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Can't ignore cosmetic dental.

The road to wellness could very well be paved with a healthy dose of vanity. Something that our society deems to be central to our self esteem is probably one of the biggest motivators to actually make dental appointments.

As recently as 2007, the American Academy of Cosmetic Dentistry, estimated that the specialization generated $2.75 billion in revenues. The average patient spent $5,640 to have work done on their smiles in 2006, and 3 percent of cosmetic practices in the United States reported average patient expenditures of $20,000 or more.

Typically, dentists won't perform cosmetic procedures without a careful examination of the mouth. There's no downplaying the importance of regular dental examinations. Recent studies have shown there is a link between oral health and overall health. Early detection via dental exams can help patients not only halt gum disease, but also detect cancer, diabetes and a host of other major illnesses.

Still, it should come as no surprise (especially right now) that there are those who believe procedures long deemed cosmetic--such as teeth whitening and dental implants--are best left to celebrities. At first glance, extending coverage to nonessential procedures seems likely to drive up costs for no good reason.

If you think it may seem easiest to push cosmetic dentistry outside the coverage tent altogether, consider this: In some cases, patients are so eager to whiten their teeth that they bypass the recommended steps and opt instead for home treatments or bleaching performed outside a dentist's office--sometimes in shopping malls or spas. The ADA has taken notice, with the organization now imploring the U.S. government to pay more attention to the regulation of teeth-whitening and set up classifications for chemicals used in the procedure.

Leading edge carriers with large dental networks have found ways to cover procedures such as whitening and implants without significantly lifting overall plan costs. There are also benefits to brokers, dentists, employees and employers. For one, teeth whitening is a relatively affordable and enormously popular procedure that can help a broker satisfy their clients with an innovative plan provision. Further, employees who already value dental as one of the most popular and widely used workplace perks can instantly reap the benefit of having a dental plan that will help them avoid bleaching strips or the self-certified teeth whitening "specialists."


In most cases, patients spend less time and effort undergoing procedures administered by a dentist rather than applying strips or other time consuming measures on their own. Steps prescribed by a dentist are not only more expedient, but also safer and more effective. The availability of insurance coverage also makes the procedure more affordable at the dentists' office and is consistent with the fact that the trained dental professional is a safer choice.

The insurance community has waged a similar debate about dental implants, another procedure that as recently as 10 years ago seemed purely elective and/or cosmetic. It has become clear over the past decade that implants are the way of the future. Yes, they are often more expensive than bridges and other procedures such as crowns. The benefits of implants, however, far outweigh the costs. They are sturdier than dentures or other replacements. They are long lasting and convenient for a patient to care for over time. And yes, implants are typically more appealing to the eye and actually make patients improve their oral hygiene. Over time, the insurance industry has come to understand why implants are an important part of mainstream dentistry and not a fringe treatment for the rich and famous.

We can continue to ignore popular trends and exclude cosmetic dentistry from our coverage, or we can look at cosmetic procedures and determine what procedures can cost-effectively contribute to better oral health and are worthy of adding to the employee benefits line-up.

Dr. Richard Goren is the second vice president, Group Dental, and National Dental Director for The Guardian Life Insurance Co. of America, New York, with responsibilities for PPO and DHMO network development and development of national DHMO plans, including the quality management program.
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Title Annotation:Dental Special Section
Author:Goren, Richard
Publication:Benefits Selling
Date:Mar 1, 2010
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