Commonly Asked Questions
Asking questions and getting answers is a part of good oral health care. To help you find those answers, we’ve prepared responses to the most commonly asked questions in our office. If you don’t see the answer to your question here, contact us and we’ll be happy to help!
To help you locate the question you are looking for, please scroll down this page, or click on the index links listed below.
If you have any questions please give NOVO Dental Centre a call!
Questions about SureSmile Aligners:
SureSmile clear aligners rely on a customized series of plastic aligners to exert that gentle pressure on your teeth and shift them into position, so it doesn’t need wires or brackets. Instead, the smooth plastic of the aligners lays flush against your teeth.
By utilizing the SureSmile technology, which creates your personalized aligners, your teeth will move into place faster and more comfortably.
When wearing your SureSmile, it should fit like a glove over your teeth and must be worn for 20-22 hours a day for best results. You should change your aligners every 2 weeks (14 days). Do not change sooner or your teeth will become very sensitive and your aligners will not work as well as they should.
When patients leave out their SureSmile aligners for too long, the teeth will begin to shift back into their original positions. Orthodontic treatment can move the teeth rather quickly by applying pressure. In a similar fashion, a reduction in that pressure will have the opposite effect. In some instances, your aligners may not fit correctly if you try to place them back over your teeth. One of the benefits of SureSmile is that the aligners can be removed while eating but they do need to be replaced as soon as possible.
Consistency: Clear aligners must be worn for 20-22 hours a day for best results. Removing them multiple times and then not wearing them could slow down the treatment process.
Loss: Easy removability can lead to loss if not inserted back immediately after eating or brushing your teeth.
Yes, you will receive a retainer upon completion of your ortho treatment. Many people make the mistake of thinking that SureSmile treatment ends when you finish with your aligners. But immediately after treatment is complete, you will receive a retainer and instructions for wearing it.
Questions about SureSmile Aligners:
SureSmile clear aligners rely on a customized series of plastic aligners to exert that gentle pressure on your teeth and shift them into position, so it doesn’t need wires or brackets. Instead, the smooth plastic of the aligners lays flush against your teeth.
By utilizing the SureSmile technology, which creates your personalized aligners, your teeth will move into place faster and more comfortably.
When wearing your SureSmile, it should fit like a glove over your teeth and must be worn for 20-22 hours a day for best results. You should change your aligners every 2 weeks (14 days). Do not change sooner or your teeth will become very sensitive and your aligners will not work as well as they should.
When patients leave out their SureSmile aligners for too long, the teeth will begin to shift back into their original positions. Orthodontic treatment can move the teeth rather quickly by applying pressure. In a similar fashion, a reduction in that pressure will have the opposite effect. In some instances, your aligners may not fit correctly if you try to place them back over your teeth. One of the benefits of SureSmile is that the aligners can be removed while eating but they do need to be replaced as soon as possible.
Consistency: Clear aligners must be worn for 20-22 hours a day for best results. Removing them multiple times and then not wearing them could slow down the treatment process.
Loss: Easy removability can lead to loss if not inserted back immediately after eating or brushing your teeth.
Yes, you will receive a retainer upon completion of your ortho treatment. Many people make the mistake of thinking that SureSmile treatment ends when you finish with your aligners. But immediately after treatment is complete, you will receive a retainer and instructions for wearing it.
Questions About Family and Children Dentistry:
It is never too early to get a child acquainted with our dental team. Decay can start within months of eruption and accidents can occur at any time. Your child’s first dental visit should occur by age one or within six months of when you see the first tooth. Regular dental examinations support good health. The earlier your child visits our office, the better the chance of preventing a problem, such as decay. This can also increase your child’s comfort with the experience. During your child’s visit we will:
- Examine your child’s mouth
- Address any problems before they become more serious
- Monitor the development of your child’s teeth
- Provide tips to care for your child’s teeth and gums
Removing food and plaque from the teeth and gums should be done routinely as the first tooth erupts; however a cloth or soft-bristled toothbrush dampened with water is only necessary in the early stages. As your child gets older he or she can use a “training toothpaste” that is non-fluoridated up to age 3. At or around the third birthday, your child should transition to fluoridated toothpaste that is flavored especially for children. Try to avoid minty flavors which can be perceived as “too spicy” or “burning” to your child’s mouth. When applying the toothpaste, a pea-sized portion for children over three years of age and a smear (size of a grain of rice) for those under three. Teach your child to spit the toothpaste out.
