Scaling and root planing (SRP) is a deep cleaning procedure used to treat gum disease. It removes plaque, tartar, and bacteria from below the gum line. Unlike regular cleaning, which only cleans above the gums, SRP targets the root surfaces of teeth to prevent further infection and inflammation.
Why is Scaling and Root Planing Important?
Gum inflammation is often caused by the buildup of plaque and tartar on teeth. If left untreated, this can develop into periodontal disease, a serious form of gum disease. Scaling and root planing helps control this by cleaning infected areas, reducing inflammation, and promoting healing of the gums. This treatment can prevent tooth loss and maintain oral health.
What is Delta Dental?
Overview of Delta Dental
Delta Dental is one of the largest dental insurance providers in the United States. It offers a range of dental plans that cover preventive, basic, and major dental procedures. Their plans are designed to help patients manage the cost of dental care, including treatments related to gum disease.
Types of Plans Offered
Delta Dental offers various plans such as PPO, DHMO, and Premier. Coverage details can vary based on the specific plan, employer benefits, and location. It is important to check your individual plan’s policy for exact coverage, especially for specialized treatments like scaling and root planing.
Does Delta Dental Cover Scaling and Root Planing?
General Coverage for Periodontal Treatment
Most Delta Dental plans include coverage for scaling and root planing as part of periodontal therapy. Since SRP is considered a necessary treatment for gum disease, it is often classified under periodontal procedures. Typically, coverage is available when a dentist diagnoses gum inflammation or periodontal disease requiring this deep cleaning treatment.
How Coverage Works
Delta Dental usually covers scaling and root planing in two or more visits, focusing on different sections of the mouth. Coverage often depends on meeting certain clinical criteria such as the presence of gum disease or a specific depth of gum pockets. Plans may pay a percentage of the treatment cost, often between 50% and 80%, after any deductible has been met.
Limitations and Waiting Periods
Some Delta Dental plans have waiting periods before periodontal treatments like scaling and root planing are covered. This means you may have to wait several months after starting your plan before the insurance will pay for this procedure. Additionally, there may be annual maximums on the amount Delta Dental will pay for periodontal care.
Preauthorization and Documentation
Delta Dental may require preauthorization for scaling and root planing. This means your dentist will need to submit clinical information, including X-rays and gum measurements, to justify the need for treatment. Proper documentation ensures your claim is processed smoothly and coverage is approved.
Understanding Gum Disease and Its Treatment
What is Gum Disease?
Gum disease, also known as periodontal disease, is an infection of the tissues that hold your teeth in place. It usually starts as gum inflammation or gingivitis, characterized by red, swollen gums that may bleed. If untreated, it can progress to periodontitis, causing the gums to pull away from the teeth and bone loss.
Symptoms of Gum Inflammation
Common signs of gum inflammation include redness, swelling, bleeding during brushing or flossing, persistent bad breath, and sensitive or loose teeth. Early treatment is critical to stop progression and avoid more invasive dental procedures.
Treatment Options Beyond SRP
Besides scaling and root planing, treatment may include improved oral hygiene, regular cleanings, antibiotics, or surgery in severe cases. Delta Dental coverage often includes preventive care and basic cleanings, but advanced treatments may require higher patient co-pays or be limited by annual maximums.
How to Maximize Your Delta Dental Coverage for Scaling and Root Planing
Verify Your Plan Details
Before undergoing scaling and root planing, review your Delta Dental plan documents or contact customer service. Confirm coverage limits, waiting periods, deductibles, and any requirements for preauthorization to avoid unexpected costs.
Work Closely with Your Dentist
Your dentist can help document your gum condition properly and submit necessary claims to Delta Dental. They can also explain alternative treatments if insurance coverage is limited or denied for SRP.
Consider Preventive Care to Avoid Advanced Gum Disease
Regular dental check-ups and cleanings can prevent gum inflammation from progressing. Delta Dental strongly encourages preventive care by offering higher coverage percentages for routine cleanings compared to complex procedures.
Conclusion
In summary, Delta Dental generally covers scaling and root planing as a treatment for gum inflammation and gum disease. Coverage is subject to plan specifics such as waiting periods, deductibles, and documentation requirements. Since periodontal disease can seriously affect oral health, it is important to seek timely treatment and verify insurance benefits in advance.
Maintaining healthy gums with early intervention and professional care is the best way to avoid costly and extensive dental treatments later. If you have symptoms of gum inflammation or have been diagnosed with periodontal disease, talk to your dentist and check your Delta Dental policy to understand your coverage options for scaling and root planing.
