Does Your Health Insurance Cover an Emergency Dentist Appointment?

What Is an Emergency Dentist?

Emergency dental professionals are qualified to treat specific, urgent issues with the teeth and gums. Typically, a general dentist falls into this category and will see you for an emergency. Alternatively, you may visit a location that is designated to serve patients in this situation, especially after normal business hours. You may also need to visit an emergency dental if there are no available appointments with a general dentist in the necessary time frame.

When Should You See an Emergency Dentist?

Any trauma to the mouth, such as a sudden or forceful blow, can result in a dental emergency. When this occurs and any of the following symptoms develop as a result, you should see a dentist as soon as possible:

• A tooth becomes loose, chipped, or cracked.
• A tooth is knocked out (either baby or permanent).
• There is uncontrolled bleeding from the mouth that will not slow or stop.
• There is abnormal swelling in the mouth or lower part of the face.
• There are visible signs of bulging or oozing at the gums.
• There is severe oral pain.

Time is of the essence, especially when dealing with a knocked-out tooth. In these cases, quickly clean the tooth and try to hold it back in place in the mouth to prevent tissue damage to the tooth. In young children or unresponsive patients, wash the tooth, place it in a container with milk, and see an emergency dentist as soon as possible, preferably in less than 30 minutes. In all scenarios, try to keep the tooth clean and protect it from drying out in the air.

Some dental emergencies develop over time rather than as a result of sudden trauma. In these cases, it is still important to get emergency care quickly, especially when symptoms point to potential or developing infections.

Are Emergency Dentist Appointments Covered by Private Health Insurance?

In general, most dental expenses, including emergency dental appointments, are not covered by public health insurance. (Cost of Dental Care | Healthdirect, n.d.) There are a few exceptions in certain situations, most often amongst children, when Medicare will help cover dental costs in what is considered necessary or essential. Typically, to be covered for emergency appointments and most other types of dental work and care, you will need to have an appropriate level of private health cover.

Which Types of Insurance Plans Cover Emergency Dentist Visits?

When it comes to securing private health insurance that includes dental, you may have options to consider. Some insures offer either routine or major dental benefits depending on the type and level of cover you choose. Routine dental may only cover some preventive services or screenings, such as cleanings, X-rays, routine examinations, and minor tooth decay treatment, which is often classified within extras cover which provides benefits for a wide range of services not covered by Medicare. Major dental tends to cover a wider variety of treatments and procedures, such as bridges, crowns, implants, or dentures and often requires an appropriate level of hospital cover. (Cost of Dental Care | Healthdirect, n.d.) Contact Health Partners today to learn more about your coverage options.

It is also important to note that some insurance companies recommend a specific list of emergency dental offices to choose from. If you have a specific policy but seek treatment from a provider not listed with your policy, you may not have coverage, or it may be for a much smaller amount.

If you only have public health insurance, there is a good chance you will not be covered for your trip to the emergency dentist. If you have private insurance, contact your health insurer to find out exactly what your policy allows and to locate the participating providers in your area. You can also call individual dentists that accept your private insurance to find out exactly how much the procedure should cost.

Understand that if you seek emergency treatment for a dental crisis that is not truly an emergency, it could affect your coverage. This useful teeth and dental problems symptom checker can help you determine just how quickly you need to be seen. It can also offer suggestions on what to do and what to watch for until you can receive professional treatment.

What Happens If You Do Not Treat a Dental Emergency?

Without proper coverage, you may be tempted to wait it out or simply endure the discomfort of a recent oral injury. However, failing to see an emergency dentist when it's necessary can have serious consequences. Some of the most severe complications include:

• Severe, worsening, or chronic pain
• Blood loss
• Infection, leading to potential sepsis
• Tooth loss
• Progression or spread of tooth damage

Injuries and damage from trauma to the mouth can lead to long-term issues, affecting a person’s physical and mental health for a lifetime. (Oral Health, 2022) For these reasons, it is essential to have all true dental emergencies evaluated and treated as soon as possible by a dental professional. If you wait until your next regular checkup, it may be too late to repair or save a tooth and could lead to serious health issues.

Get the Coverage You Need To See an Emergency Dentist

Without the right coverage plan in place, you may avoid seeing an emergency dentist, putting your dental and overall health at risk. It is important to have a policy in place so you can protect your teeth and gums, even when the unexpected occurs. At Health Partners, we focus on ensuring everyone has the health insurance they need to enjoy expert care at an affordable price. Contact us today to learn more about how we can help you find the cover for all of your health and wellness needs.

References:

Cost of dental care | healthdirect. (n.d.). Healthdirect. Retrieved October 1, 2022, from https://www.healthdirect.gov.au/cost-of-dental-care#medicare

Government Dental Care | Teeth.org.au. (n.d.). Australian Dental Association. Retrieved October 1, 2022, from https://www.teeth.org.au/government-dental-care

healthdirect Symptom Checker | healthdirect. (n.d.). Healthdirect. Retrieved October 1, 2022, from https://www.healthdirect.gov.au/symptom-checker/tool/basic-details

Oral health. (2022, March 15). World Health Organization (WHO). Retrieved October 1, 2022, from https://www.who.int/news-room/fact-sheets/detail/oral-health