Time is your enemy when an accident or any trauma dislodges a tooth. First locate the tooth, or teeth, and determine if the tooth broke or if the entire tooth and root came out in one piece. Gather together the pieces you’ve found, and with warm water gently rinse off obvious dirt or debris. Avoid touching the root as much as possible. Place and transport the tooth in milk or in some of the person’s own saliva.
Call our office immediately so we can see the injured person and tooth as soon as possible. The goal is to re-implant the tooth. The tooth may also be splinted with a wire to the adjacent teeth for a period of time.
This is a true dental emergency. If it is after regular business hours you should still call our office to get the emergency phone number so you may be seen right away. The more time that goes by the less likely that the re-implantation will be successful.
Tooth decay is caused by plaque bacteria in the mouth. Decay occurs when the bacteria in the mouth feed on carbohydrates (sugars and starches) in certain foods to create an acid. This acid eats away at the tooth enamel (the outer surface of the tooth) causing pitted areas and holes.
Without effectively removing the plaque bacteria it can build up and increase the likelihood of developing decay. Decay cannot be reversed yet you can try to prevent it.
Prevention – What you can do:
- Brush twice daily with a fluoride toothpaste. It is especially important to brush before bedtime.
- Eat a well-balanced diet. Limit sugary foods and drinks as well as the number of times you eat during the day.
- Floss daily to remove plaque between the teeth. Brushing alone only cleans two-thirds of the tooth’s surface.
- Have regular professional cleanings and dental examinations. We are trained to identify the early signs of disease and through regular dental exams we will monitor your mouth and work with you to prevent and/or stop the progression of disease.
There are many important reasons why we may recommend you have an X-ray, or an updated X-ray, taken as part of your examination. An exam is not complete without seeing what is under your gums.
X-rays help us see all that is going on in your mouth–things that can’t be seen with the naked eye, such as:
- early stages of decay
- infections in the bone
- decay below the gum line
- loss of bone due to gum disease
By catching these issues early we can treat the problem and reduce the likelihood of you needing more complex and costly treatment later.
Questions About Emergency Dental Care:
Time is your enemy when an accident or any trauma dislodges a tooth. First locate the tooth, or teeth, and determine if the tooth broke or if the entire tooth and root came out in one piece. Gather together the pieces you’ve found, and with warm water gently rinse off obvious dirt or debris. Avoid touching the root as much as possible. Place and transport the tooth in milk or in some of the person’s own saliva.
Call our office immediately so we can see the injured person and tooth as soon as possible. The goal is to re-implant the tooth. The tooth may also be splinted with a wire to the adjacent teeth for a period of time.
This is a true dental emergency. If it is after regular business hours you should still call our office to get the emergency phone number so you may be seen right away. The more time that goes by the less likely that the re-implantation will be successful.
If a tooth develops deep decay, has a deep or leaking filling, or suffers a crack or trauma, the tissue living inside the tooth (the pulp) becomes inflamed or infected, and may sometimes abscess.
One can then experience spontaneous and long-lasting pain, pain on chewing, along with hot and cold sensitivity. If the tooth is also infected and abscessed, there may be swelling of the gum tissue around the tooth; pus may come out from the gum tissue as well. Abscessed teeth that are not treated can cause severe infections in the face and jaws, and in rare cases can spread throughout the body. Occasionally one can have no symptoms for a long time and signs of nerve changes could be found on routine x rays.
