There are many reasons for seeking a new dentist in Sunderland On. You may have moved to another neighborhood in Ontario or a different city altogether. Perhaps your current dentist is retiring, your needs have changed or you are dissatisfied with the service you are receiving.
Voted #1 orthodontist in Sunderland On
What should I expect during the first exam?
The answer should include a conversation with the dentist about your general and oral health history and concerns, including information about any diseases or conditions you have and any medications you are taking. They should also mention that you’ll be given a thorough examination of all teeth, including any restorative work you’ve had done; a thorough check of gum health with a periodontal probe; a check for signs of oral cancer; and x-rays, as needed.
General dentists often use the monikers “cosmetic dentist” or “family dentistry” to indicate that they offer cosmetic dental treatments or can treat your whole family but these aren’t officially recognized dental specializations. The dental specialists recognized by the American Dental Association include pedodontists, also known as a pediatric dentist (kid dentist), endodontists (root canal specialists), oral and maxillofacial surgeons (tooth extraction and oral surgery), prosthodontists (restorative specialists), periodontists (gum disease treatment specialists) and for dental braces, an orthodontist (bite specialist).
Finding the right orthodontist in Sunderland On for you and your family can be as taxing as finding a parking space in a crowded shopping center. With thousands of dentists practicing all over the country with their own specializations, specific locations and office hours. How do you narrow your search down to that one dentist who’s right for you?
When you’re looking for a new Orthodontist in Sunderland On, you’re searching for more than someone to just straighten your teeth. Orthodontists and dentists both help patients improve their oral health, but in different ways. Dentistry is a broad medical specialty that deals with the teeth, gum, nerves, and jaw, while orthodontics is a specialty within dentistry that focuses on correcting bites, occlusion, and the straightness of teeth.
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Orthodontic Treatment - For a Beautiful Smile
Orthodontic billing is one of the things that gets questioned all the time and in all truth, it probably deserves its own book. There are a number of reasons for the confusion that crops up between providers and insurance personnel whenever orthodontics comes into the picture. However, it's just tough to make nifty catch-phrases over something that should be simple and relatively mundane. As we talk about some of these items remember that we are coming to you from an insurance adjusters point of view.
How Does Insurance View Orthodontics?
Let's start with the insurance side of the coin. For an insurance company, orthodontics can be a big pain in the you know what. We have multiple providers supplying multiple types of services and billing for them in a myriad of billing styles. Some bill all up front. Some providers charge their patients a certain amount based on what their insurance will pay. Some providers have adjustable payment plans to allow patients to gradually pay for services over the years. All of these options and more make orthodontics billing more complicated than it should be.
From the insurance side, orthodontic benefits are strictly limited. Almost every plan we've ever seen has a maximum lifetime benefit. Note that there ARE exceptions to this rule, but an open-ended orthodontics maximum is an extremely rich benefit and is definitely being seen less and less these days. These benefits are usually applied to the individual patient, but may also apply to the entire family in some cases. For example, little Susie Jones who has a $1,000 lifetime maximum benefit for orthodontics goes to an Orthodontist and has $1,500 worth of work performed. The insurance company pays out based on their coverage level - usually 50 percent or 60 percent, which would make the payment in this situation $750 or $900 respectively. If Susie needs an additional $1,000 worth of work, she will only receive $250 or $100 - again dependent on coverage level. If the $1,000 orthodontic lifetime maximum applies to her entire family, then there will be NO other payments for any other members of her family. This is the starting point of view for insurance companies and different companies have different payment philosophies based on this starting point.
How Does Insurance Pay Orthodontics?
Some companies are just tired of dealing with orthodontics. They acknowledge that there is a strict limit put on orthodontic benefits, so they don't even bother messing with it. They're doing this because somebody somewhere made the decision that it costs more to try and review these claims than that review would be worth. Some companies take the opposite approach, since orthodontics can be such a big-ticket item. They're going to require you to submit a logical, well-thought-out plan documenting every step of the process in that patient's treatment. Then there's another approach still in which the insurance company tries to control these treatments to ensure that the patient is really getting his money's worth out of his orthodontic treatments. An excellent indicator of this is some kind of limitation on orthodontics dates-of-service. For example, a provider can submit an adjustment for little Susie dated April 27, 2011 and then another on May 2, 2011. Most companies will simply pay each of those without comment - their rules are set up to allow treatment once a month. In the real world though, is it really doing Susie any good to show up for two adjustments within a week of each other? Granted there are times where situations come up that this is necessary. We're simply talking about the general rule, here. So there are some companies that will deny one of those adjustments since they consider them as not really being beneficial to the patient.
