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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 Goedecke Family 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 Dr. Mark Goedecke, 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– Dr. Mark Goedecke 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 Mt. Pleasant office.

That’s a good question! But first, we’re going to do that roundabout thing where we consider other questions before circling back to our original topic. Trust us, we’ll get there!

• Why Get Your Teeth Cleaned Professionally?

Before you consider how often to have your teeth cleaned, you might be wondering why you need to have them cleaned professionally at all. After all, you’re doing all the right things. You brush twice a day for two minutes each time. You floss at least once a day. You even use a soft-bristled brush to protect your enamel. Shouldn’t this be good enough?

Conscientious dental hygiene at home is a very good thing, but, when it comes to plaque and tartar, it might not be good enough. Plaque, especially between the teeth and along the gum line, is easy to miss. In a matter of days, that overlooked plaque hardens and becomes tartar. While you can do a lot to remove food particles and plaque at home, once plaque hardens into tartar, a professional cleaning is necessary to remove it safely.

• Why Worry About Plaque and Tartar You May Have Missed?

Because you want to avoid cavities and gum disease. You know that the bacteria in plaque cause tooth decay, but did you know that plaque and tartar can be a real problem for your gum health as well? Plaque and tartar irritate delicate gum tissue, causing inflammation and gingivitis (mild gum disease). If you have chronic bad breath, if your gums are swollen, red, or painful, if your gums bleed easily when you’re brushing and flossing, you might have gingivitis.

Left untreated, mild gum disease can become periodontitis, a more serious condition. Irritation and inflammation cause gum tissue to pull away from the teeth, forming deep periodontal pockets where bacteria and infection spread. Infection and inflammation response damage the bone and tissue supporting the teeth, and teeth become loose or lost altogether. In fact, periodontal disease is the leading cause of tooth loss in adults.

A professional cleaning at our Mt. Pleasant is one of the preventive steps you can take to reduce your risk of gum disease.

• What Happens During a Cleaning?

First, your teeth and gums will be checked carefully to see if there are any problems that we need to address before the procedure begins.

The first step in cleaning usually involves removing plaque and tartar. This may be done with an ultrasonic scaler, a hand scaler, or a combination of both. Plaque and tartar need to be scraped from tooth enamel above and below the gum line to prevent cavities and gum disease, so this is definitely a job for a dental professional. Gum attachment around the teeth will be checked, and shallow pockets will be cleaned. Your dentist will have suggestions if you have deeper periodontal pockets caused by gum disease.

After all the plaque and tartar have been removed, your teeth will be polished with a gentle abrasive to remove surface stains. There are two common methods of polishing: applying a special gritty toothpaste with a small rotating cup, or air polishing, which uses a stream of fine abrasive powder, water, and pressurized air. (If you have your teeth cleaned more than twice a year, your dentist will let you know if polishing is advisable during every visit.)

Next, flossing. A professional flossing will remove any remaining plaque from between the teeth. This is a good time to double check your own flossing technique and ask for any tips which will make your personal flossing more effective.

Finally, after rinsing, a fluoride treatment might be applied to strengthen your enamel, and you’re good to go. The entire process usually takes between 30-60 minutes.

• So, How Often Should You Have Your Teeth Cleaned?

That is a good question, and we did get there! But we don’t have just one answer for you. As with every aspect of your dental care, Dr. Mark Goedecke will recommend cleaning treatments and procedures with your specific dental needs in mind.

• If your teeth and gums are healthy, and you don’t have periodontal disease or risk factors for periodontal disease (such as smoking, a family history of gum disease, or medical conditions such as diabetes), you might be able to get by with two cleanings each year.
• If you have a history of periodontal disease, or are at higher risk for periodontal disease because of one or more risk factors, Dr. Mark Goedecke might recommend more than two cleanings each year.

Professional cleanings play an important role in your preventive dental care. Whether it’s done once a year, twice annually, or more often as needed, a cleaning performed by a dental professional takes only a short amount of your time and provides you with long-term benefits—not only a brighter smile, but healthier teeth and gums!

What’s the big deal about a little snoring during the night? Or feeling a bit drowsy during the day? Or an occasional bout of insomnia? If your sleep problems are few and far between, probably not a major worry. But if your sleep disruptions are frequent, getting worse, or more noticeable to those around you, your problem might be sleep apnea. And that can be a big deal.

