Has Dental Insurance Come Full Circle?

by Cathy Miller on February 10, 2014

in Dental

Dental insuranceDental professionals have often felt like the Rodney Dangerfield of health care.

I don’t get no respect.

Even health reform’s Affordable Care Act declared only kids’ dental health (pediatric oral care) as essential health benefits.

A recent post at Boston’s National Public Radio (NPR) news station site wondered why we separate dental and medical care.

Being the self-professed dental geek that I am, I had to chime in.

Dental Care Vs Dental Insurance

We discovered with the Affordable Care Act that there is a difference between care and insurance. We’ll use the NPR post to illustrate those differences.

Dental Care

The patient was concerned about the lack of coordination between his dental and medical care. His doctor had no idea he was receiving dental implants or the prescribed antibiotics.

As the post’s author expressed ~

“…why, in this era of integrated medicine, do we continue to
carve out the teeth?”

Dr. James Gutmann, editor of the Journal of the History of Dentistry, points to the birth of insurance as the time medical and dental care began to be viewed separately.

Dr. Gutmann states there was no dental insurance back in the 1960s and 70s – as far as he knew.

Not true.

Dental Insurance

One of the advantages of being old is you know obscure stuff. I paid dental claims in the 1970s. Generally, you saw two types of dental coverage.

  1. Unions for large companies had dental insurance policies, separate from medical.
  2. Most medical policies had limited coverage for specific dental treatment.

Typically, the limited coverage included the removal of wisdom teeth, an apicoectomy (removal of the tip of a tooth and infected tissues), and accident-related treatment.

As employee benefits evolved, more companies added separate dental insurance policies.

Then and Now

Dental policies of the 70s were never intended to cover all dental treatment.

  • Dental policies had a specific list of covered services
  • The policies had limited annual maximums
  • Orthodontic coverage was optional – if purchased, treatment was subject to a lifetime dollar maximum

While some dental policies expanded the list and increased maximums, the policies have not changed much. Even with insurance, patients can end up owing thousands of dollars.

The Broken State of Dental Insurance explains some of the effects of today’s dental policies.

  • Only 1% of dental policies are purchased as an individual policy
  • Most (81%) are purchased through an employer
  • Emergency room visits for dental-related problems are on the rise

So, are we back to square one?

  • Should dental and medical coverage join forces?
  • Do we continue to compartmentalize our health when it comes to insurance?
  • Or are we ready to create a system for total health?  Total well-being?

BigStock Photo Credit


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Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.



{ 2 comments… read them below or add one }

Kevin H @ Growing Family Benefits February 11, 2014 at 9:32 am

In my experience the only “good” dental plan is one that somebody else pays for: the employer, or union. When employees have to pay the full cost of the premium, most choose to go without.

The only exceptions seem to be those with bad teeth, lots of kids, or those understanding the value of pretax payroll savings.
Kevin H @ Growing Family Benefits´s last blog post ..Life Insurance Policy Types Pros and ConsMy Profile


Cathy Miller February 11, 2014 at 9:53 am

Exactly the problem, Kevin. As someone who moved from employer-sponsored benefits to owning my own business, even routine dental care adds up when you consider adding that on to premiums, and medical out-of-pocket expenses.

Even the discounted plans still mean the individual is paying the entire amount. Health savings accounts can help if you have one, but I find myself saving those dollars for my high deductible on my medical plan.

With more employers shifting dental to a voluntary benefit, I think it’s only going to get worse.

Thanks for sharing your thoughts, Kevin.


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