Your Smile Dental Care


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Choosing Dental Floss

 

So you’ve decided to make flossing an addition to you home oral care routine. Great idea!

Your local pharmacy is be stocked with all kinds of different types of floss and the choices can be confusing.

 

How do you know which one is right for you?

 

Floss comes in different flavours, coatings, sizes, thicknesses, textures and specialized uses. Finding the one that will do the job right and fits your oral health care needs is a conversation that you can have with your dental care provider via telephone or during your next visit.

 

Let’s look at some of the possibilities that may suit your “specific to you situation:

Sensitivity – Understandably, people who suffer with sensitive teeth or bleeding, swollen gums are are reluctant to begin flossing. Finding soft floss or one coated in wax that will slip easily and comfortably between teeth will make the task more manageable. A daily routine of proper brushing and flossing will soon have gums looking pinker and the bleeding will subside. You should arrange to see your dentist, however, if your gums bleed consistently and your teeth are always sensitive. Don’t ignore theses symptoms as they may be signs that something more serious is going on with your dental health.

 

Tight teeth – Oftentimes, people who have teeth that are very tight or close together find that traditional floss will shred when sliding it between teeth or that they have to force it through. This can cause the floss to snap through the contact area too forcibly and possibly injure gum tissue. They can use:

Waxed floss that is coated and more resistant to breaking. The way coating allows it to fit easier between tight spaces.

Glide floss is specially woven with a light wax coating making it strong, shred-resistant and easy to slide between teeth.

 

Wide spaces –  Some people have teeth with gaps or they are spaced further apart that normally. Superfloss with it’s unique design can be used for wide areas between teeth, braces, and bridgework. It is made up of 3 parts:

1. A stiff string to help thread the floss through or into an area (floss threader)

2. A softer, spongy to gather food particles and plaque more efficiently

3.  A traditional flossed end

 

 

 

Braces: If you wear braces or have dentures, that doesn’t mean that you can’t floss. Try a specialized floss threaders or Superfloss that has a stiff end that you can thread beneath the main wire of your braces and a spongy component that slides easily between the teeth. Your orthodontist will also recommend other dental cleaning tools that will help you clean the particular type of braces that you have.

 

 

Children – It’s harder for children to use floss, so start them off with floss wands. Once their dexterity develops and their teeth become closer together,  you can teach them to use traditional floss. Some creative people have introduced the concept using mega blocks as pictured below:

 

 

 

*Mobility issues – Finding practical dental hygiene solutions for people who have physical or mobility issues can be challenging. They may be caring for their own teeth or may have a caregiver that provides this task. When it comes to flossing, there are electric flossers on the market that help clean in between teeth. A  floss holder/wand, like the one pictured above, or tying floss into a circle for easier handling can also help simplify oral care.

 

Is your floss always shedding or catching on something in between your teeth?

Sometimes, floss can become stuck on something in between teeth making it difficult to remove the floss without breaking or shredding it. Many things can make floss snag including, a broken tooth/filling, a cavity, tartar buildup or an overhanging margins of a filling. Seeing your dental healthcare provider will help identify the problem, and after remedy, they will ensure that the area in question is snag-free so you can resume flossing at home.

 

When to Floss…

Brushing your teeth and using mouth rinse does not replace flossing. Floss goes when your toothbrush can’t reach and mouth rinses are not as effective either. Most people find that flossing once a day, usually before bedtime, is ideal for the. Others, however, get food stuck in between their teeth and under their gums often and need to floss after meals immediately to feel comfort. Finding any time during the day that works best for you is the best time! Once you get the hang of flossing, it only takes a few minutes to include this in your daily hygiene routine, but the benefits last a lifetime!

 

 

Yours in Better Dental Health
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com

 


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The Do’s and Dont’s of Orthodontic Treatment

Want “Someday” to get here as quickly as possible?

 

One of the first questions a patient will ask their orthodontist during the first visit is, “How long will my treatment last?”

Each mouth is unique, so treatment time will naturally depend on your individual, “specific-to-you situation. Some people require less than a year, while others will be involved in treatment for 3 years or longer.

Initially, most people are eager to begin treatment so that they can have the smile they’ve always wanted as quickly as possible. We don’t think anyone intentionally prolongs the duration of their treatment, but there are, however, a number of things along the way that can complicate and lengthen your time in braces.

Although these following tips may not speed up your time in treatment, they will certainly help to ensure that it will not go slower than predicted or result in additional treatment fees.

Food

Limiting your sugar intake and eating proper foods, while avoiding others is critical during your treatment.  Some people wear single aligning trays that are made of a plastic composite material, while others use the traditional system involving a number of brackets, wires, elastics and bands. These components are fragile and can break easily if not cared for properly. The biggest culprit involved in broken or bent ortho gear is food. When it comes to the foods that you should avoid during treatment, it’s just a matter of using common sense and avoiding those foods that could break, stick to, or otherwise, interfere with your orthodontic work. treatment. Hard, chewy, crunchy, and sticky foods should be avoided during treatment time especially:

  • Fruit roll ups and fruit snacks
  • Sticky or chewy bars, caramel, chocolate, taffy, peanut brittle, etc
  • Pretzels and chips
  • Popcorn
  • Taco shells
  • Hard Cookies
  • Pizza crust
  • Crackers
  • Nuts
  • Chewing Gum
  • Pickles
  • Bagels
  • Hard rolls
  • Beef jerky
  • Ice
  • Ribs
  • Chicken wings and drumsticks
  • Corn on the cob

Some foods can be modified so that they are easier on your bracework. Try cutting them into smaller pieces, softening them in a beverage or cooking them before eating. We know that avoiding the above foods is a tall order, but trust us, your new smile will be worth it.

