Delta Dental is one of the largest dental insurance providers in the United States. It offers a range of plans designed to help individuals and families manage dental costs. Understanding what Delta Dental covers is important before scheduling any dental procedure, especially when it comes to cosmetic dentistry.
Delta Dental primarily focuses on covering necessary dental treatments. These treatments include preventive care, restorative work, and treatments related to oral health problems such as gum inflammation and gum disease. Cosmetic dentistry, however, often falls into a different category in insurance coverage.
What Is Cosmetic Dentistry?
Cosmetic dentistry refers to dental procedures aimed at improving the appearance of teeth, gums, and overall smile. These treatments are typically elective, meaning they are chosen by the patient rather than being medically necessary. Common cosmetic dental procedures include:
- Teeth whitening
- Veneers
- Bonding
- Invisalign or clear aligners
- Crowns and bridges done primarily for aesthetic reasons
While these procedures enhance appearance, they do not usually address dental diseases like gum inflammation or decay directly.
Does Delta Dental Cover Cosmetic Dentistry?
General Policy on Cosmetic Procedures
In most cases, Delta Dental does not cover purely cosmetic procedures. This is because cosmetic dentistry is considered elective and not essential for oral health. Since dental insurance plans, including those by Delta Dental, are designed to cover treatments needed to maintain oral health, cosmetic treatments usually fall outside the scope of coverage.
For example, teeth whitening, a popular cosmetic procedure, is generally not covered because it is not medically necessary.
Exceptions When Cosmetic Procedures May Be Covered
There are cases where treatments that appear cosmetic might be partially covered if they are medically necessary. For example, if a dental crown is placed to restore a tooth damaged by decay or injury, Delta Dental may cover the cost.
However, if the crown is placed solely to improve the tooth’s appearance, coverage might be denied.
Similarly, orthodontic treatment such as braces or Invisalign may be covered for children if there is a medical need, such as correcting bite issues, but cosmetic use in adults may have limited or no coverage.
Understanding Gum Inflammation and Gum Disease in Relation to Coverage
What Are Gum Inflammation and Gum Disease?
Gum inflammation, also known as gingivitis, is a common early stage of gum disease. It causes redness, swelling, and bleeding gums. If left untreated, gingivitis can progress to periodontitis, a more severe form of gum disease that damages the tissues and bone supporting teeth.
These conditions are dental diseases that require proper treatment. Delta Dental plans generally cover treatments to manage gum inflammation and gum disease, as they are necessary for maintaining oral health and preventing tooth loss.
Delta Dental Coverage for Gum Disease Treatment
Treatments such as professional cleanings, scaling and root planing (deep cleaning), and sometimes surgical procedures to treat gum disease are typically covered by Delta Dental plans. This is because these treatments aim to restore the health of the gums and prevent further oral health problems.
Insurance coverage for these treatments depends on the specific plan you have with Delta Dental, but preventive and periodontal therapies are often included because they address serious dental diseases rather than cosmetic concerns.
Other Dental-Related Treatments Covered by Delta Dental
Preventive Care
Delta Dental strongly supports preventive care. This includes routine check-ups, cleanings, X-rays, and fluoride treatments. Preventive care is essential to avoid gum inflammation, cavities, and other dental diseases.
Restorative Treatments
Restorative treatments such as fillings, crowns, bridges, root canals, and extractions are commonly covered by Delta Dental.
These treatments fix damage caused by decay, trauma, or disease rather than purely cosmetic concerns.
Orthodontic Coverage
Some Delta Dental plans offer orthodontic benefits, mainly for children and teens to correct bite and alignment issues. Adult orthodontic treatment for cosmetic reasons may not be covered.
How to Confirm Your Specific Delta Dental Coverage
Because Delta Dental offers many different plans with varying levels of coverage, it is crucial to review your specific policy details. Here are some steps to confirm what is covered:
Check your plan documents: Your policy booklet or summary of benefits will detail covered services.
Consult your dentist: Your dental provider can help you understand what procedures are likely to be covered based on your plan.
Tips for Managing Cosmetic Dental Care Costs
If your Delta Dental plan does not cover cosmetic treatments, there are still ways to manage costs:
Ask about payment plans: Many dental offices offer financing options for cosmetic procedures.
Consider dental discount plans: These plans offer reduced rates on dental services, including cosmetic treatments.
Shop around: Prices for cosmetic dentistry can vary, so getting multiple quotes can help.
Prioritize oral health first: Treat any gum inflammation, gum disease, or decay before cosmetic procedures to avoid complications.
Conclusion
Delta Dental generally does not cover purely cosmetic dentistry because these procedures are elective and not medically necessary. However, treatments addressing dental diseases such as gum inflammation, gum disease, and tooth decay are usually covered. Some dental work that improves both function and appearance may receive partial coverage if it is necessary for oral health.
Understanding your specific Delta Dental plan’s coverage is essential before proceeding with any cosmetic dental work. Always focus first on treating dental diseases to maintain a healthy mouth before investing in cosmetic improvements.
