Do You Really Need Dental Insurance?

 

As a dental hygienist I have quite a good understanding of dental insurance, based on the dental fees and codes I use every day at work. Now I realize I’m in Canada and insurance in Canada vs. the US is different (medical anyway) but my main point can probably be generalized no matter where you live. If you’ve ever looked at the breakdown of your healthcare insurance premiums, the dental insurance portion is usually substantially more than your medical portion (again, in Canada). I know for instance my sister-in-law has the option of paying something menial like $30.00 bi-weekly for medical, only or $100.00 bi-weekly for medical+dental. This is a pretty huge difference. I realize all plans are different but in general, dental is more than medical, maybe not by this much but by some percentage.

Having insurance is a very comforting thing for people. Dental insurance in particular because there is a notion that dentistry is outrageously expensive. Why I won’t argue it is expensive, for some people, they end paying more for insurance than they will EVER use in a lifetime of dentistry.

Who Needs Dental Insurance?

Before explaining why one may not need dental insurance, I will explain who probably will need it. Dentistry has changed substantially over the last 40-50 years. The focus has shifted 180 from restorative to preventative. It use to be that you only went to the dentist if you had a problem, they dealt with that one problem and you were on your merry way. This is still the way for a major portion of the world, but in North America, most of Europe and parts of Middle East, the focus is on prevention, especially starting at an early age. With all this in mind, if you’re over the age of 40 or so, it stands to reason that you grew up in the ‘older model’ of dentistry regardless of where in the world you are from.

From this I will make some assumptions. You probably:

  1. Don’t have the best memories of childhood dentistry
  2. Have some form of restorative work done in your mouth (fillings/crowns/root canals)
  3. Have, over the past 40 years had to maintain your restorative work (repairing fillings, fixed broken or cracked teeth/fillings, replaced bridges/crowns etc).

If this is the case, you should probably keep your insurance. If this is not the case, you’re a minority.

Source: Turner Pediatric Dentistry

Who Doesn’t Need Dental Insurance?

I’m happy to say I am 100% dental-restoration free. I have no fillings of any sort. Luck?, No. The fact is, is that I grew up in a city with a fluoridated water supply, started seeing the hygienist for bi-annual cleanings at a very young age, brush and floss regularly and had dental sealants applied when I was a child. I am thankful to say this is a more common trend among children these days. Not that early childhood caries (baby bottle decay) isn’t still a rampant global problem (dental caries is the number one bacterial infection in the world) but there are more cavity-free children and adults in the world because of advances in dentistry, regular fluoride usage, overall knowledge and prevention.

If you are like many people I see every day in my chair, you come to the dentist every 6 months for a ‘cleaning’ and may need the odd restoration done (small cavity), but in general, the need for major restorative work in younger populations is decreasing. Based on general dental fees in Canada let’s look at what you’re paying for (all very approximate prices):

Bi-Annual Cleaning:

  • Scaling (the ‘scrapping’): $70.00-$120.00 depending on time/amount of deposit present.
  • Polishing: $20.00
  • X-rays once/year: $15.00-$30.00
  • Fluoride Treatment: $12.00
  • Check-up with dentist: $50.00

Total: $217 (based on $120 for scaling) and since usually you only ‘need’ a check-up, assuming everything is fine, every 12 months, as well as x-rays, your second bi-annual appointment will only cost $152.00. An annual total of $369.00. That’s less than $31.00/month. I can’t say I know anyone who pays less than $31.00/month in dental insurance premiums. Even if you break a tooth and need a filling every 5 years of $250.00 (healthy cost assumption) or God forbid, a Crown once in your lifetime of $1,000…still much less than most dental insurance premiums.

Setting aside $50.00 a month in your budget to pay for dentistry in CASH is probably cheaper than paying for your dental insurance portions.

My job as a hygienist is to do my damnedest to prevent you from ever seeing the dentist outside of regular check-ups. If I do my job, and you work with me by keeping up with your home care, following my instructions, you shouldn’t need to see a dentist unless an emergency happens. I realize every case/patient/mouth is different but I wanted to give everyone something to mull over and offer insight that may not have been thought of before.