 

Beverages

Most drinks that we advise you to avoid during ortho treatment are unhealthy for your teeth with or without braces. Drinks that are highly acidic and sugary drinks like soda pop, sports drinks, flavoured milk drinks, sugar-sweetened coffee/tea and fruit juices work to weaken and dissolve tooth enamel and eventually result in tooth decay. How often you consume these types of drinks is the most important factor. An occasional beverage can be tolerated, but allowing the sugars and acids to come in contact with your teeth often and for long periods of time (as in sipping the drink slowly or throughout the day) is a recipe for disaster for any teeth, especially during orthodontic treatment. If you must have a drink of this sort now and again, just remember to drink through a straw and rinse with water afterwards. Wait 20-30 minutes to then brush your teeth.

 

 

Appointments

You will have adjustment appointments scheduled with your orthodontic office at periodic intervals. Missing even just one of these appointments will delay your treatment time, so make sure that your attend every one that is booked for you. Your appointment will be made well ahead of time, so putting the information into your calendar, planner or phone and scheduling all other things around this reserved time will go a long way in helping you keep plan ahead.

 

Dental Hygiene

Bacteria like to accumulate in and around all the nooks and crannies along your tooth’s surface and in between teeth. Adding brackets, bands and wires becomes a virtually jungle gym – giving them all kinds of new places and surfaces to gather and multiply. All of this plaque leads to tooth decay and swollen, bleeding gums, so it is essential that you take your oral hygiene to the next level. Your orthodontist will instruct you on the proper method for keeping your particular type of orthodontia clean. Follow this plan meticulously and always check in the mirror after you’ve brushed to ensure that you haven’t left anything behind. Replace your tooth brushes when they begin to fray (every 2-3 months) since worn brushes are not effective. Using a fluoridated mouth rinse will give added protection and help keep your mouth clean.

 

 

Protection

Straightening your smile with orthodontia is a big investment in terms of cost and time. Protect this investment and avoid costly repairs by safeguarding your teeth during treatment. Although the importance of proper oral hygiene and diet cannot be emphasized enough, defending your teeth and braces during activity is critical and a protective mouth sports guard is a must! The brackets, bands and wires of your orthodontic braces can potentially cut your lips, gums, tongue and other tissues of the mouth during any sudden contact or force. Your orthodontist will make you custom-fitted guards that do not interfere with your braces and are more secure and comfortable than a store bought “one size fits all” type.

Additionally, certain habits like chewing on pencils and fingernails, playing with your braces with your fingers or tongue can also loosen and damage your orthodontia gear. Always call your orthodontist immediately if your have sustained a traumatic injury to your mouth. They will determine if you need to be seen for an examination. Having any broken or loose gear corrected as soon as possible will help you keep your treatment on track!

 

Broken Gear

Sometimes, even with the greatest of care, a part of your orthodontic gear may break or become loose. Although, you may not be in pain or think that it isn’t an urgent matter, waiting to get it fixed may delay your treatment since broken brackets and wires can’t do their job. Call your orthodontist right away and they may want to see you right away or will schedule more time at your next appointment to correct the problem. In the meantime, if there are any parts of your gear that are sharp or protruding, you can find relief by placing some orthodontic wax around the area. If a wire is long and sticking into your gum, lip or cheek, you can try to carefully bend it back down with a Q-tip or pencil eraser so that it runs flat against your tooth. Be careful when eating and brushing so that you do not cause further damage to your braces.

 

Check-ups

ups and cleaning during ortho care. Although your orthodontist is helping you achieve a great smile, they involve themselves with straightening teeth and correcting bites, Your orthodontists does not replace the role of your dentist, who is you primary dental care provider. Keeping your teeth clean is especially challenging when your mouth is full of ortho gear and it takes patience and effort. This makes it even more important to keep up and hygiene appointments where you dentist can monitor your dental health, diagnose problem and then administer treatment accordingly.

 

 

 

 

We know that you want to set things straight with your teeth as quickly as possible. When the day finally comes to get your braces off and reveal your new smile to the world, you want it to be the best it can be. Following these tips may not decrease the time that you have to spend in treatment, but it can certainly help cut down on any delays in treatment.

 

Yours in Better Dental Health
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com

 

 


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Top Dental Cosmetic Improvements

Today’s Smile Options

Dr. Sam Axelrod and his team of caring dental professionals believe Your Smile should not only be healthy, but one you can be proud of! One of the best ways to boost your self confidence is with a great smile!

Having a beautiful smile is easier than ever thanks to the amazing cosmetic advancements over the past 10 years. What was once considered a luxury that only the wealthy could afford, is now easily attainable for everyone of all ages!

Teeth Whitening

What could be easier than giving your tired teeth a little smile lift with tooth whitening? Many people are skipping the more expensive in-office bleaching and opting to brighten their teeth in the privacy and comfort of their own home in as little as 1/2 hour a day. The new advances in formula can eliminate stains and discolourations in as little as 3 days! There are even new toothpastes formulas that you can purchase that will help your new smile stay brilliant for longer than ever now. Our patients love having their very own custom-made tray and being able to buy extra whitening gel at cost and have the luxury of touching up their teeth as needed throughout the year! White teeth have never been easier than this!

 

White Fillings on Molars

Have a wonderful big smile or just love to laugh out loud? There are so many white filling options available that you should be saying goodbye to your old silver amalgam fillings. Tooth-coloured fillings are typically made of powdered glass and acrylic resin and are available in many different shades of white. Your dentist will colour match so that it will be almost impossible to tell the difference between the filling and your natural tooth. Get ready to lol with confidence!

