Is dental insurance a scam?


Of course it isn't a scam, but it isn't doesn't really follow the model of most other types of insurance. Most of us buy insurance to cover us in case of a catastrophic loss or event. If something bad happens and we would incur a large personal expenditure  that would be difficult or impossible fund out of personal savings.

Although dental insurance can be a big help it doesn't come close to covering a high percentage of the cost of complicated dental treatments  that can cost from 5,000 to in excess of $50,000. Most dental plans have a yearly outlay of between $1,000-$3,000. For implant and crown and bridge procedures, most plans commonly allow only 50% reimbursement up to their yearly maximum.


There is no insurance that comes close to fully covering extensive dentistry performed over the course of one calendar year and there really are no "pro-bono" dentists, since providing dentistry is expensive . Nationally dental overheads run in the range of 60-70% and finding a dentist willing to provide lenghtly and expensive dentistry for a vastly reduced fee is an unlikely scenario.

This can lead to considerable hostility towards the dental profession from many people who are living paycheck to paycheck and have the expectation that their dental insurance will cover most of their yearly dental expenditures. Some people, as witnessed some  on online forums, seem to blame "rich" greedy dentists who want to enrich themselves at peoples expense. It's human nature to want to find one group to blame, but dental health care and it's high expense, is not solely the repressibility of the dental profession. Tuition at dental schools is high and so is  the cost of building and equipping a modern dental office.  Salaries and rent also  contribute to a large part of the cost of healthcare.

The public at large has reasonably high expectations and many middle class people would never consider removable dentures as an acceptable option for their mouths even though it is usually the most affordable tooth replacement option. At the same time most are taken aback  by the cost of full arch implant supported restoration that can approach the cost of one of the larger luxury sedans.

The best solution is to take good care of your teeth from childhood until old age,  to help ensure that extensive treatment won't be needed later in life. This implies that a person should watch their diet, spend adequate time cleaning their teeth twice a day, and visit their dentist regularly.

As a practicing dentist for over three decades I hear a lot of excuses for missed or delayed recare appointments and often lack of dental insurance is an excuse used for delaying dentistry, but this represents faulty logic, especially for people of limited means, who may not be able to afford extensive restorative dental procedures in the event that they lose any teeth. Keeping teeth healthy is much less costly than replacing them after they are lost.

If a person can not afford twice yearly visits, than a yearly recare schedule is much better than no visit to the dentist. Procrastinating care can definitely lead to worse dental outcomes and much a much larger expenditure than a simple check up, x-rays and a cleaning once per year.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/09/is-dental-insurance-scam.html - http://lspindelnycdds.blogspot.com/

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