Cosmetic dentistry works to improve the appearance of your teeth and gums. However, most of its treatments are elective dental care that insurance companies do not cover. Your insurance provider will provide partial coverage when a cosmetic procedure is medically necessary. You want to review your insurance plan and consult your dentist when exploring options to manage costs effectively. This article examines the cosmetic procedures for which insurance plans might provide coverage.

Dental Implants

Missing teeth can affect more than smile aesthetics; they could reduce your ability to chew and speak properly and interfere with your dental health maintenance. Dental implants are a permanent dental solution that replaces missing teeth with artificial ones that function as natural teeth would. The surgical placement of dental implants into the jawbone creates a stable foundation that provides long-lasting durability.

Patients avoid pursuing implant procedures because they worry about the cost and want to know if insurance plans will assist with payment. The answer? It depends. Most insurance providers treat dental implants as cosmetic, but specific policies partially cover medically essential implant procedures. Your insurer can cover your dental implant procedure when oral functional disorders arise from congenital disabilities, traumatic dental injuries, or severe diseases that could lead to tooth loss.

Your insurance provider may cover the following:

  • The initial consultation and diagnostic imaging (X-rays, CT scans).
  • Tooth extractions of the damaged tooth if it must be removed before implant placement.
  • Bone grafting treatment to restore bone density when implant support requires reinforcement.
  • The final restoration includes crowns, bridges, or dentures placed on implant surfaces.

However, patients must cover the expenses for implant posts and surgical procedures; insurance plans do not cover these parts of the treatment. Before starting treatment, you should confirm your insurance coverage with your provider.

Types of Dental Implants

Dental implants are not a one-size-fits-all solution. Your dentist will suggest a particular implant based on your dental requirements, bone structure, and general oral health status. There are three main dental implant options; they include:

  • Endosteal Implants

Endosteal implants are the most frequently used implant design, and they work best for people with strong and dense jawbones. The surgical process involves doctors inserting titanium posts into jawbone tissue, which functions as synthetic tooth roots. The titanium implant integrates with bone tissue during osseointegration to create a stable dental crown, bridge, or denture base.

A bone grafting procedure should precede endosteal implant placement when your bone mass is inadequate. These implants have become the standard for long-term tooth replacement due to their durability and authentic feel.

  • Subperiosteal Implants

Patients with insufficient bone for endosteal implants yet unwilling to undergo bone grafting can use subperiosteal implants as a viable treatment option. These implants are not embedded within the jawbone but on the bone underneath the gum tissue. The implant receives its support from a metal framework, which enables the gums to heal and lock it into position.

  • Zygomatic Implants

The zygomatic implant is the rarest and most complex implant type because it is designed for patients with substantial upper jaw bone deterioration. Zygomatic implants are fixed into the cheekbone, known as the zygoma, to create a powerful base for artificial teeth.

Dental Fillings

Cavities are among the most prevalent dental conditions, affecting millions annually. When cavities go untreated, they can cause severe pain and infection, eventually destroying your tooth. Dental fillings repair decayed teeth and protect them from additional harm.

The dental filling starts with removing and replacing decayed tooth material with a durable substance that enhances tooth structure. The procedure is quick and minimally invasive. Dental insurance plans cover the cost of dental fillings if they are considered medically necessary to preserve your tooth.

Insurance plans can pay for filling expenses entirely or partially based on the filling material selection. Dental plans provide full coverage for silver amalgam fillings, yet they pay only a portion of tooth-colored restorations.

Types Of Dental Fillings

Dentists provide several dental filling choices that have different benefits and limitations. Your decision about dental fillings depends on the cost, durability, appearance, and insurance coverage.

  • Amalgam Fillings

Amalgam fillings are used extensively because they are affordable and durable. The dental filling is made up of silver, mercury, tin, and copper. It is durable even under heavy chewing pressure; it is used to fill molars and other back teeth. However, patients often prefer tooth-colored options instead of amalgam fillings. Insurance plans fully cover amalgam fillings and are a cost-effective option.

  • Composite Fillings

Composite fillings are made of plastic materials mixed with glass components to create tooth-like restorations. These dental fillings resemble natural tooth color, so people use them to restore front teeth that need fillings.

These materials bond directly to tooth structures, enhancing their supportive properties. They lack the longevity of amalgam fillings because they tend to break down more quickly in areas where heavy chewing occurs. Many insurance plans cover composite fillings up to the cost of an amalgam filling, meaning you may need to pay the difference.

  • Metal Fillings

Gold and silver amalgam are used as primary materials for metal fillings. Gold amalgams are more durable, lasting up to 20 years; however, they cost up to ten times as much as silver amalgams. Silver amalgam is more affordable and just as strong but lacks the aesthetic appeal of tooth-colored options. Insurance plans cover silver amalgam fillings, but they do not cover or only partially cover expensive gold fillings.

  • Ceramic Fillings

The porcelain material used for ceramic fillings makes them attractive and durable. They are stain-resistant and blend naturally with tooth color, making ceramic fillings an outstanding option for discreet permanent tooth restoration. Ceramic fillings are more expensive than amalgam and composite fillings. Insurance policies often restrict coverage to only a portion of the total cost.

  • Glass Ionomer Fillings

Glass ionomer fillings consist of acrylic and glass components that release fluoride to protect teeth from decay. They are used to fill children’s teeth, non-weight-bearing teeth, and root cavities. Glass ionomer fillings provide preventive benefits but need more frequent replacement than other filling materials because their durability is lower. The insurance system provides coverage for these fillings.

