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Navigating the World of Dental Insurance Terminology

August 4th, 2021

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 Convivial 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 Drs. Cartsos and Zavras, 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– Drs. Cartsos and Zavras 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 Chestnut Hill, Massachusetts office.

Dental Fear in Children: Brought on by parents?

July 28th, 2021

Two studies – one conducted in Washington State, and whose findings were published in the Journal of Pediatric Dentistry in 2004, and another conducted in Madrid, Spain, and whose findings were reported in 2012 in Science Daily, reinforce earlier findings that show a direct relationship between parental dental fear and that of their children.

The Washington study looked at dental fear among 421 children whose ages ranged from 0.8 to 12.8 years. The children were all patients at 21 different private pediatric dental practices in Western Washington State. The Spanish study looked at 183 children between the ages of seven and 12, and their parents in Madrid.

The Washington study used the Dental Sub-scale of the Child Fear Survey Schedule. The survey responses came from either parents, or other parties charged with taking care of the children. The people responsible for each child filled out the survey, which consisted of 15 questions to which answers were given based on the child’s level of fear. The scale used was one to five, with one meaning the child wasn’t afraid at all, and five indicating the child was terrified. The maximum possible points (based on the greatest fear) was 75.

Spanish researchers found that like past studies, there is a direct connection between parental dental fear levels and those of their kids. The most important new discovery from the study conducted in Madrid, was that the more anxiety and fear a father has of going to the dentist, the higher the fear levels among the other family members.

Parents, but especially fathers, who suffer from fear of going to the dentist and fear of dental procedures in general pass those fears on to every member of the family. While parents may not feel like they have control over those fears, the best way to help your child understand the importance of going to the dentist is by not expressing your fears in front of them – or around the rest of the family.

Drs. Cartsos and Zavras and our team understand that some patients are more fearful than others when it comes to visitingour Chestnut Hill, Massachusetts office. We work hard to make our practice as comfortable for our patients, both children and adults.

Pacifiers and Your Child's Oral Health

July 21st, 2021

Children are born with a natural sucking reflex. In fact, sonogram images from the womb often reveal an unborn baby practicing by sucking on his or her fingers or thumb. Not only does sucking aid in your baby’s ability to acquire food and nutrients, but it is also a security and possible analgesic outside of meal times.

Though it is both normal and beneficial for parents to soothe their children with pacifiers during infancy, long-term use could interfere with oral health and development. Most children will stop using a pacifier on their own. However, the American Academy of Pediatric Dentistry recommends halting pacifier use after age three. Prolonged thumb sucking or pacifier use after this time can cause the upper front teeth to begin to lean outward. It can also cause new teeth to erupt crookedly, and it can negatively affect jaw alignment.

If your child is not showing signs of self-weaning by age two, you may begin the process by limiting pacifier usage to specific times, such as nap time or when getting vaccinations. Offer an alternative security item, such as a blanket, and be sure to praise your child when he or she chooses the blanket over the pacifier.

Tips

  • Never under any circumstances should you dip your baby’s pacifier in something sweet. Though it is a tempting way of encouraging your child to take a pacifier when crying, it can also lead to early childhood tooth decay.
  • If your child has not discontinued pacifier use by age three, talk with Drs. Cartsos and Zavras about behavioral modifications or appliances that can help your child wean.
  • Never use negative reinforcement to discourage pacifier use. Punishment for pacifier use is not effective for changing your child’s habits.

If you have any questions or concerns about your child’s pacifier usage or which types of pacifiers are best for your child’s oral health, please give our team at Convivial Dental a call at our convenient Chestnut Hill, Massachusetts office!

Treatment Options for TMD

July 14th, 2021

Temporomandibular dysfunction (TMD) refers to a diverse range of disorders that relate to muscular function in the jaw and face — the temporomandibular joint (TMJ). That could mean difficulty opening your mouth, pain in the jaw or face, or any sort of problem with the jaw joint.

TMD can be difficult to diagnose because of the varied causes. Whatever the case, an accurate diagnosis from Drs. Cartsos and Zavras helps make treatment as successful as possible.

Most often, jaw problems will resolve themselves within several weeks or months. Surgeries like arthrocentesis, arthroscopy, and open-joint surgery should be a last resort. More conservative and reversible treatments should come first and are in fact the most critical step in the treatment of TMD.

Less invasive treatments like acupuncture and splints can be helpful, but that will depend on your particular case. It’s worth your while to speak with Drs. Cartsos and Zavras at our Chestnut Hill, Massachusetts office to learn about solutions that could work for you.

A combination of treatments will most often produce the greatest relief for TMJ patients. It’s a good idea to avoid activities that overuse the jaws, such as chewing gum or clenching your jaws.

You can be proactive in finding relief for TMD by trying the following remedies at home:

  • Eat soft food: When you eat soft and/or blended food, your jaw gets an opportunity to rest. Avoid chewy and crunchy food, and food that requires you to open your mouth wide, like apples or corn on the cob.
  • Apply moist heat: A hot water bottle wrapped in a moist towel can help reduce symptoms.
  • Apply ice: Applying an ice pack wrapped in a cloth or towel for no longer than 15 minutes may also reduce pain and promote healing.
  • Do jaw exercises: A physical therapist can help identify the exercises that will work for you. Jaw exercises have been shown to be an effective treatment method that can be performed at home.
  • Relaxation: Actively try to relax the muscles of the face and lips, and let your teeth come apart. Many find meditation, yoga, and slow, deep breathing to be helpful for reducing stress and tension.
  • Avoid wide yawns: Keep your fist under your jaw when you feel a yawn coming on, to keep your jaw from opening too widely.
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