Should any of the mentioned changes happen to the nerve, then a root canal may be recommended to eliminate pain/discomfort, help resolve infection and save the tooth to restore structure and function. The root canal treatment is done under local anaethesia to ensure your comfort throughout the procedure. A root canal is the process of cleaning inflamed and infected tissue from within the tooth. A small opening is made in the biting surface of the tooth to gain access to the inflamed/infected pulp tissue. The infected tissue is removed with fine instruments to clean and shape the inside of canals of the tooth. Once all the infected tissue is removed from inside the tooth, the canals are disinfected, filled and sealed with an inert biocompatible material.
Treatments may be completed in one appointment, or may span several appointments depending on severity of inflammation/infection. Following treatment, the symptoms will usually resolve, as the source of the problem (the dying or infected pulp tissue) has been removed. The abscess on the tooth will typically resolve, and the symptoms the tooth had been experiencing should begin to improve. After root canal treatment is completed, we recommend that a crown be placed to restore esthetics and function, and to prevent the weakened tooth from fracture.
For more information see our Root Canal Treatment information page.
Questions About Dental Hygiene:
Tooth decay is caused by plaque bacteria in the mouth. Decay occurs when the bacteria in the mouth feed on carbohydrates (sugars and starches) in certain foods to create an acid. This acid eats away at the tooth enamel (the outer surface of the tooth) causing pitted areas and holes.
Without effectively removing the plaque bacteria it can build up and increase the likelihood of developing decay. Decay cannot be reversed yet you can try to prevent it.
Prevention – What you can do:
- Brush twice daily with a fluoride toothpaste. It is especially important to brush before bedtime.
- Eat a well-balanced diet. Limit sugary foods and drinks as well as the number of times you eat during the day.
- Floss daily to remove plaque between the teeth. Brushing alone only cleans two-thirds of the tooth’s surface.
- Have regular professional cleanings and dental examinations. We are trained to identify the early signs of disease and through regular dental exams we will monitor your mouth and work with you to prevent and/or stop the progression of disease.
Dry mouth occurs when there is not enough saliva, or spit to keep your mouth moist and comfortable. It is a side effect of taking medications or can be a symptom of certain diseases or medical conditions.
Dry mouth is a common complaint amongst older adults but can occur at any age. It is not a normal sign of aging. Dry mouth is a common side effect of some prescribed and over-the-counter medications.
Tips to manage dry mouth:
- Clean teeth (or dentures) and gums daily
- Brush teeth with a high fluoride toothpaste
- Rinse mouth with a high fluoride mouthwash
- Take frequent sips of water to keep the mouth moist
- Chew sugar-free gum or candy to stimulate saliva
- Avoid tobacco, alcohol, and caffeinated or sugary beverages
- Allow us to advise other products that will keep your mouth moist
- Schedule regular dental examinations and cleanings as dry mouth can increase the risk for tooth decay
There are many important reasons why we may recommend you have an X-ray, or an updated X-ray, taken as part of your examination. An exam is not complete without seeing what is under your gums.
X-rays help us see all that is going on in your mouth–things that can’t be seen with the naked eye, such as:
- early stages of decay
- infections in the bone
- decay below the gum line
- loss of bone due to gum disease
By catching these issues early we can treat the problem and reduce the likelihood of you needing more complex and costly treatment later.
Questions about Teeth Whitening:
The time required to whiten teeth depends on how dark the teeth are initially, the degree of whitening desired, and the frequency of applying the whitening gel. The best way to determine if you are a good candidate for whitening treatments is to have a consultation with us.
One question we get quite often is, “Do the tooth whitening kits from the drug store work as well as the more expensive professional ones you get at a dental office?” The answer to the question is that the drug-store kits, such as Crest White Strips do work for some people, but can be cumbersome as they are not custom fitted.
Over-the-counter (OTC) whitening systems use Hydrogen Peroxide as their active ingredient. This is the same active ingredient used in many of the professional tooth whitening systems but in a much lower concentration. With commercial white strips, this relatively low concentration of hydrogen peroxide is mixed into a glycerine gel, which forms the gel on the backside of the application strips.
The main difference between the OTC systems and the professional systems is the way in which the chemically active gel is applied to the teeth. The professional systems use a custom-made “tray” that holds the hydrogen peroxide gel in contact with the teeth and minimizes the gel contacting the gum tissue. The tray is a thin flexible shell of clear plastic that gently rests over the teeth and forms a seal along the gum line.
