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Understanding Dental Insurance Terminology

October 4th, 2023

If you have a hard time understanding your dental insurance plan, particularly the treatments and services it covers, you’re not alone. That’s why our doctors and our team have put together a cheat sheet to help you through them.

It’s common for patients to get lost in the morass of the terms and phrases that surface when you’re dealing with a dental insurance plan. Knowing the commonly used terms can help speed up the process and enable you to get the most out of your coverage.

Common Terms

Annual Maximum: The most your policy will pay per year for care at Oak Grove Dentistry. It is often divided into cost per individual or per family.

Co-payment: Typically, a small amount the patient has to pay at the time of service before receiving care, and before the insurance pays for any portion of it.

Covered Services: A list of all the treatments, services, and procedures the insurance policy will cover fully under your contract.

Deductible: An amount you must pay out of pocket each year before the insurance company will contribute for any treatments or procedures. The amount can vary according to your plan.

Diagnostic Services: A category of treatments or procedures that most insurance plans will cover before the deductible, which may mean services that occur during preventive appointments with our doctors, including X-rays or general screenings.

Exclusions: Dental services not covered under a dental benefit program.

In-Network: An insurance company will usually cover a larger portion of the cost of the care if you see an in-network provider for treatment.

Out-of-Network: If you visit someone who is not a part of your provider’s network, the insurance company may pay for a portion of the care, but you will be responsible for a significantly larger share out of your pocket.

Lifetime Maximum: The most that an insurance plan will pay toward care for an individual or family over the entire life of the patient(s).

Limitations: A list of all the procedures the insurance policy does not cover. Coverage may limit the timing or frequency of a specific treatment or procedure, or exclude some treatments altogether.

Member/Insured/Covered Person/Beneficiary/Enrollee:  A person who is eligible to receive benefits under an insurance plan.

Premium: The regular fee charged by third-party insurers and used to fund the dental plan.

Provider: our doctors 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.

It’s essential to understand the various insurance options available to you. Knowing what your insurance covers can save you major costs in the future.

our doctors and our dental staff hope this list of terms will help you understand your dental insurance plan better. Be sure to review your plan and ask any questions you may have about your policy the next time you visit our Green Bay office.

Gum Disease in Children

September 27th, 2023

When it comes to gum disease and your child, it’s a good news/bad news situation. The very good news is that children rarely suffer from advanced gum disease, or periodontitis. The not-so-good news? Early gum disease, called gingivitis, is unfortunately an all-too-common childhood problem.

  • What does gingivitis look like in children?

Childhood gingivitis has the same causes and symptoms as the adult version. Healthy gums are firm and pink. When bacteria and plaque accumulate on the teeth, your child’s gums become irritated and inflamed. Call our Green Bay office right away if you notice any of these symptoms of gingivitis: bleeding gums, puffiness, redness, gum tissue receding from the teeth, or bad breath even after brushing.       

  • How to Prevent Gingivitis

The most common cause of gingivitis is poor dental care. Creating a regular dental routine is the best way to prevent gingivitis from ever developing! Brushing and flossing with your child for two minutes twice a day from the very beginning helps make healthy cleaning a lifelong habit. Care should be taken to gently brush teeth at the gum line to make sure plaque doesn’t get a chance to build up there and cause gum irritation. And when your child comes in for regular cleanings, our doctors can be sure that any plaque that might remain on the teeth is removed.

Two additional notes: as your child approaches adolescence, hormone fluctuations can make gums more sensitive and easily irritated. This is a time to really emphasize careful and gentle brushing and flossing. Also, some medical conditions may make children more pre-disposed to gum problems, so be sure to make us aware of your child’s medical history.

  • Uncommon Gum Diseases

While gingivitis is very preventable with proper dental hygiene, there are some rare gum conditions that can occur around the time of puberty that are quite different from gingivitis. Aggressive Periodontitis can cause severe bone loss around the first molars and incisors, even without any kind of plaque build-up, and Generalized Aggressive Periodontitis leads to inflammation of the gums, heavy plaque, and, eventually, loose teeth. Again, these conditions are rare, but if you have a family history of these diseases, let us know. Checkups and cleanings are a great way to catch any potential gum problems, so be sure to bring your child in for regular visits.

Almost all childhood gingivitis is preventable. With careful brushing and flossing at home, and visiting us regularly for checkups and cleanings, your child can enjoy healthy gums and teeth now and learn habits that will keep those gums and teeth healthy for a lifetime. And that is a good news/great news situation!

When do children usually lose their baby teeth?