Sleep apnea occurs in three forms:

• Obstructive sleep apnea

This is the most common form of sleep apnea. It can be the result of the muscles in the back of the throat relaxing during sleep to obstruct the airway. Obstruction can also be caused by a physical condition such as a deviated septum, excess throat tissue or enlarged tonsils.  Loud snoring often results as the sleeper struggles to inhale through the obstructed passageway.

• Central sleep apnea

Central sleep apnea is caused by the brain failing to transmit the proper signals to breathe during sleep. The sleeper either stops breathing, or takes such shallow breaths that he or she can’t get enough air into the lungs.

• Complex sleep apnea

This condition is a mix of both obstructive and central sleep apnea.

Any of these forms of sleep apnea will cause a miserable night’s sleep. Sufferers actually stop breathing for a brief time. To start breathing properly again, our bodies move from the deep sleep we need to restore our physical and mental health to shallow sleep or even momentary wakefulness. And these disruptive episodes can happen dozens of times an hour, all night long. You might think you have gotten a full night’s sleep, while in reality you are suffering from sleep deprivation.

When you suffer from obstructive sleep apnea, the immediate consequences are easy to see and hear. Loud snoring, choking, constant drowsiness—you (and your loved ones) suffer from these symptoms night and day. But the hidden consequences of this disorder are even more dangerous. Sleep apnea has been linked to high blood pressure, heart disease, and strokes. It can cause memory problems, depression, and mood changes. Loss of focus and slow reflexes can lead to accidents. Complications from general anesthetics and medications can also become a serious risk.

Snoring is not the only symptom of sleep apnea. If you notice that you often wake up with a sore throat, a dry mouth, or a headache, have difficulty going to sleep at night or staying awake during the day, can’t concentrate,  or constantly feel irritable—you should consider the possibility that you suffer from sleep apnea. Talk to Dr. Mark Goedecke at our Mt. Pleasant office. We can recommend options that will have you once again sleeping soundly in your bed, waking up refreshed and healthy. And that is a big deal.

Your trusty manual toothbrush has been with you from pre-school through high school—well, obviously not the same manual toothbrush, because that would be seriously unhygienic—but it’s the kind of toothbrush you’re used to and comfortable with.

Now, though, you’re off to college, and your lifestyle will be changing. Late night study sessions complete with study session snacks. Getting caught up in a project and making dinner from dorm vending machines. Grabbing fast food on the way to the practice field, or work-study job, or evening class. You get the point—meals can be hectic, unscheduled, and less than tooth friendly.

Maybe it’s time to consider an electric toothbrush. After all, anything that can make your life easier and more efficient during busy college days deserves a spot in your dorm room.

• Electric Brushes Are Effective

The most important reason to switch to an electric toothbrush is its effectiveness. Several studies have shown that regular use of an electric toothbrush leads to a marked reduction in plaque, that bacteria-filled film which sticks to the teeth and leads to cavities and gingivitis. And it’s really no surprise that an electric brush can out-perform a manual brush.

Electric toothbrushes offer several design options, from oscillating/rotating brushes to oscillating/rotating/pulsating models to brushes using sonic vibration technology. What these technologies all have in common is the ability to remove plaque far more efficiently than we can on our own, because electric brushes provide the equivalent of thousands and even tens of thousands of brushstrokes per minute, compared to the hundreds we can achieve by hand.

You know by now what your brushing habits are like. If you tend to be a bit cavalier with your brushing and flossing, make sure you set yourself up for success. Because you have better things to do during semester breaks and summer vacations than visiting Dr. Mark Goedecke!

• Electric Brushes Can Make Life Easier

Several of today’s electric brushes come with options designed to do more than simply remove plaque. They can let you know if you’ve brushed for the recommended two minutes, alert you if you’re brushing too hard, and even remind you when it’s time to replace the brush head.

Want more from your electric brush? Some models offer apps that can map out just where you’ve brushed, in case there are a few spots that often get overlooked. Or provide different brushing modes for daily cleaning, deep cleaning, whitening, and more. Or come with a travel case that can recharge while you’re busy exploring the world—or going home for a visit.

In the end, it’s up to you. Do some independent study and research the toothbrushes that will give you the best results for your individual brushing habits. You might not need or want a brush with all the technological bells and whistles.

If you’re comfortable with your manual brush and you get good grades when you visit our Mt. Pleasant office, stick with it. But if you think you might benefit from the ease and efficiency of an electric toothbrush, if an electric toothbrush makes your teeth and gums healthier and your smile brighter, that’s an extra credit project worth pursuing.