Learn More about In Office Teeth Whitening vs At Home Teeth Whitening.
Whitening has little or no effect on restorative materials such as porcelain or crowns, but it may temporarily reduce the bond strength between enamel and composite restorations. This is why we recommend that before you do any type of teeth whitening you give us a call and we can help ensure you have the best results possible.
Not everyone experiences sensitivity with whitening their teeth. If you already have sensitive teeth you may experience some increased sensitivity caused by the whitening, however, it normally goes away within a few days after treatment has been completed. If you already have sensitive teeth, give us a call and we can further discuss other options to get you whiter teeth.
Teeth whitening is a personal preference. Most people are candidates for whitening, but again, each situation is unique and it’s best to arrange an assessment to know what results you may expect and what treatment option is best for you.
Teeth whitening is not permanent. Many foods and beverages cause staining on your teeth over time. If you are able to avoid foods and beverages that stain you may be able to maintain your whitening treatment or avoid touch-ups longer. This all depends on your teeth and your diet.
Here are a few things that have a high chance of staining your teeth:
- Smoking
- Tea & Coffee
- Sodas & Sports Drinks
- Red Wine
- Blueberries, Pomegranates, Grapes
- Marinara Sauces
Questions about Restoring Your Teeth:
A crown is recommended when most of the tooth’s original enamel is broken or gone. Taking out an old filling and replacing it with a larger one takes away more of the original enamel, which makes the tooth weaker.
We don’t want the tooth to get so weak that it breaks or splits when you chew on it. The tooth might have to be extracted if it splits down the root. So most of the time, a larger filling is not the answer, especially when there are already small cracks in the enamel, which is very common. A crown can be made out of porcelain, metal (i.e. gold alloy), or a combination of both, and it surrounds the tooth to protect it from all sides and keep it from splitting. An impression is taken of the tooth and used to craft the crown.
After the impression has been made, a temporary crown will be made out of a plastic material that will last for approximately two weeks while the crown is made in the lab. It is temporarily cemented in place.
During the second appointment, the crown is custom fitted permanently onto your tooth.
You can eat normally, and if you had a root canal previously, it will protect the tooth from splitting if the tooth becomes brittle. The crown can be chewed on, brushed, and flossed like a regular tooth. The life expectancy of a crown is dependent on how much stress is placed on the teeth and how clean the margins around the crown are kept to prevent new decay from developing. Most of the time, patients are very happy to have saved their teeth by getting crowns.
Choosing how to replace a missing tooth may seem overwhelming, but it’s important to understand the significant impact it can have on your daily life. Your teeth contribute not only to the comfort and function of your mouth but also play a vital role in supporting your overall health and well-being. When a tooth is missing, it can affect how you eat a variety of nutritious foods and even impact your speech. Therefore, making an informed decision about tooth replacement is crucial for maintaining both your oral health and the quality of your daily activities.
If a tooth develops deep decay, has a deep or leaking filling, or suffers a crack or trauma, the tissue living inside the tooth (the pulp) becomes inflamed or infected, and may sometimes abscess.
One can then experience spontaneous and long-lasting pain, pain on chewing, along with hot and cold sensitivity. If the tooth is also infected and abscessed, there may be swelling of the gum tissue around the tooth; pus may come out from the gum tissue as well. Abscessed teeth that are not treated can cause severe infections in the face and jaws, and in rare cases can spread throughout the body. Occasionally one can have no symptoms for a long time and signs of nerve changes could be found on routine x rays.
Should any of the mentioned changes happen to the nerve, then a root canal may be recommended to eliminate pain/discomfort, help resolve infection and save the tooth to restore structure and function. The root canal treatment is done under local anaethesia to ensure your comfort throughout the procedure. A root canal is the process of cleaning inflamed and infected tissue from within the tooth. A small opening is made in the biting surface of the tooth to gain access to the inflamed/infected pulp tissue. The infected tissue is removed with fine instruments to clean and shape the inside of canals of the tooth. Once all the infected tissue is removed from inside the tooth, the canals are disinfected, filled and sealed with an inert biocompatible material.