 

Bonding

Now you can have that special bond with Your Smile that you’ve always wanted with a technique called just that – Bonding! This composite white filling material can help improve your appearance and your smile when used to fill in gaps between teeth, fix small cavities, repair chips or cover up root surfaces that can become exposed due to recession and toothbrush abrasion. Best of all, this can be done in a single office visit that usually requires no anesthetic freezing.

 

Gum Re-Contouring

Maybe its not your teeth that you’re unhappy with. Some people have gum tissue that is situated too high, too low or is uneven affecting the appearance of their smile. We can reshape the gumline so that it complements your teeth and frames your gorgeous smile using a simple, virtually painless, in-office sculpting technique. Want harmony and balance with Your Smile? Ask your dentist if you are a candidate for gum contouring surgery today!

 

Teeth Re-Shaping

Perhaps, you already love your smile, but have always thought your teeth should be a bit shorter or slightly more even in size. Just as gum line can be reshaped, so too can teeth that only need very minor cosmetic changes. You’ll get instant results in one short appointment without the need for anesthetic freezing.

 

Crowns

When you are not a candidate for dental veneers due to heavily damaged or restored teeth, you may still have the option to cap your teeth to get the smile you’ve always dreamed of. Not only can dental crowns change the shade, shape, position and colour of your teeth, but they are comfortable and function just like your natural tooth crown. Better still, with proper care, there can last for many years to come.

 

Dental Implants

Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth which look, feel and function like natural teeth. Once the implants are completed, one gains the ability to eat virtually anything and allows one to smile once again with confidence. With current technology, most implants are actually much stronger than the teeth they are replacing. Bring you beautiful smile back with Dental Implants!

 

Veneers

Porcelain veneers may be the perfect solution for your imperfect solution. We can whiten, lengthen, realign or reshape your smile using these strong, but ultra-thin shells of porcelain that eill blend seamlessly into your existing smile. This long-lasting option will have you smiling ear to ear.

 

Accelerated Braces

Want straight teeth but can’t put in the 2-3 year time commitment? Ask your orthodontist about a new and emerging type of orthodontic treatment called accelerated  orthodontia. This is a tooth movement method that greatly reduces the amount of time needed to move teeth into a more correct position. You will  likely have to attend the same amount of appointments as you would during the longer, conventional span of treatment but in a shorter time frame. Ask your orthodontist if this is an option for you!

 

Modern Dentures

No longer should you have to worry about loose, poor-fitting dentures when today’s modern, implant-supported dentures are available to you. You’ll get increased stability while still being able to remove them like traditional dentures. It’s time for you to smile, laugh, chew and blow out birthday candles with confidence!

 

 

Everyday, at Your Smile Dental Care, we transform smiles and restore confidence. Each patient’s mouth is unique, so we carefully consider all of the treatment options to determine together what will give you the smile you deserve. If you would like to learn more about Your Smile options, give us a call at (905) 5SMILES or book a consultation online today!

 

Yours in Better Dental Health,
The Your Smile Dental Care team
(905) 5SMILES
(416) 783-3533
www.yoursmiledentalcare.com


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How often should you go to the dentist?

Why should I see a dentist if my teeth don’t hurt?

Your Smile is important and the health of your teeth has an impact on your overall health. But what if your teeth feel and look great to you?

Many people still believe that unless they are experiencing pain or have broken a tooth, it’s not necessary to see a dentist for regular examinations, but in a healthy mouth you shouldn’t be feeling any pain or sensitivity with your teeth!

 


“Pain should not be the only factor that makes you decide to go to the dentist.”


 

The fact is, dental pain is usually a warning that you have left an undetected problem too long.

Each tooth has a soft inner core consisting of blood vessels, lymphatic tissue and a nerve center. It plays an important role in the growth and development of the tooth, but once the tooth comes into the mouth, it is the lifeline that brings nutrients to the tooth and also sends out sensory signals in response to trauma and disease.

If you have ever broken a tooth or have had a painful cavity, you know the pain signals that your nerve sends out as a warning! However, it is actually located far enough away from the tooth’s outer surface that by the time an advancing cavity reaches the nerve it is usually too late to repair the problem with a simple fix.

The fact is, many oral disease are silent. We usually think that if our teeth are “quiet” that they are healthy, but you have to treat your oral health as you would your overall health.

Screenshot_20171211-222802

Regular maintenance check-up exams allows us to catch and manage the early signs of disease, before they become bigger, more complicated issues. At Your Smile Dental Care, we are here to help our patients restore their smiles to optimal dental health so that their future focus can be on prevention! We think that by encouraging our patients to maintain regular check-ups and cleanings and teaching them how to prevent dental problems before they occur is time well spent.

How often should you be going to the dentist?

That depends!

Our recommendations are based on your own individual, “specific to you”  oral health, medical conditions and lifestyle habits. Maintaining regular professional dental care allows us to monitor and evaluate your oral health and advise you accordingly.

Some people see us twice a year for their regular check-ups and cleanings, while others, who have more tartar build-up or who are at a higher risk for cavities and gum disease, need more frequent visits. It is important to understand that there are many changes in our lives that can impact our oral health and change the schedule of our dental visits.

 


“Even if you maintain an excellent oral care routine and always have good check-ups, you still need to continue a proactive attitude to help ensure that you and your dentist can always stay on top of things.”


 

And, it is especially important to take care of your teeth and seek professional dental care if you are in one of the following high risk groups below:

  • smoke or use tobacco products
  • are pregnant
  • have diabetics
  • have current gum disease
  • have a weak immune system
  • tend to get cavities or build up plaque
  • suffer from *dry mouth (see below)
  • have limited dexterity
  • have poor dietary habits
  • Snack frequently or sip a beverage other than water all day
  • have bulimia or acid reflux

*Dry Mouth: If you suffer from dry mouth your oral health may be at risk. People can develop dry mouth for a number if reasons, especially if they have:

  • diseases, such as bulimia, Sjögren’s syndrome, rheumatoid arthritis, diabetes mellitus or pernicious anemia, that alter the flow rate or content of saliva,
  • are receiving chemotherapy with drugs that cause xerostomia
  • are receiving radiation therapy directed to the head or neck.

