13:07 PM

Prevention-Focused Dental Benefits

“An apple a day keeps the doctor away” is an appropriate reminder that the apple (nature’s toothbrush!) helps reduce gum disease, which can complicate conditions such as pregnancy, heart disease, diabetes and stroke. Another common refrain? “An ounce of prevention equals a pound of cure.” For oral health, preventing tooth decay and gum disease can save hundreds or thousands of dollars in restorative care. Together, these adages underscore the significant impact preventive dental care can have for people and the entire health system. 

Preventive dental care benefits are essential to identifying and repairing or arresting tooth decay and gum disease. These services include diagnostics such as x-rays and exams, as well as cleanings, fluoride treatment and sealants.  

One of the key tenets of Preventistry, our revolutionary approach to improving the oral health of all, is designing dental plans that provide easy access to affordable diagnostic and preventive dental care. All DentaQuest members – including Medicaid, Medicare, commercial, group and individual – have a common need for (and benefit from) preventive dental care.  

Our plans are designed with limited or no financial barriers to diagnostic and preventive services. 

  • There are no waiting periods; members can receive services right away. 

  • Deductibles do not apply to oral exams, cleanings and certain x-rays for adults or children. 

  • Children receive fluoride and sealants at no cost. 

  • There are typically no out-of-pocket costs to the member for these services.  

So what’s next for prevention-focused dental plan design? The DentaQuest Partnership for Oral Health Advancement, with other DentaQuest teams and external partners, is investigating how plan design can increase access for those most vulnerable, in particular the aging population.  

As we age, the more likely we are to lose dental benefits that may have been provided by an employer. Older Americans also face nutritional challenges and may struggle with self-care for a variety of other reasons from physical to mental.  

To get ahead of serious oral health conditions that exacerbate common medical conditions, DentaQuest is working on plan design for a public dental benefit – in particular as part of Medicare. Stay tuned for more on the subject and check out a recent Health Affairs blog post co-authored by DentaQuest’s Dr. Mike Monopoli called, “Medicare Dental Benefit Will Improve Health and Reduce Health Care Costs.”