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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 Summit Pediatric 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. Stephen Korson, 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. Stephen Korson 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 Summit, NJ office.

Great question! Yes, in fact, tooth decay is preventable! Decay, which is caused by sugars left in your child’s mouth, can turn into an acid, which in turn can break down his or her teeth. Children are at high risk for tooth decay for a simple reason: many children and adolescents tend to be lax in their oral hygiene habits.

So, how can your child prevent tooth decay?

• Start early. After the age of two, brush your child’s teeth with fluoride toothpaste twice a day. And, if possible, clean between the teeth with dental floss at least once a day, preferably before they go to bed.
• Don’t allow your little ones to eat after cleaning teeth at bedtime, as salivary flow decreases while they sleep and their teeth become vulnerable to cavities.
• Do not allow your little ones to nibble food or sip drinks continuously, and keep in mind that a low-sugar diet also helps keep tooth decay at bay. Allow time between meals for saliva to neutralize acids and repair the teeth.
• Drinking water frequently throughout the day can also reduce the possibility of new cavities forming.
• Dental sealants can also protect your children’s teeth from cavities. Sealants, which are applied to the chewing surfaces of molars, act as a shield between the tooth and harmful bacteria.

Finally, make sure your child visits Summit Pediatric Dentistry approximately every six months for a checkup and routine cleaning! Please give us a call at our Summit, NJ office.

Concerned parents often ask Dr. Stephen Korson about which kinds of snacks are best for a child's teeth. While most know that candy isn't always the best choice, many parents are confused about which kinds of after-school snacks can actually be beneficial for teeth. Left to their own devices, children might pick the sugary snack that comes in colorful packaging. There are, however, choices that are much better for your child's teeth.

Go Natural

The foods that are best for your children's teeth are also the best for their overall health. Choosing whole foods, such as fruits and vegetables, is always the best option for snacks. Try sticks of celery and let your kids dip it into all-natural peanut butter, or a juicy and crunchy apple cut into wedges.

Lean Proteins

Lean protein, such as chicken breast, fish, turkey, and lean cuts of pork also make good snacking options. For the best overall health, avoid giving your child a lot of lunch meats, because such products are often higher in sodium. However, these proteins are also low in sugar, which is always a preferable choice when it comes to teeth.

Avoid Packaged Foods

Sugars are unhealthy partly because they stick more readily to the surface of the teeth. Even foods that appear to be healthy, such as many brands of granola bars, can in fact be loaded with hidden sugars. Sugar can also be found in higher concentrations in dried fruit, honey, and syrups. The rule is that if a foodstuff has been altered in any way from its original state then there are perhaps better choices.

Beverages

Drinks are another murky area. Parents often presume that fruit juices are an acceptable beverage when in reality many of them are loaded with excessive sugar as well. The best beverages for your child's teeth are water and low-fat milk. Milk has the added benefit of containing calcium, which is highly beneficial for the bone structure that supports the teeth.

An apple a day might keep the doctor away, but it is also a great snack to keep teeth healthy. The next time your children are looking for an after-school snack, guide them toward healthier, low-sugar options that are beneficial to their overall health and their teeth.

As a parent, you know how important a happy, relaxed atmosphere is when it comes to making your child feel at home. We would like to make our Summit, NJ practice your dental home, where you and your family enjoy the best of dental care in a warm and welcoming environment.

What makes a dental home?

• It’s Welcoming

From your child’s first visit, we strive to make you both feel at ease. Our office is designed to be a happy, entertaining, and relaxing place, and our staff is trained in making little ones feel calm and secure. We want to have a lasting relationship, and we want you and your child to feel welcomed back whenever you return.

• It’s Familiar

We recommend visiting our office for the first time by the time of your child’s first tooth or first birthday. Our early visits are designed to make your child familiar with what a dentist does and how a dentist helps keep children healthy. Regular preventative care will keep those little teeth in great shape, and, if your child has a cavity that needs filling or requires any other dental procedure, we will have a history together and a familiar place to experience an unfamiliar treatment.

• It’s Comfortable

We use state-of-the-art dentistry to make sure your child has the best and most comfortable treatment as a patient, and we also consider the psychological aspect of each visit for your particular child. We are experienced in dealing with children who might feel anxious and working with them to overcome their worries. Part of our job is to make each visit a happy one, so your child is always comfortable visiting us.

• It’s Ongoing

We want to establish a relationship that will last through the years. Continuity of care means that we are able to follow your child’s dental development during those active growing years and the transition from primary to permanent teeth. We provide not only dental health education, treatment, and preventive care, but can track any changes or potential problems before they become major issues. In case of a dental emergency, we will be familiar with your child personally, and with a dental history at hand.

Give Dr. Stephen Korson a call to talk about your child and how we can make the dental experience a positive one from the very beginning. When it comes to establishing a happy and healthy foundation for your child’s dental history, there’s no place like our dental home!