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Cosmetic Classified: What it Means for Your Insurance

By Caroline Jacobson on July 25, 2017 in Insurance


cosmetic dentistry

From crowns and caps to braces and bridges, how does coverage work with cosmetic dentistry? A breakdown of the basics:

What’s considered cosmetic?
The American Dental Association (ADA) defines cosmetic dentistry as work that is done “solely for the purpose of improving the appearance when form and function are satisfactory.” In other words, a procedure is considered cosmetic unless it fixes an issue with your mouth’s functions—speaking, eating or chewing, for example.

Here are three common types of cosmetic procedures:

Veneers: Typically placed on the front of your teeth, veneers are individual coverings for your teeth. They’re used to fix teeth that are too short, far apart, discolored or crooked.

Whitening: 90% of patients request in-office teeth whitening. This procedure shows significant shade change in minutes, compared to at-home whitening methods. A trained dental professional applies peroxide gel on the patient’s teeth for 15-20 minute intervals.

Braces: Braces or orthodontia is used to correct an improper alignment of upper and lower teeth, including crooked or crowded teeth, cross bites, overbites or underbites. Some dental plans may cover for children.

Is cosmetic covered?
It depends. If some types of cosmetic dentistry are included in your plan, they’re only covered when a procedure restores tooth structure or advances oral health. However, cosmetic procedures can be optional benefits that you or your employer may choose to purchase. Coverage also depends on the specific cosmetic procedure.

When it comes to cosmetic dentistry, it’s crucial to consult your plan booklet, available on our site, to see what procedures are and aren’t covered.