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Does Dental Insurance Cover Night Guards

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Oral-B Nighttime Dental Guard- Review & Comparison

Unless you visit a professional who can diagnose you with bruxism, it is hard to know if the headaches, tooth sensitivity, or TMJ are due to teeth grinding and clenching in your sleep. Besides, dentists recommend a custom-made nightguard, and there is no way to get that without an oral hygiene specialists help.

Klement Family Dental offers a wide range of dental services, including general, restorative, orthodontics, and cosmetic, among many more. Our team will advise you on whether you need a nightguard and treat any dental issues you may have at a fair cost.Contact us today to schedule your appointment.

Q: Will Insurance Cover Any Other Things Associated With Bruxism

Technically, if you already have insurance and you start clenching or grinding, your dental insurance may cover damage caused by the action as it would not be a pre-existing condition. You can additionally look into other causes of bruxism, in addition to misaligned teeth. For instance, stress is a common cause of bruxism and you may be able to see your medical doctor who can help you with anxiety and stress coping, even prescribing medications if it is severe. When you take care of the cause of bruxism, you can take care of the bruxing action.

Your Options When Night Guard Is Not Covered By Your Insurance

Finding out your insurance doesnt cover night guards is a major bummer. Your teeth are literally aching for relief, but the number that your dentist quoted you to pay for a night guard out of pocket is astronomical. If this is your situation, you have two major options that wont cost you an arm and a leg: over-the-counter mouth guards and custom-fit night guards.

Over-the-counter Mouth Guards

This first option is probably very tempting because you can walk into your local drugstore or pop on Amazon and quickly have a night guard for a fraction of the price your dentist quoted. Unfortunately, while cheap and convenient, this option is not ideal.

Over-the-counter night guards claim to be one size fits all, but that just doesn’t hold true in reality. Some over-the-counter night guards use the boil and bite technique to attempt to mold the guard to your mouth, but youre just not going to get that perfect fit that youll get with a custom night guard.

If youve ever had to use a boil and bite mouth guard for a sport, youll remember how they tend to move around or fall out because its just impossible to get that perfect fit with a product that is designed to accommodate every mouth.

Custom-fit Night Guards

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Does Insurance Cover Botox For Tmj And Bruxism

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If the question, Does insurance cover Botox for TMJ and bruxism? has crossed your mind as you nurse the painful symptoms of TMJ and bruxism, youre not alone.

Botox can be a very effective treatment for TMJ and bruxism, as many people who have the procedure report minimal side effects and significant relief from their TMJ or bruxism.

However, repeated Botox treatments arent cheap. Though Botox is typically billed to medical insurance, many insurance companies do not coverBotox treatments for TMJ and bruxism.

Why A Night Guard For Teeth Grinding Isnt Always A Good Idea

Will Dental Insurance Cover My Night Guard?

This is why many dentists are still prescribing night guards for bruxism without screening for sleep apnea. Does this mean that a night guard is never the right

Oct 30, 2020 Some dental health insurance plans cover a part or the entire cost of custom-fitted mouthguards obtained through dental professionals.

Dec 11, 2013 After all, night guards are not the most sexy thing in the world. Also, in many case, dental insurance covers all or part of the cost.

Options PPO 30/covered dental services that the above provides only a brief, general description of coverage and does not constitute a contract.

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Does Dental Insurance Cover Teeth Grinding

We receive many inquiries from people dealing with grinding teeth. They want to know if their dental insurance covers teeth grinding. The answer is: sometimes. It really depends on your plan. Some plans cover it and other plans do not. If you are unsure, it is best to check your outline of coverage or call your plan to find out.

If your insurance does cover teeth grinding, the coverage is likely a major service. This means your cost sharing is typically higher than compared to teeth cleaning or a filling. This is why we recommend always using an in-network dentist when it comes to dental insurance. If your dentist does not accept insurance, we have options, too.

Additionally, major services usually have a 12-month waiting period. This waiting period is very common with dental insurance carriers. What does this mean? As we wrote before, if you want to receive an immediate benefit from your dental insurance for teeth grinding, you should purchase the policy 12-months in advance, long before you think you will need it.

Dental Appliances For Obstructive Sleep Apnea

Before getting too far ahead, its important to understand that in most cases, health insurance companies are not going to cover an appliance that is used for the sole purpose of controlling snoring.

That being said, most health insurance companies will cover a portion or in some cases all of the cost of an oral appliance if it has been determined to be a medical necessity. Appliances that are custom made by the dentist for the purpose of controlling obstructive sleep apnea are considered a medical necessity and are often covered by private insurance as well as Medicare, Medicaid, and obamacare when certain conditions are met.

Which insurance is responsible for covering this expense? Despite the fact that these devices fit inside of the mouth, they are covered under your health insurance, not dental insurance because they are used to treat a medical condition such as sleep apnea.

