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Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at Daisy Mountain Dentistry. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Drs. Peter Vogel, Vijal Vadecha, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

• If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

• This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

• Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Drs. Peter Vogel, Vijal Vadecha or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Anthem office.

Have you ever wondered why people have wisdom teeth? These are a third set of molars that come in behind the rest of all your other teeth, usually during early adulthood. Scientists and anthropologists believe that wisdom teeth are a result of evolution, because our ancestors needed these extra teeth to handle their primitive diets. Nowadays, the average diet consists of fewer hard-to-chew foods, which renders wisdom teeth largely superfluous.

Most people begin to experience wisdom teeth pain between the ages of 17 and 25. Our ancestors nicknamed them wisdom teeth because they appeared at a time in life when we supposedly grew wiser.

If you’ve already had your wisdom teeth removed, you know how painful they can become if they aren’t taken care of promptly. If not, watch out for discomfort in the back of your mouth and let Drs. Peter Vogel, Vijal Vadecha know right away if you think your wisdom teeth are coming in.

In some cases, people do not experience any problems or discomfort with their wisdom teeth. These patients may keep their wisdom teeth intact if there’s enough room in their jaw to fit them properly. But this is generally not the case, so wisdom teeth can cause several concerns, depending on which direction they grow.

Common problems include:

• Damage to surrounding teeth due to the pressure from the emerging teeth
• Infection that causes the surrounding gums to swell and become painful
• Tooth decay due to the lack of room to clean the teeth properly
• Impaction (when the tooth is unable to break through the skin)
• A cyst that may damage the jaw, the surrounding teeth, and nerves

If you haven’t had your wisdom teeth removed yet, there are many symptoms to watch out for when they begin to grow. Symptoms may include:

• Pain or stiffness in the jaw
• Tooth irritation
• Swelling of gum tissue
• Crowding of other teeth
• Spread of tooth decay or gum disease on nearby teeth

If you’ve noticed these symptoms, schedule an appointment at our Anthem office. Don’t forget: This is a common procedure that will take some time to recover from. Allow your mouth to heal, and then you’ll be able to get back to a normal routine quickly and be free from pain!

When working out, studying late, or any time we feel like a bit of a boost would come in handy, energy drinks are a common go-to for many teens and adults. Energy drinks promise more focus and vitality, all wrapped up in clever names and eye-catching graphic designs. What they can’t promise, though, is a drink that’s good for your dental health.

Why? Because most energy drinks come with a high concentration of caffeine, acids, and/or sugar.

• Caffeine Consequences

Before we talk about your dental health, a word about caffeine. Too much caffeine in a short period can leave us jittery, anxious, irritable, and sleepless. A cup of coffee has about 100 mg of caffeine, and some energy drinks have three to four times that much.

While the recommended daily limit for adults who aren’t pregnant is 400 mg of caffeine, doctors suggest a much lower limit for children and teenagers. Among other reasons, sleep is especially important for developing brains and bodies, and caffeine interferes with healthy sleep.

You might have to go online to find out how various energy drinks measure up and compare in terms of caffeine, but taking the time to check them out is well worth it. Now, back to your dental health!

• Acid Attacks

Many energy drinks are very acidic. The tart flavors of energy drinks might please your palate, but they attack your enamel.

Our mouths are their healthiest when our saliva is neutral, balanced between acidic and basic on the pH scale. That’s somewhere around a 7 on a scale of 0-14, where lower numbers mean more acidic conditions. That burning feeling we get from acid reflux when stomach acids back up? That’s because stomach acid is a 1-2 on the pH scale.  Many energy drinks rate an eye-opening (and not in an energetic way!) 1.5-3.5 on the pH scale, which means your teeth are bathing in acids.

Even tooth enamel, the strongest substance in the body, can’t stand up to these acids, because acids break down the mineral structure of your enamel. If your teeth are more sensitive to heat and cold, if they appear darker as the white outer layer of enamel thins, if your dentist has discovered weak spots in your enamel—you might be experiencing demineralization. Once enamel is gone, it can’t be replaced.

• Surplus Sugar

A well-known source of quick energy is sugar. A little more biology and chemistry here—sugar is a food which our bodies can break down quickly. And when sugar molecules break down, this breakdown releases energy—energy which we use to fuel essential bodily functions. This quick burst of sugar energy is why many energy drinks contain lots of added sugar. Some brands have more than 60 grams of sugar per serving—and 60 grams is almost 5 tablespoons!

We get all the sugar we require for our daily energy needs from the natural sugars found in fruits, dairy, even some vegetables and grains. With added sugars, we’re just adding empty calories, affecting the balance of our blood sugar and hormones, and increasing the risk of chronic health conditions—all while providing a convenient food source for the bacteria in plaque.

Because, just like our bodies find it easy to convert sugar to energy, the oral bacteria which cause cavities find it easy to convert sugar to acids. And just like the acids in foods, these acids attack the tooth’s mineral structure and break down its strength. Eventually, the weak spots in enamel grow larger and deeper and become cavities.

