Is Dental Insurance Worth It?

You may have heard that old adage about putting your money where your mouth is. When it comes to dental health, that saying can take on a whole new level of wisdom.

Your oral/dental health can be closely tied to your overall health. Certain cardiovascular diseases, pneumonia and even some pregnancy and birth complications can originate from bacterial infections that begin in your mouth. Other conditions — like diabetes, leukemia and some cancers and kidney diseases — can reveal themselves through telltale symptoms in your teeth and gums.¹

Good dental hygiene – including regular visits to a dental professional – can be key to staying healthy. But, like most medical procedures, the cost of dental work can significantly impact your budget.

Dental insurance plans may help reduce the cost of routine dental care and many dental procedures. They may help offset not only the cost of dental work but also the cost of routine exams and cleanings. And that can help you and your loved ones stay up-to-date with preventive dental care.

Let’s explore the basics of how dental insurance works, what may be excluded from coverage, and how much this employee benefit may cost.

Understanding dental insurance

Dental insurance is a type of insurance that provides coverage to help pay for dental care. Dental insurance plans, like many other types of health insurance plans, typically require you to pay a monthly premium for coverage. If you get dental insurance through your workplace, your employer may contribute toward that premium.

Dental insurance plans typically have deductibles, co-pays, waiting periods and/or policy maximums for certain services or treatments. Preventive care, like teeth cleanings, is often covered in full or nearly in full. However, the patient will typically have to pay a portion of the charge for more extensive care. They may also provide negotiated fees or in-network discounts for services from dentists within the plan’s network. Some plans may even come with discounts on orthodontia for patients under 18.

Some dental plans cover a percentage of the cost for various services. For instance, in a 100/80/50 model, the plan might cover 100% of preventative care, 80% of basic care, and 50% of major care.²

Dental care cost examples

Here’s how much some common dental treatments may cost you out of pocket without dental insurance and how much dental insurance can potentially save you. We based these costs on a standard MetLife in-network dental plan.³

As you can see, dental insurance may help save you hundreds of dollars on common dental procedures.

Why are dental benefits important?

Not only does dental coverage help with the financial costs of dental care, it can also encourage regular dental checkups, which can be important for your oral – and overall – health.

A study by the National Association of Dental Plans (NADP) found that those who have dental benefits have a higher likelihood of getting regular dental care, taking their family to the dentist and having better health in general than those without.4 Here are some ways dental benefits may benefit you:

Oral health maintenance

Even if you’re a healthy person who doesn’t have dental problems, dental insurance coverage can still be a smart move. Regular dental cleanings remove plaque and buildup, which can help maintain a healthy mouth. This also can help protect against cavities, tooth decay and gum diseases.

Early detection of teeth and gum problems

If you’re regularly seeing a dentist, they can identify cavities, tooth decay and gum diseases in their early stages. This can help you and your family get treatment early and protect you from serious dental issues down the road.

Identification of other health problems

Poor oral health can cause other health problems — such as heart disease, pneumonia and birth defects. Diabetes, Alzheimer's disease and osteoporosis can also make your oral health worse. By caring for your teeth and gums, you’re actually caring for your entire body.¹

Coverage for routine and major procedures

In addition to preventative care, dental insurance helps cover basic and major procedures, such as fillings, root canals, crowns or other dental work. These procedures may have an in-network discount, as well as 80% to 50% coverage.

Coverage for pediatric orthodontia

Dependents under 18 may be eligible for orthodontic coverage if your dentist deems it medically necessary. Note that most dental plans only cover braces for minors; after they turn 18 (in some cases, 16) orthodontia is no longer covered.

What kind of dental plan is right for you?

There are several types of dental insurance plans, but dental health maintenance organizations (DHMO) and dental preferred provider organizations (DPPO) are two of the most common. As you decide which plan is right for you, it’s important to check if your plan offers a network of dentists, if your preferred dentist participates in the plan and what in-network discounts may be available. This will help you understand what’s covered and what you may have to pay out of pocket.

DHMOs

DHMOs work with a designated network of dentists to provide care at a reduced rate. However, they may offer little to no coverage outside that network. If you need to see a specialist, you may need your primary dentist to refer you first. DHMOs generally don’t have a benefit maximum; instead, they’ll have a set copay amount that the insured pays for each procedure.

DPPOs

DPPOs may have higher premiums than a DHMO, but they offer far more flexibility in terms of provider selection. While they still work with a network of dentists, they can help cover care if you see someone outside your network as well. You can also visit a specialist without a referral.
Dental PPO plans typically have a deductible and an annual benefit maximum and cover a percentage of each dental procedure based on whether it’s classified as preventive (e.g. X-rays, cleanings), basic (e.g. fillings, root canals, extractions), or major (e.g. crowns, implants, dentures, oral surgery).

Making the most of your dental insurance

Getting dental insurance for you and your family doesn’t automatically guarantee healthier teeth and gums. You have to do your part with regular dental cleanings and care. Most dental insurances cover annual or biannual cleanings and X-rays for everyone on the policy. Make sure to take full advantage of this benefit as part of your personal health routine.

Should I get dental insurance?

While obtaining any kind of insurance is a personal decision, dental insurance can have a significant positive impact on your health and your healthcare budget. By providing access to routine dental care and empowering you to see a dentist, dental insurance can help you prevent or detect some medical issues in their early stages. That’s enough to make anyone smile.