 

Screenshot_20171211-221631

Early Detection

Knowing that here are also a number of oral health problems that can exist before you even begin to have symptoms will better help you understand why seeing your dentist regularly is so important for your oral health. We want to catch and treat problems early before they become more complicated.

If you’ve put off regular dental care – for whatever reason – do not delay any further. Your Smile is important!

 

 

Yours in Better Dental Health,
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com

 


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Need to know what your Dental Insurance Plan covers?


Am I covered?

This is one of the most common questions that our patients ask us, whether it is in response to a recommended treatment plan or just a general inquiry.

It is an important question because it is obviously one of the greatest factors that a patient takes into account when considering dental treatment. And although, treatment may be necessary for your dental health, no one wants any surprises when it comes to finances.

 


“It is becoming increasingly difficult for dental practices to gather information from your insurer on your behalf.”


 

Even if you already have an employee booklet that was given to you by your employer, it can sometimes be difficult to interpret or may not explain all the limitations your plan may apply to your covered benefits. Under Ontario’s Privacy Act, it is becoming increasingly difficult for dental practices to gather information from your insurer on your behalf. Oftentimes, they want the subscriber of the plan (the employee) to be present in the office to grant permission and that is not always practical.

When a patients needs to be seen by a dentist for an unexpected emergency or last minute appointment, they do not always have the luxury preparing for their visit. If we have to initiate immediate treatment in order to save the tooth, waiting for approval of a cost estimate is also always a choice. An inquiry to the insurer over the telephone about treatment eligibility can be further complicated if they do not wish to disclose the information about the plan’s benefits without the policy holder’s written permission (regardless of the emergency circumstances) or they want to review the treatment case and dental images first.

This is just one of the many scenarios that take place when dealing with dental insurance. It can be an exercise in frustration especially when you are faced with having to make an immediate or timely decision about your dental health needs. When treatment cannot be delayed and is a same-day necessity, the uncertainty of insurance coverage can trigger an additional worry for patients.

 

Dental Speak

Understanding your dental policy and the terminology used can be confusing. If you ever want to call your insurer to get a general breakdown of your policy there are a number of important terms and questions you may want to know and understand before making an inquiry:

 

Basic Services – Most insurance companies classify routine maintenance and restorative treatment under basic services. These include, but may not be limited to, exams, cleanings, fluoride, x-rays, sealants, fillings and extractions. Your plan will likely limit the frequency under which they will pay for such procedures and you should be aware of these date/frequency limitations.

When making an inquiry to your insurer, you would ask: “What procedures are considered Basic under my policy?  How often can will these Basic services be performed?”

 

Major Services –  Most insurance companies classify Major as those services that go beyond the scope of routine procedures because they involve more complex or extensive treatment in order to restore or repair a condition where breakdown, loss or damaged has occurred.

When making an inquiry to your insurer, you would ask: “Am I covered for major services? What are those major treatments and the associated limitations that I should be aware of?”

 

Fee Guide (aka. Fee Schedule) – is an annual suggested fee structure that is put together by a provincial or state dental association and serve as a guide when dentists are billing patients. Most insurance companies will base their fees according to this annual fee schedule. In order to make a dental plan more affordable for an employer to offer to employees, they may choose a plan that pays at a previous year’s suggested fees. For example, if you have an appointment in 2017 and your dentist bills you at 2017 prices, but you plan pays out at 2015 prices, you will pay the difference in fees between these two dates. From year to year, some dental fees increase, some decrease, while others may remain the same price. Dentists are not required to follow any fee guide, but most do. If the dentist practices a specialty such as oral surgery or endodontics you should inquire about their fees.

When making an inquiry to your insurer, you would ask: “What fee guide does my plan follow?”  “Does it cover both General and Specialist practitioners?”

 

Deductible – Similar to a car deductible, it is the annual dollar amount you must pay before your insurance policy takes effect. It usually is an annual deductible and is applied to your first visit of the year. You may have a deductible for each member on your policy or just one for the whole family.

Case Scenario 1: If your first visit of the year is a covered expense under the terms of your policy and you are charged $100.00 for the treatment, under a policy family deductible of $25 your insurer will pay $75.00 ($100 minus the $25 deductible). Subsequent dental treatment for your family members within the year will not be subjected to this deductible as it has already been applied.

Case Scenario 2: If your first visit of the year is a covered expense under the terms of your policy and you are charged $75.00 for the treatment, under a policy family deductible of $100 your insurer will pay not pay anything as the $100 deductible has not been met yet. In fact, there is $25 still outstanding and will be applied to the next visit in that particular year. Subsequent dental treatment for your family members within the year will not be subjected to this remaining deductible as only $75.00 has been applied.

Sometimes, the deductible is only applied to certain treatment procedures such as major services. Understand that any premium or co-payments usually do not count towards this deductible.

When making an inquiry to your insurer, you would ask: “Does my policy have a deductible and is it single or family? How much is the deductible? Is it applied  to all covered procedures or only certain treatment?”

 

Annual Maximum – Most dental plans have a certain dollar amount that they will pay towards your dental treatment per year. It involves a specific benefit period (January to December for example) and once this maximum dollar is reached then you are responsible for paying any remaining costs. It is important to understand that, if at the end of this benefit period, you still have a portion of this dollar amount still available and do not use it, it is usually lost and does not carry over into the next benefit period. Annual maximums vary depending on the policy and they are another way that employers and insurers limit their costs. There may be a different dollar amount applied to basic treatment as opposed to major services. It may also be applied to each individual under the policy or be a dollar amount for the entire family.