While most labels don’t let you know how much caffeine you’re getting, or the pH of the liquid inside, you can see how much sugar is being added to your diet with every can or bottle. Do look for added sugars before you choose your beverages.

If you have several energy drinks a day, a soft drink or two, plus the occasional sports drink—you’re bathing your teeth in acids and sugar all day long. With any beverage high in sugars and acids, limit your consumption. Rinse with water afterward, and don’t brush for about an hour to give your enamel time to remineralize after being exposed to the acids in your drink.

Better yet, choose healthier alternatives. Water is still the best way to hydrate. Try adding protein and carbs to your diet for more energy. Make sure you’re getting the vitamins you need with a balanced diet. If you see signs of enamel erosion, talk to Drs. Peter Vogel, Vijal Vadecha. The temporary boost you get from a bottle of caffeine, acids, and sugar might seem tempting, but it can have long-lasting consequences for your dental health!

April showers bring May flowers, and May flowers bring . . . allergies. If you’re one of the millions of people who suffer from seasonal allergies, you might be suffering some dental side effects as well.

When you have pollen allergies, pollen triggers your body’s immune system to release histamines. Histamines are part of the body’s defense system. They cause the tissues in the nose and sinuses to become inflamed and swollen as they increase blood supply to these areas. They also cause your body to produce more mucus.

Normally, mucus from the sinus cavities drains into the nasal cavity and then down the back of the throat, where it mixes with saliva and is swallowed. We never even notice it. Until it’s allergy season. Unfortunately, our defense mechanisms can have some offensively unpleasant consequences.

• Headache & Facial Pain

Our sinus cavities are small hollow spaces in the bones of the head which are filled with air and, like our nasal cavities, are lined with mucous membranes. It’s these membranes, not surprisingly, which produce mucus. And though we might turn up our noses at this slippery topic, mucus is actually quite helpful for trapping and filtering out unwanted hitchhikers like bacteria, viruses, dust, pollens, and other pollutants in the air we breathe before they reach our lungs.

When histamines are released, normal mucus production increases to filter out those tiny pollen invaders. At the same time, tissue around the nose and sinuses swells up, which can trap mucus inside the sinus cavities. This, in turn, causes increased pressure within the sinuses, and this pressure brings on allergy-related headaches and facial pain.  

• Nasal Congestion & Postnasal Drip

With the occasional runny nose or sneeze, you can blow your nose once or twice and that’s that. During allergy season, greatly increased mucus production might see you spending all day within reaching distance of your box of tissues. But when the tissue in your nose is swollen as well, you now find yourself with nasal congestion.

A stuffy nose means excess mucus has to exit somewhere else, which means this extra, often thicker, mucus all drains into the back of your throat. This is postnasal drip, and it can make you miserable in several different ways. Hoarseness. Coughing during the day. Worse coughing at night. Sore throat. Nausea. Difficulty swallowing.

All these allergy symptoms are uncomfortable enough! But, to add to our discomfort, allergies can lead to uncomfortable oral symptoms as well.

• Tooth Pain

A common result of allergies is tooth pain. How does this happen? It’s because of the way our bodies are designed. The maxillary sinus cavities are directly above the roots of our upper molars.

When sinus cavities are congested and sinus pressure builds up, it also puts pressure on these roots. The result is tooth pain, usually affecting several upper molars at once.

• Dry Mouth

One of the natural responses to a stuffy nose is mouth-breathing—we can’t go without air, after all! But exposing the inside of the mouth to all that air dries out delicate gum and mouth tissues. It also reduces normal saliva flow. This can cause xerostomia, more commonly known as dry mouth.

Because saliva neutralizes acidity in the mouth and washes away bacteria and other germs, lower saliva production means greater risk of cavities, infections, and bad breath. Dry mouth can also cause gum irritation and gingivitis, because less saliva means more harmful bacteria build-up between the gums and the teeth.

• Antihistamines & Your Oral Health

If histamines are the problem, are antihistamines the obvious solution? This is a good question for Drs. Peter Vogel, Vijal Vadecha or your physician. Antihistamines can be very drying—so you might find you’re experiencing dry mouth even when all those other pesky allergy symptoms have disappeared. And, if you already suffer from xerostomia, it’s especially important to get your doctor’s advice before buying over the counter antihistamines.

In allergy season, just like any other time of the year, be sure to hydrate and keep up with brushing and flossing for fresh breath and healthy teeth and gums. Talk to Drs. Peter Vogel, Vijal Vadecha if you have persistent tooth pain, dry mouth, or irritated gums—it’s always best to rule out other causes like infection or decay.

But, if your problems are caused by allergies, you don’t have to wait until the next snowfall to get relief. Talk to your doctor or allergist for ways to reduce or eliminate your symptoms before allergy problems start blooming into dental problems. You’ll breathe easier!