September 27th, 2023

Many parents have concerns about their children’s teeth not falling out on time. our doctors and our team are here to answer any questions parents may have about when children lose their teeth.

Children have 20 primary teeth that come in around age three. By about age six, these teeth will loosen and begin to fall out on their own to make room for the permanent ones. It is common for girls to lose their baby teeth earlier than boys. Most children lose their final baby tooth by age 13.

Baby teeth normally fall out in the order in which they came in. The lower center incisors are usually the first to fall, around age six or seven, followed by the upper central incisors.

If a child loses a tooth to decay or an accident, the permanent tooth may come in too early and take a crooked position due to teeth crowding. If your child loses a tooth to decay or accident, call our doctors to make an appointment.

Some kids can’t wait for their baby teeth to fall out, while others dread the thought of losing a tooth. When your child begins to lose teeth, you should emphasize the importance of proper dental care on a daily basis to promote a healthy mouth.

Remember to:

  • Remind your child to brush his or her teeth at least twice a day and offer assistance if needed
  • Help your child floss at bedtime
  • Limit eating and drinking between meals and at bedtime, especially sugary treats and drinks
  • Schedule regular dental visits for your child every six months.
  • Ask about the use of fluoride treatments and dental sealants to help prevent tooth decay.

Call Oak Grove Dentistry to learn more about caring for baby teeth or to schedule an appointment at our Green Bay office!

A Prescription for Oral Health

September 20th, 2023

You and your dentist are essential partners in making sure you have the best dental care. You do your part by eating a tooth-healthy diet, brushing and flossing as recommended, and seeing our doctors regularly for checkups and cleanings.

And one more essential step you can take for your dental health? Let our doctors know which prescriptions and over the counter medications you’re taking.

Medications Have Oral/Dental Side Effects

We’ve all grown used to hearing “Possible side effects include . . .” at the end of every pharmaceutical commercial. That’s because those unintended side effects can affect our health in any number of unexpected ways—and this includes oral health.

For example, a common side effect of many medications is xerostomia, or “dry mouth.” Because saliva helps keep our teeth and gums healthy by washing away food particles and oral bacteria and by reducing acidity in the mouth, a reduction in saliva production means a greater risk of cavities, gum disease, oral infections, denture discomfort, and bad breath.

Knowing a patient is taking one of the hundreds of medications which cause xerostomia allows our doctors to both monitor the condition and suggest the most effective treatment options to control unpleasant symptoms.

Medications can cause not only dry mouth, but excessive gum tissue growth, oral sores, tooth discoloration, and changes in taste, among other side effects, so knowing which medications you’re taking can provide essential information for the diagnosis and treatment of these conditions.

Medications Interact

Medication might be needed for your dental treatment. Because certain drugs, supplements, and even some vitamins and foods can affect the way our bodies metabolize, absorb, and respond to other medications, we need to know which medicines you’re taking to arrive at your best treatment options.

  • There are different classes of antibiotics used to treat oral infections. Knowing your medical history enables our doctors to choose an antibiotic option which won’t interact with your other medications.
  • Local anesthetics such as lidocaine, which numb the area to be treated, can also interact with certain medications. our doctors can prescribe an alternative local anesthetic or adjust the dosage as needed.
  • If you will be using sedation during your procedure, you have several options, including nitrous oxide gas, oral sedation, or IV sedation. Be sure we know about all of your medications beforehand because of possible interactions. Changes can be made to the type of sedation and/or the dosage as needed.

Medications Impact Treatment

It’s important for our doctors to know if any of your medications will affect standard treatments.

Anticoagulants, for example, are a necessary medication for preventing blood clots from forming, and are often prescribed for certain heart conditions, after joint replacement surgery, or for anyone at risk for developing blood clots. Because these medications prevent the blood from clotting, it’s important to let us know if you are taking such drugs before any kind of oral surgery.

If needed, our doctors can work with you and your doctor to create a treatment plan which will be safe, effective, and designed to work with any of your medications. You should never discontinue taking your prescribed medications before dental work without medical approval, as this can be dangerous.

We need the most up to date information about your health to provide you with the best care possible. Knowing which medications you take and why you take them can help us:

  • Diagnose and treat any side effects from non-dental medications which have affected your oral health,
  • Prevent drug interactions from occurring, and
  • Tailor your treatment to your specific medical needs.

Your prescriptions, over the counter medications, and even herbal supplements and vitamins are essential information. It’s a good idea to make a list before your next appointment at our Green Bay office so you have specific medications and their dosages at hand. It’s one small—but vital—step you can take to work with our doctors for your best dental health!