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Navigating the World of Dental Insurance Terminology

October 14th, 2015

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at Miller's Family Dentistry. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Dr. Ron Miller, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

  • If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

  • This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

  • Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Dr. Ron Miller or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Tracy, CA office.

Year-End Insurance Reminder

October 7th, 2015

Dr. Ron Miller, as well as our team at Miller's Family Dentistry, would like to give those patients with flex spend, health savings, or insurance benefits a friendly end of the year reminder that it’s high time to schedule your dental visits so you optimize your benefit.

Now is the time to reserve your appointment with us. Space is limited and we tend to get busy around the holidays, so don’t wait to give us a call at our convenient Tracy, CA office!

Five Common Reasons for Emergency Care Visits

September 30th, 2015

A dental emergency can strike anywhere, anytime, and without warning. Perhaps you’re playing a game of touch football on Thanksgiving and your brother-in-law decides to up the ante and tackles you, accidentally knocking out your two front teeth. Or maybe you’re on vacation somewhere in the tropics and decide to go deep-sea fishing, but when you’re climbing onto the boat you slip on the dock, fall, and chip three of your teeth. From misplaced fly balls to bagel seeds causing a painful bout of inflammation, there are all kinds of dental emergencies.

Here are the five most common reasons for emergency care visits.

  1. Somehow you've managed to knock out a tooth. Whether it's the result of a sports injury or because of decay, when you lose a tooth, you need emergency dental care. If the tooth is salvageable, then it can be reattached to the socket, but this needs to be done within a one- or two-hour window.
  2. A chipped tooth is the most common dental emergency. Small chips can be caused by food (chicken bones and nuts have sent many people to the dentist); however, it's usually some sort of accident or injury that more often causes a chip. While you might be embarrassed to walk around with a gaping chip in your front tooth, it is easily fixed with a bond, crown, or veneer.
  3. A broken tooth is more severe than a chipped tooth. When a tooth breaks, it might be due to a small or hidden chip. However, chances are the pain and discomfort will be more severe.
  4. It might seem comical, but getting a piece of food lodged in the wrong place can result in a dental emergency. If something gets stuck deep in a crevice, it can cause pain and inflammation.
  5. The loss of a filling happens more often than you think. When you lose a filling, you need to receive emergency care immediately. If you don’t, you risk further damage to your tooth.

When you injure your teeth or mouth, you need to seek emergency care as soon as possible. In the event of a suspected emergency, don't wait. Contact Dr. Ron Miller immediately.

Diet and Dental Health: What to eat and what to avoid

September 23rd, 2015

You are probably aware that guzzling soda and drinking those sugary Starbucks Frappuccinos aren’t particularly good for your dental health. But how much thought do you give to the effects of your diet on your teeth? Practicing healthy eating habits isn’t just helpful for your waistline, it also ensures that your teeth stay strong and cavity-free.

How diet affects dental health

Our team at Miller's Family Dentistry will tell you that your mouth is a complicated place on a microbiological level. Harmful bacteria form dental plaques which convert the sugars in food to acids that wear away at tooth enamel. Meanwhile, saliva washes away some of the detrimental acids, while minerals work to rebuild where teeth are damaged. The foods you eat are important for managing this balancing act between harmful bacteria and helpful rebuilding agents.

Rethinking your diet to prevent cavities

Carefully considering your dietary choices is a smart way to become mindful of the foods you eat and how they affect oral health.

Foods to eat

  • Calcium- and phosphorus-rich foods. We’ve all heard that milk builds strong bones, and your teeth are included in that. Milk, cheese, nuts, and chicken are strong sources of calcium and phosphorus. These minerals are used to repair damage to the teeth’s enamel.
  • Crunchy fruits and vegetables. Biting into an apple stimulates saliva flow, which washes harmful acids from the surface of your teeth. Turn to other crunchy fruits and vegetables, including carrots, celery, pears, and lettuce, to increase saliva production.
  • Sugar substitutes. If you have a sweet tooth but want to decrease tooth decay, sugar substitutes such as Stevia or Equal provide a sugary kick without harming your teeth.

Foods to avoid

  • Sugary snacks. Cookies, cakes, candies, and other sugary treats provide a feast for the acid-producing bacteria in your mouth. Furthermore, these foods often get stuck in the ridges of your teeth, and provide a breeding ground for new bacteria.
  • Acidic fruits and vegetables. Foods high in acidity, such as tomatoes, citrus fruits, berries, peaches, and lemons, wear away the enamel of your teeth. Because these foods can be part of a healthy diet, remember to brush after eating them or swish with a mouth rinse to protect your teeth.

Eating well is an essential part of keeping your teeth healthy. Consult Dr. Ron Miller about your diet for tips on food habits that keep your teeth strong and cavity-free. For more information about the link between your diet and your oral health, or to schedule an appointment with Dr. Ron Miller, please give us a call at our convenient Tracy, CA office!

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