In my opinion insurances should cover all medical necessity surgeries, some patients need some procedures to provide them with a better quality of life, but they are unable to receive them because is considered cosmetic.

by | Aug 16, 2021 | Uncategorized | 0 comments

PART 1
In my opinion insurances should cover all medical necessity surgeries, some patients need some procedures to provide them with a better quality of life, but they are unable to receive them because is considered cosmetic. Oral health is not highly recognized by insurances or medical professionals, oral health is more than just teeth to eat, I believe that dental cosmetic surgery should not even qualify as “cosmetic” as having teeth is more than just a cosmetic factor. Older people tend to have more health diseases and must be on medications that can potentially affect their dental health, I think it would be hard having to pick to lose your teeth or to be on a treatment that can better your quality of life. Use of corticosteroids, such as prednisone, and antiepileptic drugs, can lead to the loss of bone that supports your teeth. (Yoffee & Craig 2012). Some of these treat arthritis or osteoporosis which some of the older people suffer from these diseases and are put on a position to either have ache relief and lose their teeth or continue to live in pain.
For patients who face multiple health issues and due to their treatment options that affected their dental health should approve to get dentures to help them with their quality of life, dentures and other dental treatments or care can be very expensive, specially if the individual is already retired or with limited funding insurance should cover the total cost as is a medical necessity. On other any occasion or scenario I think if should be evaluated for coverage according to the necessity.
PART 2
Normally cosmetic dental procedures are not covered under insurances. This is considered elective and not medical necessary. Restorative dentistry is normally medically necessary, whereas cosmetic dentistry is considered elective. Normally insurance covers only restorative procedures or deemed medical necessary by falling into a few categories such as is it related to tooth decay or disease. Insurance will normally cover some or all of the restorative procedures, however insurance will not cover elective procedures. With that being said, many cosmetic dentists use restorative procedures, such as porcelain crowns, tooth veneers and dental implants for restorative and cosmetic procedures. So, what makes up the difference between procedure restorative versus cosmetic dentistry?
Dental insurance considers a procedure restorative if it falls into the below categories and is deemed medically necessary. Tooth decay or disease is considered medically necessary, also, if it was related to an accident or an injury. If you need to replace missing teeth or alter mechanics of the patient’s bite is also consider medically necessary.
So, what is considered cosmetic or elective dental procedures? If the procedures exist solely for enhancing the aesthetics of the patient’s smile. If the underlying tooth or tissue is not injured, impaired or decayed. And if there is no medically necessary reason for altering the tooth or performing the procedures.
Dental insurance will not normally cover cosmetic dentistry procedures that have no medical necessity. However, if a patient needs dental work because they were involved in an accident. If they want the procedure to correct the damage that was done and to have a aesthetically appealing what category does this fall into? It would be both, because the patient has a medical need for replacing their teeth, and the procedure would then be considered a restorative procedure.
Dental companies should believe in that every restorative procedure should be completed with a cosmetic appeal in mind. When patients are finding a dental office they should be very selective when choosing to have dental work done. Many insurance companies consider bleaching or teeth whitening a cosmetic procedure. Also correcting a space between your teeth that was not a result of an injury.
I would always suggest checking with your insurance company before having an dental procedure completed to make sure it will be covered.

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