Did you know, in Canada you can claim dental fees paid as an income tax deduction?

Comments

  1. wow I didn’t realize Dental insurance was so different in Canada. I am really luck that my dental insurance costs $1.58 per bi-weekly and that saved me around $1000 in the dental work I had done earlier this week. Plus having a FSA account allowed me to afford the $293 out of pocket expense for my wisdom teeth extraction and 3 cavity fillings. I have never had braces (my parent’s didn’t have dental insurance while I was growing up since my Dad was self-employed and it’s $$ if not offered through and employer plan)- so they weren’t going to pay for optional braces. How different are you health expenses for health insurance plans than mine? Keep in mind I work for a medical center. . .
    Medical Service Plan $45.19/biweekly
    Dental Service Plan $1.58/biweekly
    Vision Service Plan $0.54/biweekly
    sofia recently posted..It’s Officially the HolidaysMy Profile

    • Honestly every single private insurance in Canada is different. For my husband’s work we pay about 50.00 bi weekly for ”insurance”, his plan doesn’t differentiate between opting into medical and/or dental but most plans do. Since we have universal healthcare we really don’t need medical services covered. Our insurance is for private sector stuff like massage therapy, vision (we get 75.00/year for an exam and 200/year towards glasses or contacts), international coverage-so if I went to the US and broke my leg, I have a few thousand I can claim when I get back to Canada. Prescription cost (we get 80%-100% coverage on all prescriptions, no annual max and this does not include anything we may need for (God forbid) cancer etc-these sorts of things would all be covered under Canada’s universal healthcare, we’d never need to pay for things like chemo tx). Our insurance also covers things like if we need wheelchairs, orthopedic stuff, even modifications made to our house should we need a wheelchair ramp or something crazy. The only thing we personally use insurance for is prescriptions and, when I work, massage therapy.

  2. As someone with perfect teeth, I really don’t need dental insurance. But since the premiums are completely covered by my company, I have it. My fiance on the other hand, has terrible teeth and has to have a lot of work done on them. So I’ve discovered through him that dental insurance works completely differently than medical (at least in the US). Instead of there being a maximum copay after which everything is paid for, there’s a maximum benefit after which nothing is paid for, and it’s really low! I want to say his maximum benefit is either $1500 or $2000 per year. How can you really even call it insurance when it doesn’t protect you from large expenses?
    Gen Y Finance Journey recently posted..Where You Buy MattersMy Profile

    • We have an annual max on all insurance as well so if a LOT of work is needed you need to spread it out over a few years but 2k/year should be more than enough for a few cleanings, fillings and even throw in a root canal every year…2k of dentistry is quite a bit for the ‘average’ person.

  3. Ugh, there are so many reasons that I am jealous of you Canadians! The American healthcare system is a giant clusterf%ck and it’s getting worse. Hardly anyone has dental coverage and those who do don’t seem to be too happy with the actual coverage that they get.
    Holly@ClubThrifty recently posted..I Am a Cheap-Ass Santa: A Christmas Shopping RantMy Profile

  4. I am sad to say that I am one of the older folks you talk about that was raised with poor dental habits. While I have done a lot as an adult to look after things, the stuff from childhood occasionally causes me big grief and money. Last year at this time I had my first tooth pulled after I cracked it eating an apple (aside from wisdom teeth) and then I needed a crown (gold). $$$$
    Tackling Our Debt recently posted..Fun, Inexpensive Christmas Gifts You Can Make at HomeMy Profile

    • Yup. You are exactly the people I’m talking about! Keep your insurance my dear! Your gold crown should last you a lifetime though (although there’s no guarantee on everything! most DDS’s will tell you 10yrs/crown).

  5. I’ve been thinking about this a lot. Don’t have it right now, but when I have the opportunity to purchase it I’m not sure if I will. Last time I hit the deductible on the nose, and I had been paying the premium. I felt robbed.
    femmefrugality recently posted..Help me earn a $10,000 scholarship!My Profile

    • Yup, you may not need it then! If you haven’t needed any major work ever, or in the past few years you could probably get away without it (as long as you were setting aside something in your monthly budget for regular dental care).

