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If you have a hard time understanding your dental insurance plan, particularly the treatments and services it covers, you’re not alone. That’s why Dr. David Shipper and Dr. Howard Vogel and our team have put together a cheat sheet to help you through them.

It’s common for patients to get lost in the morass of the terms and phrases that surface when you’re dealing with a dental insurance plan. Knowing the commonly used terms can help speed up the process and enable you to get the most out of your coverage.

Common Terms

Annual Maximum: The most your policy will pay per year for care at Central Park West Dental. It is often divided into cost per individual or per family.

Co-payment: Typically, a small amount the patient has to pay at the time of service before receiving care, and before the insurance pays for any portion of it.

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

Deductible: An amount you must pay out of pocket each year before the insurance company will contribute for any treatments or procedures. The amount can vary according to your plan.

Diagnostic Services: A category of treatments or procedures that most insurance plans will cover before the deductible, which may mean services that occur during preventive appointments with Dr. David Shipper and Dr. Howard Vogel, including X-rays or general screenings.

Exclusions: Dental services not covered under a dental benefit program.

In-Network: An insurance company will usually cover a larger portion of the cost of the care if you see an in-network provider for treatment.

Out-of-Network: If you visit someone who is not a part of your provider’s network, the insurance company may pay for a portion of the care, but you will be responsible for a significantly larger share out of your pocket.

Lifetime Maximum: The most that an insurance plan will pay toward care for an individual or family over the entire life of the patient(s).

Limitations: A list of all the procedures the insurance policy does not cover. Coverage may limit the timing or frequency of a specific treatment or procedure, or exclude some treatments altogether.

Member/Insured/Covered Person/Beneficiary/Enrollee:  A person who is eligible to receive benefits under an insurance plan.

Premium: The regular fee charged by third-party insurers and used to fund the dental plan.

Provider: Dr. David Shipper and Dr. Howard Vogel 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.

It’s essential to understand the various insurance options available to you. Knowing what your insurance covers can save you major costs in the future.

Dr. David Shipper and Dr. Howard Vogel and our dental staff hope this list of terms will help you understand your dental insurance plan better. Be sure to review your plan and ask any questions you may have about your policy the next time you visit our New York, NY office.

There are certainly situations when going to an emergency room is the best response for your problem. A severe injury to your mouth, jaw, or face would qualify.

However, when it comes to long-term solutions for other dental problems, an emergency room visit may fall short. If you suffer from a major toothache, cavity, a broken tooth, crown, or veneer, it’s better to go straight to the dentist for treatment.

Dr. David Shipper and Dr. Howard Vogel can provide you with a treatment plan that will be long lasting. When you visit an ER for a common dental problem, more likely you’ll only be given temporary relief for a serious and ongoing problem.

In many cases, the emergency room will give you pain medication to mask the symptoms until you can schedule an appointment at our New York, NY office. That results in a lot of wasted time, as well as two separate medical bills. The ER may give you a temporary crown or filling, but you will still need a follow-up appointment for a permanent restoration.

We recommend you find the nearest emergency dental clinic, or even try a home remedy to relieve the pain until you can schedule an emergency appointment at Central Park West Dental. A warm salt-water rinse or cold compress can be used to sooth tooth and gum pain in the meantime.

If you experience a dental emergency and are unsure about what to do, feel free to contact our New York, NY office at any time. We will fit you into our schedule right away and figure out the best course of treatment for your problem.

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 Dr. David Shipper and Dr. Howard Vogel 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 New York, NY 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!

Dental emergencies are bound to come up when you have young children. Dr. David Shipper and Dr. Howard Vogel and our team want to you to be prepared in case you run into a difficult situation. Problems can vary, from minor gum irritation to knocked-out teeth. Take a look at the different possibilities and how you can handle them.

Teething

Depending on the age of your child, there are common things to watch for when it comes to his or her teeth. Starting from a young age, your son or daughter may experience teething pain. This starts at about four months and can last up to three years.

Teething may cause your little one to become irritable and more prone to drooling due to tender gums. This is very common in young children who are teething, and can be alleviated by giving them a cold teething ring or by rubbing their gums with your finger.

Teething pain is as normal as your child’s first set of teeth falling out. On the other hand, if a baby tooth is knocked out in a forceful accident, make sure you bring him or her into our New York, NY office to check that other damage hasn’t occurred in the mouth. On occasion, permanent teeth may grow in before baby teeth have fallen out. This may not cause any discomfort, but Dr. David Shipper and Dr. Howard Vogel should make sure the teeth are growing in properly. Catching teeth that are coming in incorrectly can prevent issues from arising in adulthood.

Gum Issues

If you’ve noticed your child’s gums bleeding often, this could result from a number of things. Bleeding gums may be an early sign of periodontal disease, which is caused by poor oral hygiene when it appears in children. Excessive gum bleeding can also occur when children brush their teeth too hard, or suffer an injury to their gum tissue.

If bleeding is continuous, rinse your child’s mouth with warm salt water and apply light pressure to the area. If you become concerned about the amount of blood, contact our New York, NY office and we will schedule an appointment for your youngster as soon as possible.

Depending on what type of dental issue your child is experiencing, you should make sure to treat it quickly and properly. If you have questions or concerns about what you can do to help your son or daughter develop better oral hygiene habits, ask Dr. David Shipper and Dr. Howard Vogel for tips during your next appointment.

Don’t forget: As a parent, you can provide the best education to your children on the importance of proper oral hygiene by setting a good example.