Online Dental Education Library

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.

 

INSURANCE

Usual and Customary. What Does It Mean?

 

Every once in a while a patient calls us after receiving a statement from their dental insurance company and asks: “Your fee for this is over what my dental insurance company calls ‘usual and customary,’ does that mean you are overcharging me?” 

That’s a good question, one we’re happy to answer. 

Each separate insurance company has its own “usual and customary” fees for all dental procedures for a certain geographical region. When our state dental association asks these companies for data to see how the numbers were arrived at and which dentists (if any) were surveyed, they are told that this is privileged company information and they do not reveal that. 

The fact is that different insurance companies have different “usual and customary” fees for the same area.  If the calculations were done correctly they should all have the same fees.  But they don’t! In fact the ranges are quite broad. 

Because the insurance companies establish artificially low fees in an effort to keep their profit margins as high as possible, animosity can be created between the dentist and the patient.  The insurance companies’ main goal is to collect as much in premiums as possible while paying out as little as possible and delaying payment for as long as possible. That is how they make their money.  Unlike us, they do not have the patients’ best interest at heart.

What is Dental Insurance?

Dental insurance is nothing more than a contract between the employer and the insurance company to partially pay for certain services.  It exists to help in covering the costs; it was never intended to cover all the costs. There are deductibles, some services get paid at 50 % or 85 % and some aren’t covered at all. 

The type of insurance coverage your employer is willing to buy is determined by how much the employer is willing to pay for.  The employer selects as many or as fewer benefits they want.  The higher the premium paid by your employee – the higher is your usual and customary fee.

How Are Our Fees Set?

Our fees are set by the actual cost of doing business in this particular office.  Costs vary from office to office depending on rent, the salaries of out employees, quality of materials used, lab costs and many other "cost of doing business" factors.

For example, we will not compromise on sterilization because it’s just too important for our patients.  Likewise we will not use inferior materials for our dental restorations just to “save money”.  The fact is you never save money this way because the cheaper materials don’t last as long and the patient ends up back in the dental chair in a few years complaining that their crown or filling failed. We hire only the best, well trained staff, who love their jobs and give 110% every day to our patients care and customer service.

                          (information taken from Dr. Alex Shvartsman)

 



Braces are applied to teeth for various reasons, including poorly aligned jaws, crooked, crowded and missing teeth, or a bad bite (also called malocclusion).

Various things can cause teeth to become crooked or jaws misaligned, including thumb-sucking or a traumatic injury. Some conditions are inherited.

Children between the ages of 7 and 14 are typical candidates for braces because their facial structures are still developing. Adult braces usually entail additional procedures because their faces have already fully developed.

About Braces

Orthodontics is a field of dentistry that deals with corrections involving jaw and teeth alignment.

Braces employ the use of wires and are usually one of three types:

  • Old-fashioned, conventional braces, which employ the use of metal strips, or bands.
  • Metal or plastic brackets that are cemented or bonded to teeth.
  • Brackets that attach to the back teeth (also called lingual braces).

Procedures

Orthodontic procedures, also called orthodontia, are complex processes.

In most cases, a dentist will need to make a plaster cast of the individual's teeth and perform full X-rays of the head and mouth.

After orthodontic appliances are placed, they need to be adjusted from time to time to ensure that they continue to move the teeth into their correct position.

Retainers are used following braces to ensure that teeth remain in position.

Aesthetic and Comfort Issues

Advances in technology have vastly improved appearance issues with orthodontia.

Braces today are made from extremely lightweight and natural-colored materials. The materials that braces attach to-brackets-are bonded to the surfaces of teeth but can be later removed.

People can expect to wear braces for about two years—less or more in some cases. Adults are usually required to wear braces for longer periods of time.

Because orthodontic appliances need to be adjusted from time to time to ensure they continue to move the teeth into their correct position, they can create pressure on the teeth and jaws. This mild discomfort usually subsides following each orthodontia adjustment.

Hygiene issues

People who wear braces must be diligent in ensuring that food particles and other debris do not get trapped in the network of brackets and wires. In addition, brackets can leave stains on enamel if the area surrounding them is not cleaned on a daily basis.

Daily oral hygiene such as brushing, flossing and rinsing are a necessity. Some people with orthodontic appliances can benefit from using water picks, which emit small pressurized bursts of water that can effectively rinse away such debris.

Another caveat: Braces and sticky foods don't mix. Crunchy snacks and chewy substances should be avoided at all costs because they can cause orthodontia to be loosened or damaged.

Space Maintainers

Space maintainers are helpful dental devices that can help teeth grow in normally following premature tooth loss, injury or other problems.

The devices can help ensure that proper spaces are maintained to allow future permanent teeth to erupt.

If your child loses a baby tooth early through decay or injury, his or her other teeth could shift and begin to fill the vacant space. When your child's permanent teeth emerge, there's not enough room for them. The result is crooked or crowded teeth and difficulties with chewing or speaking.