Unfortunately, with so many insurance companies out there, its impossible to make a blanket statement concerning all insurance coverage. Since the insurance companies do not publish the amount that they will cover, not even your doctor can give you an exact out of pocket amount until several weeks after getting the insurance process rolling.

How about a rough estimate?

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Services Covered By Insurance:

  • Crowns & Bridges: Dental crowns and bridges are restorative treatments that affect the patientâs oral health. So, most insurance companies will fully cover the cost of the dental crown treatment and cover major portions of the dental bridge treatment.

  • Root Canal: The cost of root canal treatment will depend on the extent of the infection. Most insurance companies will cover at least part of the cost of root canal therapy.

  • Dentures: Major insurance companies will cover the partial or full cost of the treatment, depending on your plan. Usually, insurance will cover up to 50% of the cost of dentures.

  • Fillings: The full or the partial cost of cavity fillings may be covered by insurance, depending on your plan.

  • Mouth guards: Mouth guards are a preventative measure. So most dental insurances will cover the full or partial cost of customized mouth guards made by dental professionals.

  • Night guards: Night Guards are often covered by most insurance plans due to their preventative nature.â
  • Mandibular Advancement Devices: Some dental insurances may cover the full or partial cost of mandibular advancement devices for sleep apnea treatment, depending on your insurance plan.
  • Reveal Clear Aligners: Some insurance companies may cover part of the cost of Reveal Clear Aligners, depending on your insurance plan.

What Dental Procedures Are Covered By Medical Insurance

Does the chomper custom night guard hard plastic splint upper cover the front teeth?

So what dental care will medical insurance cover? What is secondary dental insurance and do I need it? If youre in a car accident and you hit your face on the steering wheel and knock out several teeth medical insurance might pay for some of that treatment but you would need to have a dental insurance plan that covers implants to have insurance pay for the cost of replacing the lost teeth. Medical insurance may also pay for some devices that help your teeth but also have medical value like mouth guards, sleep apnea appliances, TMJ appliances, or biopsies¹. Secondary dental insurance is additional insurance that help cover things like emergencies and fill in the gaps in your existing coverage. Medical insurance also might cover the cost of treatment for accidents that cause serious damage to your mouth or X-rays that are needed to see what damage an accident has caused².

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Differences Between Sports Guards And Night Guards

Its not uncommon for patients to confuse sports guards with night guards. While both of these oral appliances protect your teeth, they do so in different ways. A sports guard or mouth guard protects your smile while playing contact sports. A night guard stops you from grinding or clenching teeth while you sleep.

Since both contact sports and grinding your teeth put you at high risk for tooth fractures and other oral health issues, youll want to talk to our Wyoming dentist at River Ridge Dentistry about getting a teeth guard that works for you.

Custom Fitted Athletic Mouth Guards

Unlike a bite splint, athletic guards are made to prevent injury to the teeth and certain facial structures While most people wear mouth guards to prevent injuries like chipped and knocked-out teeth, certain types of professional mouth guards can also be used to protect athletes against concussions.

A custom fitted mouth guard is molded precisely to your teeth, sitting snuggly over them at all times. The smoother contour makes it easier to talk and hydrate with it in place. If any type of blunt force injury occurs, the guard helps to limit the blow to the teeth and jaw.

Mouth guards that offer this level of protection can only be made by seeing a dentist and having an impression made of your mouth. If youre ordering one for a child, it will need to be replaced each season as teeth erupt and oral development changes. Otherwise, older teens and adults can continue to use the same mouth guard each year unless something significant changes with their smile

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So Why Do They Cost So Much

Mouthguards vary in price and style. A one size fits all mouthguards can be purchased over the counter at a pharmacy for $20, but might not be as comfortable as a custom fit guard. Your dentist may justify the cost if you bruxism is caused by sleep apnea or malocclusion that requires a more complex mouthguard. Conventional night guards that are custom fit to the individuals mouth provide added comfort and protection. However, this usually requires multiple dentists visits and impressions that need to be sent to a lab which can drive up the cost.

Like the informed consumer you are, knowing all of the options could save you money in the long run. We want to show you all the advantages and disadvantages of getting a mouthguard from your dentist.

How Are Sleep Apnea And Teeth Grinding Related

Does Cigna Dental Insurance Cover Night Guards

At night, when you cant breathe, the body will automatically attempt to reopen the airway through a reflex mechanism. One of the ways that the body can do this is through grinding or clenching the teeth. This action will tend to bring the lower jaw forward and open up the airway. The grinding motion also moves the jaw from side to side, helping to create airway space.

The scientific evidence that bruxism can be a symptom of sleep apnea has come from studies that were relatively recent, and not all dentists are aware of this information yet. This is why many dentists are still prescribing night guards for bruxism without screening for sleep apnea.

