My insurance benefits say I get two free visits. Is this any visit?
Most insurance carriers will pay for two cleanings per year under your preventative portion of the plan. It used to include your exam and x-rays in the past, but it has become common practice to charge the deductible for these services. This amount is also deducted from your annual maximum, for most plans.
Insurance companies (normally) pay 100% of a prophylaxis (cleaning) two times per year. A “prophy” is for patients who do not currently have or have never had an issue with periodontal (gum) disease. It is the scaling and polishing of the crowns of the teeth to remove plaque, tartar (calculus), and stains.
Periodontal disease can be described as inflammation and/or infection of the gums and the bone which support teeth. Your hygienist will do periodontal probings at your cleaning appointment. Any reading of 4 millimeters (mm) or higher are indications of early to moderate gum disease. Periodontal maintenance is usually covered at 80% after the deductible has been met under most insurance plans, and allows for two visits per year. Most periodontal patients see their hygienist every three to four months, as in any chronic condition, successful long-term control of the disease and prevention of tooth loss depends on continual, possibly lifetime maintenance.
The number of times you have your teeth cleaned should be personalized between you, your hygienist, and your doctor, and not set by your insurance carrier. It is a mistake to let benefits be your sole consideration when you are making decisions about your dental care. Your teeth, smile, attractiveness, ability to chew, 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.