  6. Thanks for your perspective. My husband and I don’t have dental insurance but we have a dental discount plan though our health insurance. He is restorative work-free and I have had a few cavities, so we hope to stay on the (largely) preventative track. We do save monthly for our 6-month checkups and find it manageable alongside our many other short-term targeted savings accounts.
    Emily @ evolvingPF recently posted..The Blogging Scholarship Application EssayMy Profile

    • That’s great and even if you guys ever do need something ‘major’ which is probably unlikely saving a little extra every month is probably suffice for you. If it were related to a major accident (car accident or alike) it wouldn’t go through regular dental insurance anyway it would be made part of the larger accident claim.

  7. I don’t have dental insurance. In France routine clean ups, cavities, root canals and other basic treatments are priced very low and reimbursed 70% by social security. A cleaning is around $35 and so is a simple cavity treatment, my cost being 30% of that.
    I usually come back once or twice a year and have my check up then.
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  8. I’m sort of in the middle. I’m 42 and grew up with regular check ups and cleanings (and, er, it helped that my dad was a dentist), although I also grew up with the old style fillings (actually never got a filling till i was in my 20′s), so I’m at a point where they will start to need to be replaced. I just had a crown/root canal this summer and it cost me a fortune. I used to have dental insurance when I worked full time, which was nice, but even with all that I probably still won’t get dental insurance.
    Budget & the Beach recently posted..Financial ConfidenceMy Profile

    • Having a father as a DDS helps for sure :) old style filling (the silver ones) tend to last longer and have less reaction than newer, ”white” ones. You may never need them replaced. Every time you electively remove a filling you have to take it out+a tiny bit of surrounding tooth so your tooth structure is further compromised, if there are no issues with them, leave them be! If they’re well taken care of they may never need replacing! I’ve seem 50+yr old fillings perfecting intact.

  9. I share your view on dental insurance. It costs about $35 a month, so I almost never spend that much per year on routine stuff. However, I went for my cleaning yesterday and found out that I need a gum graft. I had one about 7 years ago, and the gum has receded again. They said I would someday lose the tooth to bone damage if I don’t eventually do the graft again. I also took my 5 year old to the orthodontist today for a cross bite. Luckily, the orthodontist wants to wait a year before they fit her with a retainer, but that cost is looming. Do you have any idea if dental insurance covers either of these treatments? I will do some research on my own, but any ideas would be appreciated.
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  10. I love it when employers offer dental insurance. I had to have a root canal and at the time I had absolutely 0 insurance. It cost me quite a bit. Then the root canal got infected (a 5% chance – just my luck) and had to have microsurgery at an endodontist – 2 grand down the toilet. Learn from my mistakes :)

    By the way, you consider yourself lucky to have fluoridated water? Too much fluoride actually causes health problems. Down Syndrome, bone cancer, other diseases. It’s mass medication for the masses without a justifiable cause. In kids it causes their teeth to decay. I have been avoiding fluoride for years now and have never had a cavity.
    Veronica @ Pelican on Money recently posted..“Secret” Forumla for Living ComfortablyMy Profile

    • Yes I do. While I’m glad you’e been fortunate in your dental needs (fyi- if you have a root canal you have a filling), I politely have to disagree with you. You have been greatly misinformed! While I don’t deny extreme excessive doses may kill you (although highly unlikely since it needs to be ingested and is quite nauseating so you’d probably never be able to keep it down), fluoridated water has, time and time again been proven to be the single best vehicle to greatly decrease dental decay world wide. The Centers for Disease Control and Prevention has proclaimed community water fluoridation as one of 10 great public health achievements of the 20th century(from the ADA website). Dental decay *cavities* is the number one bacterial infection affecting the world’s population. Fluoride works by making teeth resistant to decay through strengthening natural bonds. It can also reverse decay once started. With the exception of dental fluorosis, scientific studies have not found any credible link between water fluoridation and adverse health effects.. Again from the ADA website; Studies prove water fluoridation continues to be effective in reducing tooth decay by 20 – 40%, even in an era with widespread availability of fluoride from other sources, such as fluoride toothpaste.