To make matters worse, many companies combine approaches on orthodontics. Some subscriber groups may have requested additional orthodontics scrutiny in an attempt to lower their premiums. Different departments within the same insurance company may have different rules. Some states may have different laws that make added scrutiny tougher or easier. All of these things combine to make a big swamp out of the process in which a lot of providers get lost.
When You Are WAY Too Consistent
Another scenario we see is that a provider submits the exact same way every single time. It's statistically impossible for every patient an Orthodontist sees to get the exact same treatment. Now we know what's happened. The provider found a 'sweet spot' - a set of claims that he KNOWS will work. And so he just uses them as a template every single time. There is not a lot we can say about this, other than it does put us on our guard. Also, it only benefits you as long as your treatment plans fall beneath that threshold. By not taking the time to learn and understand the true process, you're simply handicapping yourself in those situations where you could be legitimately charging more and receiving higher reimbursements.
Not Quite the Final Word
This is probably a good place to take a break. We go into specific strategies in our e-book Dental Claims Help included in our Dental Insurance Course which will enable providers to start reading between the lines when it comes to insurance benefits and rules. Those can be extremely helpful in this area. You have to start by watching what you send out and learning from what comes back in (reading your Explanation of Benefits, talks with company representatives, etc.). Note differences in payments, denial codes, speed of payment, etc. You should already be working on baselines so that you know 'normal' processing times for the different companies. Watch how different companies handle similar claims in different ways. Watching and learning from all these things will teach you a lot about the different approaches to orthodontics.
Orthodontic Dental Insurance
They say to introduce your child to dental hygiene from a very, very young age - as early as he or she becomes 6 months old. Yes, as soon as the two front rabbitlike white pearls show up in your baby's mouth, experts insist that you should start rubbing them clean with oral baby swabs twice a day. You can do this even before the very first tooth has appeared, as it is crucial to clean the baby gums daily, too.
I had been following the advice of the professionals in making sure that my boy’s oral health was up to scratch throughout his toddler’s years without a hitch. We went through an array of massaging, training and first toothbrushes, flossing tools and what not. We played games, used the hourglass sand timer, you name it until he hit the age of seven.
The important first seven years in a child’s life that so much had been written and talked about, together with all the good healthy habits, which I tried to instill, all of this went out of the window. And it seemed that this happened overnight.
My son simply neglected everything he had learned about taking care of his teeth. He regularly skipped brushing them before bedtime, often told me fibs that he had done it, blowing fresh proofs, that smelled of toothpaste, in my face. He carried on indulging on sweet treats after dinner, yes, homemade, but still sugary. He moaned or made excuses about how tired he was in the evening and promised to clean his teeth in the morning for longer.
Oh, did I not try everything? There were the threats, at first, replaced by the star stickers and the weekly prizes, if he did well in this cumbersome for his task.
I gave him examples from the animal world. I talked about how even wild beasts made sure their teeth were clean. I attempted to explain in a simplified manner to him what cleaning symbiosis meant. We watched a documentary together, where we saw how zookeepers clean the lion’s teeth.
I went on asking him about what would happen if we stopped changing and washing our clothes, if we did not shower, ate from dirty plates or did not call some professionals to deep clean our carpets twice a year. He was not impressed but carried on stubbornly with his little tricks.
One day, I gave him one of my favorite children’s book - “Karius and Bactus” by the Norwegian writer Thorbjørn Egner. For those, who have not read it or do not remember it… It is about two trolls, who live in Jen’s mouth. Jen is a little boy, who hates brushing his teeth. Karius and Bactus, on the other hand, feel over the moon to be living in a place, where the feast on chocolate cakes, cookies, and other treats never ends. So they make a residence for themselves in the boy’s mouth by knocking holes out in Jen’s teeth with their little hammers. The book, published in 1949, revolutionized dental health at the time. Unfortunately, it did not revolutionize my son’s unhealthy habits.
And then, his first ever dental treatment came into view and shook his little world. The fear and anxiety, which engulfed him prior to the visit at the dentist surgery, were overwhelming even for me. In the big scary dental chair, he enquired with a feeble voice about what happened to Jen from the book, when he went to see his dentist.
I smiled, holding his hand in reassurance, and told him that as soon as Jen started brushing his teeth every day, Karius and Bactus went to sea on a raft to look for another naughty boy, who had a sweet tooth but hated cleaning his teeth.
I had no problems with my boy ever since!