Treatments may be completed in one appointment, or may span several appointments depending on severity of inflammation/infection. Following treatment, the symptoms will usually resolve, as the source of the problem (the dying or infected pulp tissue) has been removed. The abscess on the tooth will typically resolve, and the symptoms the tooth had been experiencing should begin to improve. After root canal treatment is completed, we recommend that a crown be placed to restore esthetics and function, and to prevent the weakened tooth from fracture.
For more information see our Root Canal Treatment information page.
Questions about Anxiety Of Dental Treatments:
If you get worried or anxious about visiting the dentist, we want you to know that these feelings are perfectly normal, and we can help you feel better. Even people who go to the dentist on a regular basis still feel anxious about it; you’re definitely not alone. We offer sedation options that will help you feel more at ease during your dental appointments. Sedation will allow you to relax while undergoing your dental procedures, meaning you’re more likely to get dental care when you need it – and the result? Better oral health! Dental sedation refers to the use of sedative medications to help you relax before, during and after your dental treatment. Sedation is often recommended for patients who feel highly anxious about dental procedures, or who have extensive treatment needs, time constraints and/or a severe gag reflex.
When you’re ready, you can schedule a time that works for you for your welcoming visit. This is when our treatment concierge will gather information regarding your health and discuss with you your wants and desires. If you’re comfortable, we will take x-rays and look inside your mouth. You will never be judged or made to feel embarrassed.
It is important to talk to us about your fears and concerns during your consultation or examination appointment before any dentistry is performed. Our doctors are happy to answer any questions you may have and will discuss with you the protocols we have in place. It is critical that you provide us with an updated health history including all medications you are on, as well as any vitamins and supplements. Factors like smoking and alcohol consumption can alter the effectiveness of sedation medications. By providing us with a complete and accurate record we can then offer you the most effective and safe care.
Should you be a candidate for sedation dentistry, it is important you have a responsible caregiver accompany you to the procedure (and drive you to the office if you must take oral medication before your dental appointment). The caregiver should drive you home after the procedure is complete and stay with you for most of the day while the effects of the sedation wears off.
Commonly Asked Questions About CEREC (Ceramic Reconstruction)
CEREC is a fast and comfortable treatment because the dental prosthesis is created digitally and manufactured at our practice. In a single visit, a new prosthesis is ready regardless of whether you need a crown, bridge or veneer. We have put together a list of commonly asked question. Learn More about how NOVO Dental Centre is using CEREC to improve client care.
CEREC is a brand name – the technology is called CAD/CAM (Computer-aided design and computer–aided manufacturing). CAD/CAM dentistry has been in use since the mid-1980’s. Early efforts were considered a cumbersome novelty, requiring an inordinate amount of time to produce a viable product. This inefficiency prevented its use within dental offices and limited it to lab-side use (that is, use within dental laboratories). As adjunctive techniques, software, and materials improved, the chairside use of CAD/CAM (use within dental offices) increased.
We have a wide shade selection of tooth-coloured ceramic blocks to restore your teeth to their natural function, strength and beauty and closely matches the composition of your natural tooth structure. To further enhance the aesthetics we are able to customize the colour of your new crown for a natural look to blend it beautifully with your natural teeth.
Once we have finished the preparation of your tooth an optical image of the prep site will be taken with a special 3D scanner. The scanned information is then turned into a 3D model on the computer. While you watch, we will design your new crown according to your tooth’s appropriate form and function. When we have completed the design your precise specifications are sent via secure WiFi to the milling chamber where diamond burs carve your restoration out of a solid block of ceramic.
The milling process takes approximately 10-25 minutes depending on what type of ceramic block is selected. Once the milling has been completed your crown will be placed into the firing oven to harden and strengthen the crown for durability. The total time in the oven is 15-30 minutes depending on the ceramic block.