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What Is The Best Mouth Guard To Protect Your Teeth

Wearing a mouth guard is often a requirement for athletes involved in extracurricular, high school, or collegiate activities. But even if its not a rule that you wear one, investing in a protective mouth guard could be the most important piece of insurance to have on you or your child, while in the game.

For individuals that arent involved with sports but tend to grind, clench, or have invested in cosmetic veneers other types of mouth guards can safeguard their smile and prevent damage to their aesthetic enhancements.

Depending on your needs, dental health, and activities, there are different designs of mouth guards that can be worn. Selecting the best one for your smile will ensure you get the most protection.

Dental Night Guard Insurance Codes

What Are the Night Guard Dental Insurance Codes

When you’re shopping for a new custom night guard, it’s natural to turn to your dental insurance provider for help to cover the cost.

In 2019, the ADA altered its Current Dental Terminology Code to offer three codes for various dental mouth guards associated with Bruxism and TMJ. The ADA states that the “purpose of the CDT Code is to achieve uniformity, consistency, and specificity in accurately documenting dental treatment.”

Ensuring that you use the correct dental code when submitting your claim for your nightguard can help you get the coverage and reimbursement you need.

The New ADA CDT Codes for Night Guards

  • D9944 occlusal guard – hard appliance, full arch
  • D9945 occlusal guard – soft appliance, full arch
  • D9946 occlusal guard – hard appliance, partial arch

Okay, but what does any of that actually mean?

Occlusion is the fancy word for how your teeth come together, so an occlusal guard prevents your top and bottom row of teeth from touching. The appliance referenced is the guard itself. The arch doesn’t mean the arch of your mouth but whether your guard reaches to your back molars.

A hard night guard covering all of your teeth on the top or bottom row would be classified as a hard appliance, full arch. In this case, you would use code D9944 on your insurance claim.

Do I Even Need a Night Guard?

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What Are Night Guards

Night guards/bite splints/or bruxism mouthguards are protective appliances you wear over your teeth to protect them. A night guard is made for sleeping, where a bite splint or other type of mouthguard is usually reserved for daytime wear.

A professionally fitted night guard is generally crafted out of a highly durable layer of acrylic that prevents tooth-on-tooth wear. Usually you only need one instead of a set to fit both arches of teeth.

Most night guards cover the entire arch of teeth from one side to the other, instead of just a few teeth at a time. But there are types of splints out there that only go over your front teeth. With a night guard, you want one thats secure enough that it will stay in place while youre sleeping, wont slip out of place and is durable enough that youre not going to chew right through it.

What Does The Road To Recovery Look Like

Best Dental Mouth Night Guard – NTI Nightguard – NYC Dentist

Depending on your individual case, and how diligently you wear your mouth guard, impacts how long you need to wear one. You might find after wearing your mouth or night guard for a while that it does not inconvenience you to wear one, and there is no downside to wearing one for life. Alternatively, you might feel like it is something you simply put up with. If that is the case, you might not need to wear your mouth guard forever. The damage to your mouth will be stopped by the mouth guard, giving your mouth time to heal. You will find that the bad habits of grinding or clenching your teeth will be unlearned at a certain point.

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How Do I Care For A Mouthguard

Mouthguards pick up bacteria from your mouth. Be sure to clean the teeth very well before putting a mouthguard in. To clean your mouthguard:

  • Dont expose the mouthguard to extreme heat, such as direct sunlight or hot water. Heat can cause it to warp and change shape.
  • Keep the mouthguard in a sturdy, vented plastic case when not in use or when traveling to sports and activities.
  • Rinse your mouthguard in cool water and use a brush and soapy water to clean it after each use. Let it air dry.
  • Store the mouthguard out of reach of dogs and other pets.

Why Do Night Guards From The Dentist Cost So Much

So you just had a visit with your dentist about suspected bruxism and to no surprise he recommended a night guard. With a hefty price tag of up to $800, your jaw might just be hurting from the financial shock. But not to worry because there are ways to get you into a comfortable night guard that wont break the bank.

There is no doubt that you need a mouthguard to protect your teeth from the grinding forces. Untreated bruxism can lead to tooth wear/loss, fractured tooth cusps and broken fillings, poor sleep quality and many other symptoms.

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How Long Do Mouthguards Last

Depending on how frequently you use your mouthguard and how much wear and tear it takes, a custom-fitted mouthguards can last several years with proper care. However, some people may find they need a mouthguard replaced more often than that. You should bring the mouthguard to your dental checkups so your dentist can inspect it for cracks or other signs of wear.

Over-the-counter mouthguards arent as durable. You may need to replace them every few months. Children and teens may need to replace mouthguards more often as their teeth and mouth grow.

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