Strategies for Affording Emergency Wisdom Tooth Extraction
Wisdom teeth that are impacted can have an impact on health, yet most dental insurance plans do not cover tooth extraction.
1. The Impact of Wisdom Teeth
It is estimated that 5% to 37% of people do not have wisdom teeth and therefore never experience wisdom tooth complications.
But for those who have wisdom teeth, wisdom teeth are "the third molars and the last set of teeth to erupt", Dr. Lesline Davis, a dentist and public health consultant, told Health magazine. "Wisdom teeth erupt between the ages of 17 and 21, but some people don't have wisdom teeth at all."
The initial signs that wisdom teeth need to be extracted are pain, swelling and stiffness in the jaw.
The reason for this pain is that partially erupted wisdom teeth allow bacteria to enter the gums and cause an infection.
In addition, wisdom teeth may be fully or partially impacted.
Impacted wisdom teeth are difficult to clean, increasing the chances of tooth decay or a localized gum infection. Impacted wisdom teeth can also cause pain, swelling, cyst formation and damage to other teeth.
2. What Does Your Dental Insurance Cover?
Dental insurance is a basic health benefit for children. But for adults, health insurance plans do not require dental insurance to be provided for anyone over 18.
Depending on the severity of the oral surgery required to extract wisdom teeth, you may be able to bill Medicare. However, the charge depends on the insurance code of the dentist when filing a claim. Medicare only helps pay for oral surgery when it is considered "medically necessary" for your overall health and well-being.
Insurance may cover the cost of wisdom tooth extraction and pay for hospitalization or general anesthesia for the surgery. But it may not. The key here is to correctly use the Current Dental Terminology (CDT) developed by the American Dental Association (ADA) to identify the oral treatment procedures provided to the patient.
Insurance may cover the extraction of wisdom teeth and pay for hospitalization. The Patient Protection and Affordable Care Act, which took effect in 2010, allows dental insurance to cover many basic services. Unfortunately, wisdom tooth extraction does not fall into this category.
Most dental plans that can be purchased through the health insurance marketplace will cover 100% of the cost of preventive care (such as cleanings, examinations and X-rays). These dental plans will also cover about 80% of basic treatments (such as fillings) and 50% of complex procedures (such as root canals and crowns).
But it is known that untreated wisdom teeth can cause complications, and unfortunately this policy has not yet met the medical need.
Dr. Davis explained that untreated impacted wisdom teeth can "lead to serious complications, such as swelling of the jaw and face, affecting breathing, requiring hospitalization, and the infection can spread to the brain and blood, both of which can be fatal. It is worth noting that this risk still exists even if the pain is reduced."
3. Low-Cost Oral Surgery Options
If your dental insurance plan is part of a Health Maintenance Organization (HMO), it will cover the extraction of wisdom teeth for younger patients if recommended by your dentist.
The problem is finding an oral surgeon who accepts your medical insurance. In the case of my son, his state-subsidized dental insurance for braces treatment was almost useless for wisdom tooth extraction. I spent a whole day calling every oral surgeon in New York to find one who accepted his medical insurance. But the earliest appointment was still a few weeks away.
Eventually, I paid $900 out of my own pocket to have my son's wisdom teeth extracted. Because of the high cost, I decided not to give him a sedative.
Registered dental hygienist Alwaine Fenton told Health magazine that many training institutions and medical credit companies offer affordable dental care costs.
So, what are the low-cost options for adult oral care and surgery? Fenton recommended the more popular options, which are to use federally funded community health centers and United Way. United Way is regarded as a one-stop service center for many social services, including dental care.
In addition, Fenton also mentioned that he strongly advocates getting dental care from dental schools, including wisdom tooth extraction.
"Although the students are in practice or training and may work more slowly and the procedures take longer to complete, the cost of dental treatment is reduced," Fenton explained. "And the students are closely supervised by licensed dentists."
Dental schools have extremely high standards to maintain the accreditation issued by the Commission on Dental Accreditation (CODA). In addition, if a resident who specializes in oral surgery extracts your wisdom teeth, they are a graduate of a dental school. Therefore, they have completed the education required to become a dentist.
In addition, the types of dental insurance accepted by dental schools tend to be more flexible. At a dental school, the out-of-pocket cost you pay may even be lower than what you pay at a private clinic.
However, there are also some disadvantages to using a dental school. For example, Fenton mentioned that anyone who needs emergency treatment has to wait a long time for an appointment.
However, Fenton reiterated, "Accredited dental schools or dental hygiene schools can provide high-quality and low-cost dental treatment because they meet the high treatment standards of the American Dental Association (ADA) and the American Dental Hygiene Association (ADHA)."
Another way to extract wisdom teeth is through clinical trials. Some people think that the risk will increase when they hear the term "clinical trials", but this is not the case.
According to the regulations of the Food and Drug Administration, clinical trials must comply with the strictest compliance standards. In 2013, the Food and Drug Administration issued a draft guidance suggesting how research sponsors must fulfill their obligations to oversee or regulate clinical research.
4. Quick Review
For most medical procedures without comprehensive medical insurance coverage and a large budget, obtaining information is the best option.
Although not everyone needs to have their wisdom teeth extracted, it is still beneficial to understand and explore your options so that you can plan well in case of an emergency.
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