Case Scenario 1: If you have an individual annual maximum of $1000 and you have seven cavities totaling $700 and have not used any other monies from your plan during that specific benefit period, then you still have $300 remaining.

Other consideration that can affect this dollar amount of deductible, co-payments and type of dental services – basic or major.

Case Scenario 2: If you have an individual annual maximum of $1000 and you have seven cavities totaling $700 and have not used any other monies from your plan during that specific benefit period, but your plan only pays 80% for this type of basic treatment and has a $25 deductible, then they will pay $535 toward the dental cost leaving you with $465 remaining.

Unfortunately, the annual maximums that many insurance companies offer do not match the realty of today’s dental healthcare costs.

When making an inquiry to your insurer, you would ask: “Does my policy have an annual maximum? Is it a single or family maximum? What period does it cover? How is it applied – basic, major towards any treatment? What happens to remaining dollars at the end of the benefit period? Does my policy have a lifetime maximum? How can I best keep track of this annual maximum?

*TIPSometimes, a patient needs a lot of dental treatment during their benefit period. They may choose to have only the treatment that is covered by their annual maximum, and then delay the remaining treatment until their benefit period renews. Sometimes, it may be a viable option for you, while other times, delaying dental treatment can lead to higher costs in terms of fees, pain, complications and disease progression. Always consult your dentist if you are considering delaying recommended treatment. Oral health can be unpredictable, especially if you do not visit your dentist on a regular basis.

 

Co-Payments (aka. co-insurance) – is the percentage of the procedure bill that your insurance does not pay. It is your portion of the dental cost. If your dental office bills your insurance directly, then you will pay this fee after each dental visit. If you pay your dentist first and are reimbursed by your insurer then they will pay the covered costs minus this co-payment.  Co-payment are usually expressed as percentages.

Case Scenario: your dental policy may cover basic procedures at 80% and major services at 50%. You will be responsible for paying the remaining 20% or 50% respectively. For basic treatment, your insurer will pay $60 of a $75.00 dental bill.  If you were charged $500 for a major service your insurer will pay $250.00. Other factors will also be accounted for such as annual maximums and deductibles etc…

Again, it is a way for employers or insurance companies to limit their costs of offering dental coverage. Not everyone is fortunate enough to have a dental policy that covers 100% of all treatment. Like a deductible, a co-payment represents your portion of your dental expenses. Some patients ask their dentists to waive or write-off their co-payments, but each dentist in Ontario has a legal and ethical obligation via-a-vis the insurance company to collect all co-payments from a patient.

When making an inquiry to your insurer, you would ask: “What co-payments am I responsible under this policy? Are there different co-payments for different types of procedures?”

 

Coverage period – This term basically means the period of time for which you or a member of your dental plan is covered for insured benefits. It can be used to describe a benefit year or the period of time that your policy is in effect. Some plans kick in only after a specified “waiting period”, so it is essential that you call your insurer to ensure that you are eligible to use the plan before you make a dental appointment. Additionally, you may only be covered for basic services for a period of time before any major coverage applies.

When making an inquiry to your insurer, you would ask: “When is the exact date that I can begin using this plan?” “Up to what age are my dependents covered and what conditions apply?” “What happens if I am laid-off or go on leave from my job?” “Is there a wait period for any procedures such as major treatment? “Is there anything else that can affect my eligibility under this plan.”

 

Single/Family – Single refers to the individual policy holder/employee and Family includes their spouse and at least one child. Single coverage usually costs less in premiums than a family plan. Clarify with your insurer who is covered under your plan and ensure that their personal information (spelling of name, date of birth etc…) is correct. If you are living in a co-habitation arrangement with a common-law spouse or separate with your spouse, ensure that you understand how it can affect their eligibility under the plan. Lastly, you may want to know if your yearly deductible applies to the family as a whole or each individual member of the plan.

When making an inquiry to your insurer, you would ask: “Does my policy cover my family?” “Do we have one maximum dollar amount for the whole family or do we have individual annual maximums?” “Is my plan’s annual deductible single or family?”

 

Frequencies – Your insurer often limits the number of times that they will pay for a particular dental procedure. The time lapse between two identical procedures and the limitation your insurer will place on having the same procedure performed again can be very problematic for patients if they are not aware of these plan limits. For example, you may be covered to have a check-up examination every 6 months. There are other plan frequencies applied to different treatment such as crown replacement (ie. every 5 years), orthodontics (ie. once in a lifetime), fillings (ie. once every 3 year for same tooth, same surfaces) or new patient exam (i.e. once every 36 months).

When making an inquiry to your insurer, it becomes a little trickier when asking about frequencies. If you think that a tooth has had dental tx performed on it in the past, your dental provider can make this inquiry to your insurer on your behalf.

 

Examinations – There are different types of exams that a dental provider may perform. The exam that is arranged for you depends on the situation and the amount of time involved for the dental provider.