      Do you really think agencies like WHO, ADA, CDA would promote a product knowing it caused Down’s Syndrome? Down’s is a genetic chromosomal abnormality that happens in utero, NOT from drinking water, using toothpaste or rinsing with mouthwash. From the Canadian Down’s Syndrome Society: The sole characteristic shared by all persons with Down syndrome is the presence of extra genetic material associated with the 21st chromosome. The effects of that extra genetic material vary greatly from individual to individual. Persons with Down syndrome karyotypes may be predisposed to certain illnesses and medical conditions, but that genetic arrangement does not guarantee their development. The same illnesses and conditions are also present in the general population. No where in here is anything about Fluoride. And cancer?! Cancer is an uncontrolled proliferation of cells, NOT caused by fluoride.

      I’m sorry you have been so hugely misinformed but part of my professional responsibility is to do my best to correct your misunderstandings. I would love to know where you gained this information as well. Please check these links out! I don’t care if you chose to use fluoride or not, as long as you make an EDUCATED choice.

      http://www.cda-adc.ca/en/cda/media_room/news_releases/2011/01_10_11.asp
      http://www.cda-adc.ca/en/oral_health/faqs_resources/faqs/fluoride_faqs.asp
      http://www.ada.org/fluoride.aspx

      • Sorry, I guess my response came off as very aggressive. I tend to have that effect sometimes by being too direct. I hope I didn’t offend you or your beliefs – we’re all entitled to our own opinions. I’ll just agree to disagree, but if you really want to know my reasoning behind everything I’ve said, I’d be happy to have a conversation in an email or something. Thank you for your thoughtful and very thorough response, its not every day you see someone take the time to address a comment that can simply be deleted. You’re passionate about the subject and that is something I can respect.
        Veronica @ Pelican on Money recently posted..Waking Up Early Black Friday? No Thanks.My Profile

  11. It’s so difficult to know where to draw the line with dental insurance. This is just an opinion I’m expressing and I’m no expert, but based on my own experiences the answer is, if your young don’t bother look after your teeth instead and have yearly checks. If you’re older, you’re possibly a product of the old school which for me created more problems than it solved.

    I was raised in a country with a great welfare system but as always in life people don’t know where they are well off and abused it. No I’m not talking about the public in general, I’m talking about some dentists, and I do emphasize some.

    Where I was raised, under-16s had free dental treatment and allowed a 6 monthly check up all paid very nicely by the state. Trouble is many dentists took advantage and as in my case drilled the hell out of my mouth built bridges and crowns and a stupid amount of extractions for such a young boy.

    At the time my parents would simply trust the dentist and my mouth became more drilled than an oil well. For the rest of my life I was having crowns repaired which would constantly not last. I had braces as a young lad, yet I don’t recall my teeth ever growing out my lip.

    The old school created a lifetime of dental problems. I may be wrong, but it’s much better today and you should just take care of your teeth as I personally feel my mouth as a young boy was a goldmine to the dentists of the time.
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  12. In Australia, we have universal health care, meaning that the government pays for all of our healthcare – except dental. Which is bizarre. It’s almost like they don’t think your teeth are part of your body! There are plans to introduce dental care into the Medicare umbrella, but obviously it’s going to cost billions of dollars.

    • We have universal healthcare in Canada as well (the only thing I ever pay for out of pocket is certain prescriptions) and we have dentistry covered until the age of 10. You’re right though, there’s a big disconnect between the mouth and the rest of your body.

  13. I recently had my wisdom teeth removed and I was really glad that I had dental insurance. I think overall I have spent more on it that I have received, but if I ever need to have some major work done (like a crown or root canal) I think I’ll feel better knowing it is there.
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    • Multiple extractions at once can be pricey (depending on impaction severity 100-250/tooth). You’re like most people, like having it for security and if you don’t pay much for it then why not? I’m more talking about people who pay through the nose for it.

