Covered Dental Expenses

Virtually all dental problems fall into 10 professional treatment categories:

1. Diagnostic. Examination to determine the existence of oral disease or to evaluate the condition of the mouth. Included in this category would be such procedures as X-rays and routine oral examinations.
2. Preventive. Procedures to preserve and maintain dental health. Included in this category are topical fluoride applications, cleaning, space maintainers, and the like.
3. Restorative. Procedures for the repair and reconstruction of natural teeth, including the removal of dental decay and installation of fillings.
4. Endodontics. Treatment of dental-pulp disease and therapy within existing teeth. Root canal therapy is an example of this type of procedure.
5. Periodontics. Treatment of the gums and other supporting structures of the teeth, primarily for maintenance or improvement of the gums. Periodontal curettage and root planing are examples of periodontic procedures.
6. Oral Surgery. Tooth extraction and other surgery of the mouth and jaw.
7. Prosthodontics. Construction, replacement, and repair of missing teeth. Examples include onlays, crowns and bridges, which are fixed prostheses, and dentures and partials, which are removable prostheses.
8. Orthodontics. Correction of malocclusion and abnormal tooth position through repositioning of natural teeth.
9. Pedodontics. Treatment for children who do not have all their permanent teeth.
10. Implantology. Use of implants and related services (e.g., over-dentures, fixed prostheses attached to implants, etc.), to replace one or all missing teeth on an arch.

In addition to the recognition of treatment or services in most of these 10 areas, the typical dental plan also includes provision for palliative treatment (i.e., procedures to minimize pain, including anesthesia), emergency care, and consultation.

These 10 types of procedures usually are categorized into three, four, and sometime five general groupings for purposes of plan design. The first classification often includes both preventive and diagnostic expenses. The second general grouping includes all minor restorative procedures. The third broad grouping, often combined with the second, includes major restorative work (e.g., prosthodontics), endodontic and periodontic services, and oral surgery. A fourth separate classification covers orthodontic expenses. Although excluded under most plans, implantology services are usually covered under a separate fifth classification.

Pedodontic care generally falls into the first two groupings.