A CEREC crown will be about as strong as your natural teeth. For people who are clenchers /grinders typically a Zirconia block will be selected for its higher megapascal strength. (You can hit it with a hammer and it will not break!!) Milled ceramic is stronger than the traditional method of layering and pressing, porcelain, so your smile will stay beautiful for years!
Any single or multiple tooth restorations in the mouth such as, veneers, inlays, onlays, crowns placed on either natural teeth or on implants and bridges that were previously processed by a dental lab can be made utilizing the CEREC technology.
Yes, should you have dental benefits that include major coverage, your benefit plan will contribute towards your crown. Prior to your appointment, our treatment concierge will submit a predetermination to your benefit plan to confirm eligibility and the contribution amount. The contribution from your benefits is based on the terms of your plan contract that was negotiated between your employer and benefit carrier.
Commonly Asked Questions About CEREC (Ceramic Reconstruction)
CEREC is a fast and comfortable treatment because the dental prosthesis is created digitally and manufactured at our practice. In a single visit, a new prosthesis is ready regardless of whether you need a crown, bridge or veneer. We have put together a list of commonly asked question. Learn More about how NOVO Dental Centre is using CEREC to improve client care.
CEREC is a brand name – the technology is called CAD/CAM (Computer-aided design and computer–aided manufacturing). CAD/CAM dentistry has been in use since the mid-1980’s. Early efforts were considered a cumbersome novelty, requiring an inordinate amount of time to produce a viable product. This inefficiency prevented its use within dental offices and limited it to lab-side use (that is, use within dental laboratories). As adjunctive techniques, software, and materials improved, the chairside use of CAD/CAM (use within dental offices) increased.
We have a wide shade selection of tooth-coloured ceramic blocks to restore your teeth to their natural function, strength and beauty and closely matches the composition of your natural tooth structure. To further enhance the aesthetics we are able to customize the colour of your new crown for a natural look to blend it beautifully with your natural teeth.
Once we have finished the preparation of your tooth an optical image of the prep site will be taken with a special 3D scanner. The scanned information is then turned into a 3D model on the computer. While you watch, we will design your new crown according to your tooth’s appropriate form and function. When we have completed the design your precise specifications are sent via secure WiFi to the milling chamber where diamond burs carve your restoration out of a solid block of ceramic.
The milling process takes approximately 10-25 minutes depending on what type of ceramic block is selected. Once the milling has been completed your crown will be placed into the firing oven to harden and strengthen the crown for durability. The total time in the oven is 15-30 minutes depending on the ceramic block.
A CEREC crown will be about as strong as your natural teeth. For people who are clenchers /grinders typically a Zirconia block will be selected for its higher megapascal strength. (You can hit it with a hammer and it will not break!!) Milled ceramic is stronger than the traditional method of layering and pressing, porcelain, so your smile will stay beautiful for years!
Any single or multiple tooth restorations in the mouth such as, veneers, inlays, onlays, crowns placed on either natural teeth or on implants and bridges that were previously processed by a dental lab can be made utilizing the CEREC technology.
Yes, should you have dental benefits that include major coverage, your benefit plan will contribute towards your crown. Prior to your appointment, our treatment concierge will submit a predetermination to your benefit plan to confirm eligibility and the contribution amount. The contribution from your benefits is based on the terms of your plan contract that was negotiated between your employer and benefit carrier.
Questions About Finance and Insurance:
Yes we can. We’ll help you understand your insurance coverage, but your benefits package is between you and your employer and may change at any time, so please stay current with your plan and provide us with up to date information so we can make your life easy. We will also help you complete your insurance forms, and can file the forms directly to your insurance company on your behalf. We can even accept payment directly from your insurance company – which makes your life even easier! Send us a message on the Contact us page, we can help you learn more.
Because your insurance coverage is between you, your employer, and the insurance carrier, your dentist does not have the power to make your plan pay. If your insurance doesn’t pay, you are responsible for the total cost of treatment. Sometimes a plan may pay if patients send in claims for themselves. The Employee Benefits Coordinator at your place of business also may be able to help.