Complete Exam (Procedure code 01101 baby teeth, 01102 mixed baby and adult teeth, 01103 adult teeth) – Exams that warrant a complete verbal, visual and radiographic (x-ray) evaluation of a new patient or of an existing patient that requires a more comprehensive assessment of their oral health status. It generally centers around in-depth information gathering to the extent that allows the dental team to acquaint themselves with a patient’s past medical/dental history, chart pre-existing dental work, diagnose current conditions and develop a plan for future care. Most insurers pay for this every 2-3 years.
Recall/Check-up (Procedure code 01102) – A regular, periodic maintenance examination of a pre-existing patient to ensure no dental problems/issues have arisen since your last check-up exam. It usually coincides with  a regularly scheduled cleaning. Every 6-12 months
Emergency Exam (Procedure code 01105)- An exam that is required in an unexpected, urgent situation such a fractured tooth, extreme pain or swelling of an area of the mouth. Insurers may limit how many of these exams can be done outside of your regular check-up exam.
Specific Exam (Procedure code 01104)- An examination that is required apart from your regular check-up exam for the assessment/diagnosing of a specific area or tooth of concern and is not urgent in nature. Again, your insurer usually place limitations on the frequency of this type of exam.

When making an inquiry to your insurer, you would ask: “How often can I have a check-up exam?” “What are my plan’s frequencies concerning emergency and specific exams” “How often can I have a complete new patient exam?”

 

Specialist – If you have been referred to a Specialist, typically their fees are higher than the suggested provincial fee guide for General dentists. Additionally, you will usually pay up front for your treatment at a Specialist office and be reimbursed by your dental insurer according to the terms of your policy. Although your insurer may not cover all of the fees, it may at least defray some of the cost. Ensure that you know the payment policy of the Specialist you will be seeing and how you are to submit a claim for treatment to your insurer.

When making an inquiry to your insurer, you would ask: “Does my policy covers Specialist fees and at what percentage and up to what maximum dollar amount?”  

 

Composite on molars – This is term that is used to describe a white filling on a molar. Some plans will only pay for an amalgam fillings on back teeth where aesthetics are less of a concern since most people cannot see your back teeth. Many dental offices no longer provide amalgam material as a choice for fillings when a tooth is decays or fractures. There is a cost difference – with the composite white filling being slightly higher in price – so insurers will scale their payment of white fillings to the amalgam price.

When making an inquiry to your insurer, you would ask: “Does my plan cover composite on molars?”

 

Dual Coverage – This is when a patient has dental coverage through 2 separate dental plans – usually their own plan and then an additional plan through another employer, school, spouse or partner. Other dependents and children oftentimes have coverage through both parents. When there is eligible coverage under 2 dental plans one becomes the Primary plan that pays first and the other plan is the Secondary policy that pays all or some of the cost that the Primary does not. When submitting your claim to your Secondary insurer, you will need to enclose proof of Primary insurance payment before they will cover the remaining cost. You may not “double dip” meaning – both insurers require that you fully disclose the presence of dual coverage as you cannot claim your dental fees in such a manner that results in both the Primary and Secondary insurers reimbursing you or the dentist for more than 100% of the claim. Having 2 plans to help defray the cost of dental treatment helps to lower your out-of-pocket expenses, not profit from it. When your Primary claim is submitted, it will include details that will indicate to your Primary insurer that you have Secondary coverage and vice versa. If, for whatever reason, you no longer have the benefit of a Primary plan, you may need to provide proof to the Secondary insurer before they step up to their new position as Primary Benefit provider.

When making an inquiry to your Secondary insurer, you would ask:  “What kind of proof do you require to pay a Secondary claim?” There are two types of Statements of proof that are available – both referred to as EOB: Explanation of Benefits. One is the statement that the Primary carrier sends along with the dental cheque (it may be in postal, email or online form) while another form of proof that is sometimes accepted is the insurer’s response to the electronic submission that your dental office sends over a specific carrier network online and has the phrase EOB on the response.

 

Secondary payments – The is the benefit/money that is paid by a Secondary insurer as in the case of dual coverage or a Health Spending Account. See above. They are not the initial insurer that pays for a dental claim.

 

Health Spending AccountA Health Spending Account is a type of benefit that provides payment for healthcare-related expenses that are over and above any insurance benefits that an employee may have. Typically, a patient would pay the dentist bill first then provide receipt of payment to their HSA for reimbursement.

When making an inquiry : You would make any inquires about a HSA to your employer or  Human Resources department.

 

Orthodontic coverage – This refers to any type of treatment involving re-positioning of teeth like dental braces. It is typically categorized under major treatment and often has it’s own lifetime maximum and co-payment limitations. Generally, your orthodontic provider will submit a treatment plan to your insurer for consideration before any benefits will begin to be paid out and usually these costs are paid out over the course of  the treatment.

When making an inquiry to your insurer, you would ask: “Does my policy include orthodontic coverage?” “What is the maximum dollar mount I can claim under orthodontics and is it a lifetime maximum?” “Is there an age restriction?” “Does treatment have to be provided by an orthodontist?”

 

Assignment of benefits – As a courtesy to patients, some dental offices will submit and bill your insurance company directly then wait for payment of the covered portion of treatment. Dentists are not required to do this. The full cost of the procedure is ultimately your responsibility. Understand, that many offices may not offer assignment of benefits for a number of reasons. It is getting increasingly difficult to do business with or make inquires on behalf of patients to insurance companies who implement very strict information policies based on their interpretation of Ontario’s Privacy Act. Lastly, dentists treat you based on your needs – not your dental plan. A dentist is still obligated to recommend treatment based on sound, evidence-based diagnosis even when your benefits do not completely match your health needs. Providing dental care while being a third party and fee collector to an agreement between a you and your insurer is a relationship that many healthcare providers do not wish to engage in.

When making an inquiry to your insurer, you would ask: “Will you make payment directly to my dental provider?” “Do you accept electronic claim submissions?”  Your dental office will then have additional information about this electronic claim process.

