Crystal Lake, IL Dentist
77 E. Crystal Lake Avenue
Crystal Lake, IL 60014

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Posts for: December, 2015


We get asked, all the time, about dental insurance. And it's almost never an easy conversation.  Dental insurance typically isn't easy  for the patient AND the dentist. There's not enough coverage, too many things aren't covered at all, the co-pays are too high, and the limitations are fairly strict. But why is this so?  Well, there's really just one reason, in our opinion, and it's dental insurance is simply not profitable to insurance companies.

Dental insurance first started in the mid 60s/early 70's.  Dental insurance was offered with a $1,000 - $1,500 cap in 1972.  And $1,000 - $1,500 bought a lot of dental care in 1972.

Today, the average cap on dental plans is ... $1,000-$1,500.  Wait ... what? No, you read that right -- it's still $1,000 - $1,500 (on average).

So in over 40 years, the benefit has not gone up.   Insurance has raised caps on nearly everything except dental insurance. That should tell you something about the business model of dental insurance.

So why isn't offering "good" dental insurance profitable?  What's a reasonable "bad" scenario for dental work? $5,000 a year? How much premium are you willing to pay to protect against that?  Probably not much. We can assume because of a fairly low "worst case" dollar number, patients will not be willing to pay all that much for the premium.

In addition, the insurance company knows if they provide coverage, it will more than likely get used to a degree (at the very least for twice yearly cleanings/checkups, and yearly x-rays). So to make a profit, they have to charge more than what that will cost, and then also average out what will get used beyond that. Very, very quickly the premium cost will add up to where it's not really worth doing, because the worst case isn't "lose your shirt" territory.

To provide "full coverage," an insurance company would have to charge more for premiums than a consumer would deem worth spending. So we get this hybrid "this is covered up to that amount/waiting periods/low maximums/no coverage at all" scenario that we're in. Which really helps nobody -- insurance companies don't like it, dentists don't like it,  and worst of all, patients don't like it.

There are no easy answers. But at least now you sort of have an idea as to why dental insurance works the way it does.  

  • The "use" factor. In plain terms, dental insurance almost always gets used, oftentimes, right up to the max. This is not so with other types of insurance. In fact, the entire profit model of insurance is based on a certain percentage of people not using it.

  • Pre-existing conditions. Many dental problems are often ignored for years. So the feeling is that many people will "save up" their problems until they get dental insurance. This happens so often that many dental insurance providers have a waiting period of one year for any major work.  

  • Dental problems are more commonplace than many other health problems. There are very, very few people out there with no need for dental work at all. Almost all people with dental insurance will use it to a certain degree every year. Conversely, looking at typical health insurance as a comparison, a great number of healthy people will often go years without seeing a doctor.

  • The total cost of work is lower, making it difficult for an insurance company to charge a high enough rate to offset the "people using it" factor, but also for the rate to be low enough to be "worth it" to the typical consumer. Put another way, you have health insurance not only for routine doctor visits, but for "catastrophic" events. After all, an operation/hospital stay could bankrupt you. Thus, even at high premiums, health insurance is a must have for most people. Not so for dental insurance.  

Fluoride treatments starting from six months of age or when your child's teeth are visible? That's right.  This new guidline, one of several updated guidelines the American Association of Pediatrics (AAP) released for preventive healthcare screenings and assessments, echoes one issued in 2014 by the American Association of Pediatric Dentists for parents to start treating children’s teeth while they are infants.   

The AAPD wrote in its Guideline on Fluoride Therapy, “There is confirmation from evidence-based reviews that fluoride use for the prevention and control of caries is both safe and highly effective in reducing dental caries prevalence.” 

The discovery of fluoride’s protective qualities for teeth is something of a medical miracle and there are many reasons children benefit from a professional fluoride treatment. Fluoride strengthens tooth enamel helping to prevent tooth decay and reverse early decay.

Timing Is Everything

Time of day can make or break your child’s appointment.  It’s important for a child of any age who’s used to a nap to not schedule during naptime. If your child is always cranky after waking up, factor that in too. 

For older children, avoid cramming in a dentist appointment right after day camp or school.  Not all kids have the energy to do that. If the child has already been exhausted or had a bad day or had tests, they just don’t have the stamina to make it through the appointment successfully. 

Make One Child a Model

If you’ve scheduled back-to-back appointments for your children, there’s a simple way to decide who goes first: Choose the child who’s had the most positive experiences at the dentist.  Every child is going to be a little bit different in their temperament about how they approach a visit.  You generally want the ones first who are more successful because the others get to see how it goes. 

A Hungry Child Is Not a Happy Patient

Feed your child a light meal before the appointment.  Hungry people are grouchy people. You want them to be comfortable. Eating light is also better for a child with a healthy gag reflex.  Some children gag a lot just because they gag with everything.  As they age and they get more control over swallowing, kids tend to gag less. 

Bonus points if your child brushes before an appointment (we have disposable toothbrushes in our office rest rooms for patient use).  

Leave Your Anxiety at the Door

The younger your kids are, the more you need to be aware of how you’re communicating with them. For example, if your child asks about getting a cavity filled, don’t say, “It will only hurt for a little bit.” Instead, encourage your child to ask the dentist.  With any child, you want them to be able to feel successful at accomplishing a good visit and link that positive feeling with the idea that their teeth are strong and healthy so they have that message going forward for the rest of their lives. 

Keep Cool If Your Child Won’t Cooperate

If your child gets upset during her visit, the worst thing you can do is swoop them out of the chair and leave.  The next visit is going to be harder.  You still have to help them get through part of the visit. 

First, assess why your child is acting out. Are they truly afraid, or are they trying to test the situation?  One of the reasons I think a 4, 5 or 6-year-old gets upset is because they think they’re going to be asked to do something they can’t be successful at. They’re in an environment they feel they can’t control and that makes them upset, so we try to break it down into small steps.

Then, work as a team with your dentist to keep the visit going. Let the dentist lead the conversation. Jump in where you think it helps most, while still allowing the dentist and your child to build a good relationship.  Give the dentist every opportunity to turn the visit around. 

‘Tis the season to team up once again with our favorite Dental Do Gooder, Hermey the Elf, to help keep smiles bright.

Visit MouthHealthy’s 
Holiday Workshop to get holiday tips, a downloadable brushing chart and Hermey coloring pages.  

Researchers tested a wide rage of sugar-free soft drinks, sports drinks and sweets and found that many of them can be just as harmful to teeth as their sugared counterparts due to their chemical composition.  Researchers found that because these sugar-free beverages contain acids like phosphoric acid (found in colas) or citric acid (found mainly in lemon and lime flavored drinks), they can strip away a tooth’s outer layer – leading to chalkiness of the tooth’s surface, pitting, opacity, tooth sensitivity and other issues. 

The researchers found that the acid in these beverages dissolves the tooth’s hard tissues, causing dental erosion.  The study showed that most soft drinks and sports drinks caused dental enamel to soften by between 30 percent and 50 percent!