Provincial laws regulate these issues. It is insurance fraud to change the dates of service on a claim. Both the patient and the dentist can be prosecuted.
Your plan contract specifies how many of certain types of procedures it will consider annually. It limits the number of x-rays, cleanings, and gum treatments it will cover because these are the types of treatments that many people need to have frequently.
To save money, many dental plans allow a benefit only for the least expensive method of treatment. For example, your dentist may recommend a crown, with your insurance only offering a benefit towards a filling. This does not mean that you have to accept the filling. The good news is that some benefit will be paid; the bad news is that more of the fee will be your responsibility. Remember that your dentist’s responsibility is to prescribe what is best for you. The insurance carrier’s responsibility is to control payments.
Maximums limit what a carrier has to cover each year and again will depend on the policy selected by the employer and the premium paid each month. Amazingly, despite the fact that costs have steadily increased, annual maximum levels for dental care have not followed suit.
Remember that what insurance carriers call “usual and customary” is really just what your employer and the insurance company have negotiated as the amount that will be “allowed” as payment toward your treatment. It is usually always less or even much less than the suggested “BC General Practitioners Fee Guide” for some dental procedures. It does not mean that your dentist is charging too much.
Even a benefit plan that does not cover a large portion of the cost of needed dentistry it does pay something. Any amount covered reduces what you have to pay out of pocket. It helps!
Since the payments are negotiated, does this mean that there is always a balance left for me to pay?
Not always, it will depend on the negotiated contract. For example, some contracts contribute in full and have no annual maximum and others have reductions. You may have 100% coverage but your contract may have limitations built into it that limits the contribution for treatment provided on molar teeth.
Many carriers refer to their allowed payments as UCR, which stands for “usual, customary and reasonable”. However, usual, customary and reasonable does not really mean exactly what it seems to mean. UCR is actually a listing of payments for all covered procedures negotiated by your employer and the insurance company. This listing is related to the cost of the premiums and where you are located in your city and province. Your employer has likely selected an allowed payment or UCR payment that corresponds to the premium cost they desire. UCR payments could be more accurately called negotiated payments. So the higher premium your employer pays the higher the UCR.
That 100% is usually what the insurance carrier will “allow” as payment toward the procedure, not what the actually fees for the procedure may be.
Dental insurance isn’t really insurance (a payment to cover the cost of a loss) at all. It is actually a money benefit typically provided by an employer to help their employees pay for routine dental treatment. The employer usually buys a plan based on the amount of the benefit and how much the premium costs per month. Most benefit plans are only designed to cover a portion of the total cost.
Will this treatment be covered by my benefit plan?
Understanding your dental benefits is not easy. There are as many different plans as there are contracts. Your employer has selected your plan and is ultimately responsible for how your contract is designed. Remember, whether your plan covers a major portion of your dental bill, or only a small amount, dental benefits are good for patients because they help pay for needed treatment.
It is important to know that each contract will specify what types of procedures are considered for benefits. Even if a procedure is medically and dentally necessary, it may be excluded from your contract. This does not mean that you do not need the procedure. It simply means that your plan will not consider the procedure for payment. For example, cosmetic procedures and implants are often excluded from a dental plan. It is a mistake to let benefits be your sole consideration when you determine what you want to do about your dental condition.
Why doesn’t my insurance cover all costs for my dental treatment?
Dental insurance isn’t really insurance (a payment to cover the cost of a loss) at all. It is actually a money benefit typically provided by an employer to help their employees pay for routine dental treatment. The employer usually buys a plan based on the amount of the benefit and how much the premium costs per month. Most benefit plans are only designed to cover a portion of the total cost.
But my plan says that my exams and certain other procedures are covered 100%.
That 100% is usually what the insurance carrier will “allow” as payment toward the procedure, not what the actually fees for the procedure may be.
How does my insurance carrier come up with its allowed payments?
