From crowns and caps to braces and bridges, how does coverage work with cosmetic dentistry? A breakdown of the basics:
What’s considered cosmetic?
ADA defines cosmetic dentistry as work that is done “solely for the purpose of improving the appearance when form and function are satisfactory.” In other words, a procedure is considered cosmetic unless it fixes an issue with your mouth’s functions—speaking, eating or chewing, for example.
Here are a few common types of cosmetic procedures:
- Veneers: Typically placed on the front of your teeth, veneers are individual coverings for your teeth. They’re used to fix teeth that are too short, far apart, discolored or contorted.
- Implants: This artificial tooth root is inserted into your jaw to hold a replacement tooth, crown or bridge. Dental implants are for people who have lost permanent teeth due to an injury or gum disease. Ideal candidates include those with healthy gums and strong jawbones.
- Whitening: 90% of patients request in-office teeth whitening. This procedure shows significant shade change in minutes, compared to at-home whitening methods. A trained dental professional applies peroxide gel on the patient’s teeth for a few 15-20 minute intervals.
Is cosmetic covered?
It depends. If some types of cosmetic dentistry are included in your plan, they’re only covered when a procedure restores tooth structure or advances oral health. However, cosmetic procedures can be optional benefits that you or your employer may choose to purchase. Coverage also depends on the specific cosmetic procedure. For example, some plans cover implants, dentures and other restorative benefits at 50%. On the other hand, you’re unlikely to find any plan that covers whitening.
When it comes to cosmetic dentistry, it’s crucial to consult your plan booklet or your Human Resources benefits representative to see what procedures are and aren’t covered, as well as know what would be considered cosmetic and what would not.