generally harmless and tend to heal on their own within a week or two of appearing, canker sores can be very irritating.

Only about one in five people develop canker sores. Of those who do, many develop them recurrently as a result of external factors. Though canker sores have been connected to allergies and hormonal changes, many people who are prone to developing canker sores find that their outbreaks are stress-related.

A combination of emotional stress and fatigue can be a perfect storm for the development of mouth sores. Some people say they are not under stress when canker sores form, but the sores appear several days after a stressful event or situation instead. Managing stress, reducing anxiety, and getting plenty of sleep may help prevent canker sores from forming and ensure that existing ones heal more quickly.

What to do if you develop canker sores

Do not be alarmed if you develop a canker sore. They are not contagious and are not harmful to your health. Over-the-counter oral numbing products can be used to manage pain, as can ice chips. Canker sores may heal faster if you apply milk of magnesia to them daily and avoid spicy foods that could irritate them.

You should contact your doctor if you find that your canker sores are unusually large or persist without healing for several weeks. Our team at Elite Smiles Dental also recommends seeking out professional treatment if you experience extreme pain or a fever develops in association with a canker sore outbreak.

For more information about canker sores, or to schedule an appointment with Dr. Dale Scharine and Dr. Alissa Edwards, please give us a call at our convenient Appleton, WI office!

Diet Soda vs. Regular Soda: Which is better for teeth?

July 21st, 2017

When most patients ask Dr. Dale Scharine and Dr. Alissa Edwards this question, they're thinking strictly about sugar content — cut out the bacteria-feeding sugar that's present in regular soda by opting for a diet soda and it will be better for your teeth. That seems logical, right? Well, there's a bit more to it than that. Let's take a closer look at how any kind of soda can affect your dental health.

Diet Soda – Why it can also lead to tooth decay

The main culprit in these drinks that leads to decay is the acid content. Diet sodas and other sugar-free drinks are usually highly acidic, which weakens the enamel on your teeth and makes them more susceptible to cavities and dental erosion. The level of phosphoric acid, citric acid, and/or tartaric acid is usually high in sugar-free drinks so it's best to avoid them.

Some patients also enjoy drinking orange juice or other citrus juices. These drinks are high in citric acid and have the same effect on the enamel of your teeth.

So what about regular soda?

We know the acidity of diet sodas and sugar-free drinks contributes to tooth decay, so what about regular soda? Like we alluded to earlier, regular soda is high in sugar — a 12 ounce can contains roughly ten teaspoons of sugar — and sugar feeds the decay-causing bacteria in the mouth. This also includes sports drinks and energy drinks, which are highly acidic and loaded with sugar too. So these drinks are a double-whammy of sugar and acidity your teeth and body simply don't need.

The problems caused by both diet and regular soda is exacerbated when you sip on them throughout the day. If you drink it all in one sitting, you won't be washing sugar and/or acids over your teeth all day long and your saliva will have a chance to neutralize the pH in your mouth.

The best beverages to drink and how to drink them

Drinking beverages that are lower in acid is a good step to take to keep your enamel strong. According to a study conducted by Matthew M. Rodgers and J. Anthony von Fraunhofer at the University of Michigan, your best bets are plain water, black tea or coffee, and if you opt for a soda, root beer. These drinks dissolved the least amount of enamel when measured 14 days after consumption of the beverage.

If you still choose to drink soda, diet soda, sugar-free drinks, or juices here are some other tips to lessen tooth decay:

  • Drink your soda or acidic beverages through a straw to minimize contact with teeth
  • Rinse with water immediately after consumption of the beverage
  • Avoid brushing your teeth between 30 minutes to an hour after drinking the beverage as this has been shown to spread the acids before your saliva can bring your mouth back to a neutral pH
  • Avoid drinks that have acids listed on the ingredients label

Still have questions about soda, sugar, and acid? Give our Appleton, WI office a call and we’d be happy to help!

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