Many carriers refer to their allowed payments as UCR, which stands for “usual, customary and reasonable”. However, usual, customary and reasonable does not really mean exactly what it seems to mean. UCR is actually a listing of payments for all covered procedures negotiated by your employer and the insurance company. This listing is related to the cost of the premiums and where you are located in your city and province. Your employer has likely selected an allowed payment or UCR payment that corresponds to the premium cost they desire. UCR payments could be more accurately called negotiated payments. So the higher premium your employer pays the higher the UCR.
Since the payments are negotiated, does this mean that there is always a balance left for me to pay?
Not always, it will depend on the negotiated contract. For example, some contracts contribute in full and have no annual maximum and others have reductions. You may have 100% coverage but your contract may have limitations built into it that limits the contribution for treatment provided on molar teeth.
If I always have a balance to pay, what good is my insurance?
Even a benefit plan that does not cover a large portion of the cost of needed dentistry it does pay something. Any amount covered reduces what you have to pay out of pocket. It helps!
I received an “Explanation of Benefits” from my insurance carrier that says my dental bill exceeded the “usual and customary”. Does this mean that my dentist is charging more than he/she should?
Remember that what insurance carriers call “usual and customary” is really just what your employer and the insurance company have negotiated as the amount that will be “allowed” as payment toward your treatment. It is usually always less or even much less than the suggested “BC General Practitioners Fee Guide” for some dental procedures. It does not mean that your dentist is charging too much.
Why is there an annual maximum on my benefits?
Maximums limit what a carrier has to cover each year and again will depend on the policy selected by the employer and the premium paid each month. Amazingly, despite the fact that costs have steadily increased, annual maximum levels for dental care have not followed suit.
Why does my benefit plan only pay toward the least expensive “alternative treatment”?
To save money, many dental plans allow a benefit only for the least expensive method of treatment. For example, your dentist may recommend a crown, with your insurance only offering a benefit towards a filling. This does not mean that you have to accept the filling. The good news is that some benefit will be paid; the bad news is that more of the fee will be your responsibility. Remember that your dentist’s responsibility is to prescribe what is best for you. The insurance carrier’s responsibility is to control payments.
Why won’t my insurance pay anything toward some procedures, such as x-rays, cleanings, and gum treatments”
Your plan contract specifies how many of certain types of procedures it will consider annually. It limits the number of x-rays, cleanings, and gum treatments it will cover because these are the types of treatments that many people need to have frequently.
I know that my insurance plan doesn’t go into effect until next month. Why won’t my dentist do my treatment today, but send in the claim next month so that the insurance will pay?
Provincial laws regulate these issues. It is insurance fraud to change the dates of service on a claim. Both the patient and the dentist can be prosecuted.
What should I do if my insurance doesn’t pay for treatment I think should be covered?
Because your insurance coverage is between you, your employer, and the insurance carrier, your dentist does not have the power to make your plan pay. If your insurance doesn’t pay, you are responsible for the total cost of treatment. Sometimes a plan may pay if patients send in claims for themselves. The Employee Benefits Coordinator at your place of business also may be able to help.
Can you help me with my insurance forms?
Yes we can. We’ll help you understand your insurance coverage, but your benefits package is between you and your employer and may change at any time, so please stay current with your plan and provide us with up to date information so we can make your life easy. We will also help you complete your insurance forms, and can file the forms directly to your insurance company on your behalf. We can even accept payment directly from your insurance company – which makes your life even easier! Contact us to learn more.
We can help you make financing arrangements with Dentalcard, which is an outside company that we work with. Dentalcard assists patients in attaining their desired smile in a financially comfortable manner. The patient is able to take up to 6 years to complete their payment plan. This service works very well for patients who may not have dental coverage or whose needs exceed what their dental benefits will contribute.
The benefits of Dentalcard include:
- the ability to take care of your entire family’s dental bill with just one simple monthly payment;
- no application fees of any kind;
- repayment terms from 6 months to 6 years; and
- fixed interest rates (no need to worry about rising rates).
Learn more about Dentalcard on their website, or send a message from our Contact Us page and we’ll be happy to answer your questions.
For your convenience, NOVO Dental Centre accept cash, debit cards, E-Transfer, VISA, Amex and MasterCard.