 

Estimates – A written treatment plan (and images/x-rays, if requested) that is submitted to your insurer to determine whether any or all of the dental procedures in the treatment plan will be covered by your plan. Most insurers no longer provide verbal authorization over the telephone and recommend that you send them an estimate for any treatment over $300-$500. In this way, you will know in advance what your plan will cover and what your out-of-pocket expenses will be. It is important to remember that a pretreatment estimate does not guarantee payment from your insurer. Your insurer will calculate benefits according to your current eligibility, any deductibles that may be applied and how much is remaining of your yearly allowed maximum.

When making an inquiry to your insurer, you would ask: “Can you tell me over the phone if I will be covered for “such and such” treatment.  If not, approximately, how long will the estimate process take?” When making an inquiry to your dentist, you would ask: “Will you submit an estimate to my insurer for the proposed dental treatment and await their reply before we proceed?” Will it be safe to postpone advised treatment until my insurer replies?”

 

Age Limitations – This is another restriction in coverage and applies to limiting or denying benefits based on age. An example is fluoride or orthodontic braces that may be limited to children under a certain age or the termination of coverage once a dependent reaches adulthood. Many plans allow dependents to still remain eligible for benefits as long as they are still in school full time and can provide proof of this. Ensure that you provide your insurer with any pertinent information they require for your post secondary school aged child to remain eligible.

When making an inquiry to your insurer, you would ask: “What are the age restrictions that limit the eligibility of any members on this plan? What information do you require in order for my post secondary children to remain eligible?”

*TIP – Know the date when your child will no longer be covered under your policy due to any age/school restriction and ensure that they receive a comprehensive dental examination and complete any recommended/outstanding treatment before this date. Waiting until last minute will put unnecessary time constraints on both you, your dependent and your dentist.

 

EOB – A statement issued by your insurer showing what the dentist billed for each procedure and how much the insurer paid. Oftentimes, the statement will contain additional information with respect to why a particular procedure was not covered, the remaining balance of your yearly allowable maximum and perhaps some information pertaining to frequencies.

When making an inquiry to your insurer, you would ask: “How will I receive an accounting of what my dentist billed and what you, the insurer pays – Email? Online? Mail?

 

Other Consideration….

Alternative  Provision: When it comes to dental treatment, your dentist will usually make recommendations based on your individual circumstances. You may be fortunate enough to have several different options available to you. When it comes to options, however, each option generally comes with their own set of advantages/disadvantages in terms of cost, material, long-term prognosis (outcome), stability, patient comfort and compliance, success, limitations, etc.  When it comes to your insurer providing payment for any particular treatment, you are limited to the terms of your policy.

Alternative  Provision 1: Your insurer may agree to pay for your treatment, but only if your choose a less costly option or another treatment option of their choosing. The least expensive alternative is not always the best treatment option for you. For example: Your dentist may suggest a crown for a tooth that has been heavily restored and your insurer may only pay for the tooth to be repaired using pins and filling material. What happens when that tooth breaks sooner than later because the filling did not provide the necessary coverage/support/strength? What happens if the break extends down into the root and the tooth has to be removed?

Alternative Provision 2: Your insurer may agree to pay for your treatment, but will only pay out at the price of a less costly option or another treatment option. For example: Your dentist may suggest an implant in the area of a missing tooth. Your plan may provide benefits for a less expensive option, but agrees to pay for your implant, but only up to the price they would have paid for the less costly option.

It’s great to have dental coverage until you find out that your plan does not cover your individual needs – needs that become more complicated with due to age, neglect accidents, disease or wear. Remember, your dentist treats you not your dental plan.

 

Pre-existing Conditions – There may be a clause in your policy that restricts benefits if your particular condition already existed before you had your current dental plan. One such common condition is the “Missing Tooth.”  If your dentist recommends that that you replace a missing tooth/teeth with a bridge, implant or denture, but this tooth was removed before you were insured under your dental plan, your insurer may not pay any money towards restoring your condition back to ideal dental function. Likewise, for treatment of gum disease if they can prove that the condition of your gums and supporting structures of the periodontium were already compromised before your plan came into effect.

 

Whew!

This is a lot of information to take in.

In dentistry, we work with many, many different types of dental plans – all with various limitations and rules. Although a dental office may become familiar with a certain number of dental plans in their particular area or community, it is not practical to expect dental staff to be fully knowledgeable of all the individual plans available.

Your dental coverage is usually part of an overall benefits package offered by your employer and is designed to help employees offset their healthcare expenses. It is generally not based on your dental care needs – needs that are necessary to keep your smile happy and healthy!

 

Help Us to Help You!

Prevention is the number #1 way to keep dental costs down!

Prevent dental disease by practicing good oral hygiene and nutrition.

– Brush and floss daily
– Limit sugary drinks and snacks
– Don’t smoke or use tobacco/marijuana products
– See your dentist at least once a year for a thorough examination and cleaning.
– Except for water, space your food intake to 4-5 hours apart to allow saliva to repair damage from acid attacks. – – If you must snack, choose raw, crunch vegetable or fruit.

Prevent  insurance complications for your dental office by informing them of any policy or personal life changes that could alter your coverage such as: changes to employment status changes (as in the case of a temporary layoff), a child in post secondary school or a change in marital status.

Prevent small issues from becoming bigger problems by maintaining regular recare visits and attending to dental issues when they are small and under control. This will go a long way in reducing the likelihood of unexpected emergencies and their associated costs in terms of pain, dental fees and future restorative care.

Prevent dental cost surprises by understanding the ins and outs of your dental plan including what’s covered, limitations and what you are expected to pay before having treatment done.

Prevent future worries by taking the time now to consider future dental costs when planning for your overall healthcare needs in retirement.

Prevent disappointment by taking the time now to discuss treatment options and expectations with your dentist. This includes asking about any risks, future maintenance, long-term prognoses, as well as the consequences of delaying or opting out of treatment.