  14. We don’t have dental insurance ourselves. I always had it through my employer because it was like $20/month to cover the whole family. But, now that we run our own business we decided to go against coverage. I was surprised to see how much it costs. We’re talking like $100-125/month, which is just crazy. My wife has never had a cavity. I have pretty bad teeth, but have had nothing major for a solid 10 years, so it was a no brainer for us to just put aside about $50/month to cover for when we go in. The nice thing too is that our dentist will give us a 15% discount if we pay all at once.
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  15. Past Personal experiences at the dentist have been less than fun. Due to an ongoing fear/phobia of the dentist I did neglect my teeth. Only under duress and severe pain would I go. And it would always end up being a root canal and or crown.

    Now that I have found a great dentist who is sensitive to my fear, I go every 6 months and am keeping it in check.
    Lisa @ Cents To Save recently posted..Debt UpdateMy Profile

    • Good! So glad you found someone you’re comfortable with, it really does only take one bad experience to turn people off forever!

  16. This is interesting! I pay quite a lot per month for my medical + dental coverage. My fiance and I went without for a lot of years and consequently skipped out on dental appointments so I think we might be in the restorative category, but this is an interesting insight into who needs dental insurance. Thanks!
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  17. justin@thefrugalpath says:

    I’m definitely glad that I have dental insurance. We go twice a year, but I grind my teeth a lot and had a great deal of dental surgeries as a kid. So I’m more prone to certain dental problems. The insurance has saved us more than what we’ve put into it.
    The only problem I’ve had is that my dentist tries to sell us products, which really bugs me.
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  18. I haven’t had a cavity in years, but I do have a few in my adult teeth, sadly. I’m not even sure if all of them were necessary – my early dentists were not very good and often sprung procedures on us during cleaning. Right now I have a great dentist and an even better hygienist and there have been absolutely no issues at all ;)

    I have dental insurance through my work and I get two cleanings a year, hooray.
    CF recently posted..Managing your debt with consolidated creditMy Profile

  19. We both are covered 100% for the Dentist and other benefits (massage,physio etc etc) and we use the benefits. We do pay something out of pocket for the dentist because the benefit companies schedule is always behind the Dental Schedule price wise. It’s no big deal though a few bucks to keep our teeth clean and healthy is worth it. Great Post!! Mr.CBB
    Canadianbudgetbinder recently posted..Mr.CBB’s Weekly Blog Post Picks Nov 16,2012My Profile

    • Thanks! If you pay basically nothing for coverage it’s a blessing! Insurance companies are always 2-5yrs behind current fee guide it seems, don’t know why.

  20. I am looking for the dental insurance ….a very good blog post .. i think this is best for me … thnx for this valuable post.. keep posting… :)

  21. Great post! We have always had traditional dental coverage through work (90% each) but now hubby has a flex account and we have to choose our plan. Decided to go with the medium plan…just in case we have crowns in our future. Better to use the flex plan money for it than use after tax dollars. If I get a job with good dental coverage we will switch hubby’s dental plan to basic.

  22. When my mom had kids at home, dental insurance was worth it. Once I left, though, and my (disabled but not on Social Security) brother got too old to be on her insurance, she realized that each person in the household would have to have a root canal or somehihng similarly expensive EVERY YEAR for her dental insurance to be worth it. So she just pays cash now!

    For us, we get basic dental for $10 a month for the family, which is worth it. We upped our coverage for one year only, and my husband and I both had our troublesome wisdom teeth out. Then we switched back. If we’d been more savvy back then, we would have used a Flexible Spending Account to cover the parts that our insurance didn’t.
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  23. I didn’t know you could claim that. One of my son’s will have to have a tooth replaced soon so I definitely need to keep my receipts. Thanks for the info!
    jolie recently posted..Taxes are done!!My Profile

  24. Never had dental insurance but I am at my dentist’s every 6 months like clockwork. Had one restoration for internal resorption and just paid for the implant accordingly. Your post is right on the money that prevention and care are the keys here, not insurance.

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