Dental Bonding

Dental bonding provides patients with an economical and fast cosmetic solution to fix minor imperfections in their teeth. They fix chipped teeth, cracks, discoloration, and slight tooth misalignment. Dental bonding involves applying tooth-colored composite resin to the affected tooth, followed by natural shaping before using a special curing light to set it.

The treatment process for dental bonding keeps the natural tooth enamel intact because it only needs minimal or no enamel removal for the procedure. Patients can expect their dental bonding treatment to last 30 to 60 minutes per tooth, while the results will stay between 3 and 10 years with appropriate tooth maintenance.

Insurance companies usually provide partial or complete coverage for dental bonding procedures. Your dental insurance will support dental bonding procedures only if they serve restorative purposes, such as fixing a damaged or decayed tooth, rather than cosmetic ones. The insurance policy excludes coverage for dental bonding procedures that serve solely cosmetic needs, such as gap closure or tooth whitening.

Dental Crowns

A dental crown is a tooth-shaped cap that dentists use to cover damaged teeth, strengthening and preserving their functionality and natural appearance. A dental crown is used for teeth that are too damaged for fillings or bonding but do not require extraction. The dental crown shields teeth from decay, fractures, and wear while preserving their natural appearance.

Dental crowns are made of four main material types: porcelain, ceramic, metal, and composite resin. The aesthetics, durability, and insurance reimbursement rules influence your selection of materials.

Dental crown insurance coverage depends on the underlying reason for the procedure. If they are used to restore decayed or fractured teeth, it covers 50% and 80% of the total expense, depending on the specific insurance plan. Insurance policies exclude coverage when crowns are used solely to make discolored teeth appear better.

Most insurance plans include coverage for crowns because this treatment serves restorative purposes. Review your policy with your dentist to understand the specific coverage amounts and learn about any costs that will be your responsibility.

Root Canals

A root canal is a dental procedure to maintain a damaged tooth after severe infection or decay. A root canal is performed when the pulp tissue inside a tooth develops inflammation or infection, requiring the removal of damaged tissue, tooth cleaning, and sealing to stop further infection. If a root canal procedure does not occur, the tooth will continue to decay, resulting in extreme pain before you have to extract that tooth.

Insurance companies generally provide coverage for root canal treatments. A root canal receives coverage from dental insurance because it is a medically required intervention. Your insurance policy could reimburse up to 50% and 80% of the costs unless you exceed your yearly coverage limit.

Additional treatments like dental crowns will need separate coverage consideration due to their distinct policy restrictions.

Dental Veneers

Dental veneers are a set of thin, customized shells that bond against tooth surfaces to enhance their color, shape, alignment, and size. They help address various cosmetic dental issues, including staining, chipping, gap teeth, alignment concerns, and tooth wear, for a durable, natural result.

Types of Dental Veneers

  • Porcelain Veneers

These are high-quality ceramics. They are durable and resistant to stains and maintain natural tooth translucency. The lifespan of veneers extends between 10 and 15 years when patients practice proper maintenance routines.

  • Composite Resin Veneers

They are made from a tooth-colored resin material that functions similarly to dental bonding. They are affordable; however, they can stain easily and need replacement between 5 and 7 years.

Insurance providers will cover part of the expense if veneers are required for restorative purposes, such as fixing a damaged or broken tooth. Insurance companies could exclude dental veneers from their coverage policies if they are used for aesthetic purposes only.

Regular Dental Checkups

Scheduling routine visits to the dentist is crucial for achieving the best oral health possible. People often fail to understand that the absence of dental pain and cosmetic issues does not mean they should avoid going to the dentist. Preventive dental care is an essential method that prevents severe dental problems that would need expensive and complicated treatments in the future.

Under most dental insurance plans, preventive dental services receive full coverage for checkups and cleanings. Some plans may also cover annual X-rays, fluoride treatments, and dental sealants for children. You should not miss going to the dentist.

Cosmetic Procedures Not Covered by Insurance

Most dental insurance plans will not cover cosmetic procedures meant to improve your smile; they only cover treatments that restore function or prevent dental problems. Teeth whitening, gum contouring, dental veneers, and teeth reshaping do not receive insurance coverage because insurers view them as elective procedures rather than essential dental treatments.

Orthodontic treatments such as braces or Invisalign receive partial coverage when they address functional problems, but patients need to pay for purely cosmetic tooth alignment procedures themselves.

Patients planning cosmetic procedures need to check their insurance policy details and also consult financial options from their dentist. Cosmetic dental treatments in many dental offices are affordable through payment plan options they provide to patients. Though insurance does not cover these treatments, investing in a confident smile leads to lasting oral health and self-esteem benefits.

How Dental Insurance Covers Work

Dental insurance can help you receive preventive, essential, and primary dental treatment coverage, which could lower your financial responsibility. Under standard insurance policies, patients receive 100% coverage for preventive care, while basic procedures like fillings and extractions receive 80% coverage, and primary treatments such as crowns and root canals have 50% coverage. You must review deductibles, annual maximums, and exclusions before treatment.

Find a Cosmetic Dentist Near Me

Knowing which procedures your insurance plan covers and its benefit limits lets you avoid unexpected costs when seeking cosmetic dental care. This is especially so since most cosmetic procedures receive limited insurance coverage.

You should inquire about payment options, including payment plans or financing from your dentist if your insurance does not cover all expenses. Several dental practices provide flexible payment options to help you handle costs during your treatment period.

Contact Washington Dental today at 310-217-1507 if you are in Carson, Los Angeles, Lomita, or Torrance. We will guide you through financial and treatment options while delivering exceptional care.