Prevent any miscommunications by practicing good dialogue techniques with your provider, including the insurance company. Practice active listening, repeat back what you understand and ask for clarification when necessary, be open about your concerns including financial considerations, voice any objections immediately, know what your portion of the bill will be etc…

 

Understanding dental insurance is crucial to making smart decisions about your dental plan’s features. Now that you have a solid grounding in the basics of dental insurance, you’ll be better prepared to understsnd you own plan’s features and help you and your family get the dental care you need!

Who’s taking care of Your Smile?

 

 

 

Yours in Better Dental Health,
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com

 


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Medications and YOUR SMILE

Are Medications Ruining YOUR SMILE?

We are seeing a growing number of patients that are experiencing dryness of their mouths and a number of dental issues associated with this dryness.

In fact, some dryness of the mouth can be so severe that it is not just uncomfortable, it becomes very painful. Additionally, there are times when the throat is so parched, that a person can’t even swallow.

The Importance of Saliva

You may not have given much thought about saliva, other than the fact that the mouth is moistened by it, but the production of saliva is an important process in the mouth. It not only moistens, but it helps control the levels of  bacteria and fungi in our mouths, aids in chewing, tasting and digestion, cleans, protects and remineralizes teeth, and neutralizes our mouth after acid attacks.

Naturally, when a patient complains about a decrease in the quality and quantity of their saliva, we become concerned.

The condition of persistent dry mouth is called Xerostomia and it is a common side effect of many of the prescription and non-prescription medications we may be taking as well as a manifestation of certain diseases such as Aids, anemia, stroke, hypertension, cystic fibrosis, arthritis, Parkinson’s disease, cancer, diabetes and a condition called Sjogren’s syndrome.

Your saliva output can also be damaged by medical treatments such as radiation and chemotherapy, smoking/tobacco products, menopause and dehydration from illnesses, bulimia, excessive sweating, diarrhea, blood loss and burns.

Because our bodies are about 60% water, even a small drop in hydration can affect us immediately, let alone long term. There are over 500 medications that list dry mouth as a possible side effect.

Check out the Colgate Oral Care webpage where the classes of prescription drugs that affect the salivary glands are listed.

 

 

 

If you suspect that you are experiencing dry mouth, speak to your family physician and even your pharmacist as soon as possible. They can, hopefully, find a solution that is right for you.

As dentists, we can recommend that you:

  • Restore any dental issues that have arisen due to dry mouth.
  • Ensure that you are brushing at least 3 times/day and flossing before bed.
  • Limiting your meals to 3-4/day and spacing them out 4-5 hours apart
  • Reduce the amount of sugar you intake
  • Ask your doctor to suggest the vitamins supplements that are right just for you
  • Choose a product from your local pharmacy for help with dry mouth. This includes, sprays, rinses and special toothpastes. You may have to try a few until you find one that works best for you.
  • Chew sugar-less gum or suck on sugar-free lozenges
  • Drink more water
  • Using a humidifier in your bedroom at night
  • Use a fluoride rinse at bedtime
  • If you use a mouth rinse choose an alcohol/peroxide-free product
  • Avoid weather and activity that causes excessive sweating
  • Use a nasal spray if you are experiencing sinusitis
  • Avoid tobacco, alcohol, caffeine, carbonated beverages and highly acidic juices
  • Avoid dry food such as crackers and toast
  • Avoid very salty foods

Unfortunately, if dryness of the mouth persists and is left unchecked, it can lead to tooth decay, mouth sores and gum problems. If you would like more information about dry mouth, please follow the link below:

 

 

 

Yours in Better Dental Health,
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com


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Defend Your Smile!

Behind Your Smile…

 

 

This is the time of year that we start to think of winter sports and the one piece of equipment that we want our patients to include in their purchases – mouth guards!

Most sports related activity carry some element of risk for injury. The more contact involved in the activity the higher the risk. We’ve certainly seen our share of orofacial and dental trauma over the years. With many sports now mandating the use of mouth guards for dental protection during participation we hope to see a decline in the area of sports dentistry.

 

 

Reduce Your Risks

Your Smile is precious, and in some cases, an expensive investment in orthodontia or cosmetic dentistry has been made to obtain your great smile. Wearing a mouth guard while participating in any activity that carries a significant risk for injury extends this investment and is the best way to protect Your Smile.

 


Accidents ~ they’re unpredictable, so be prepared!


Prevention

Wearing a mouth guard can prevent serious injuries such as:

  • concussions
  • cerebral hemorrhages
  • unconsciousness
  • broken teeth
  • jaw fractures
  • neck injuries
  • lacerations and bruising or inner mouth, lips and cheek tissues

 

Customize Your Protection!

Your Smile is unique! We advocate the use of mouth guards – even it’s an off-the-shelf one from a store. However, having your dentist make a custom mouth guard offers you added protection and the benefit of a more customized fit since they are constructed from a durable, vinyl material consisting  two strong layers. This not only ensures that your guard will last longer, but will also fit snugly and comfortably especially when it matters most – during impact!

Mouth Guard Care

If you think of your dental sports guard as a “petri dish full of germs” you will better understand why cleaning your mouth guard after use is an important step in caring for the guard and your smile. To read more about how your can protect yourself from germs and the wear and tear of wearing a guard, read more about it in our blog called: Sports Guard Care

 

 

Defend Your Smile!

Dental reconstruction and emergency dental treatment can be costly in terms of dental fees, your future dental health and time. Dr. Axelrod and the team at Your Smile Dental Care can make mouth guards for you and your family ensuring that your activities are safer for your smile.  Make sure that they are a part your essential sports equipment!

 

Yours in Better Dental Health,
The Your Smile Dental Care Team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com