So I’ve discussed dental insurance in our blog before, but one question that we get quite often is “Why are not on my insurance plan?” So I felt the urge to discuss this and rant a little, so bear with me. First off, dental insurance is a misnomer, it should be called dental benefits. Insurance, by definition, is designed to help in a catastophe. If you crash your car, you get it totaled or repaired (after paying your deductible). Your house burns down, the insurance company gives you money to rebuild your house. Dental insurance sure doesn’t pay for a full mouth rehabilitation if you’ve ground your teeth down flat and you’re now developing subsequent joint problems. That could cost $20-30K. What does “dental insurance” cover, around $1K depending on your yearly maximum. So dental benefits subsidize some of the cost, they don’t pay for dentistry. That’s the first point I want to make.
The second point is about “preferred provider plans”, aka PPOs. These are plans that your employer has agreed to be a part of. Many time this allows your employer to pay less for dental coverage. As a client of a PPO, you are encouraged by your employer and insurance company to go to a practice that participates in your plan (some insurance companies actually are quite forceful in their encouragement and make it sound like you cannot go to a non-participating practice).
So you have dental practices and clinics out there that accept pretty much every PPO that is available. From an outsiders view, why wouldn’t you participate in every PPO? But what a lot of the public does not realize is that in order to be a participating provider, you have to agree to set fees on what the insurance company decides. Well we all know that insurance companies make money by not paying out any more than they absolutely have to (see my post about end of the year benefits, “use ’em or loose ’em”). In order for a practice to participate with the PPO, the practice has to discount their fees 40%-60% in most cases. So why should a patient care about that? Especially if it means that you have to pay less for that crown.
A dental practice is a small business and it has bills to pay just like any other business. So if a practice has to discount their fees 40%-60% and still have those bills to pay, they have to make some choices. They can use lower quality/less expensive materials, not improve their dental equipment and facility, reduce staff, or see more patients. Most practices that accept those PPOs choose to see more patients. This means that you spend less time with the doctor, the doctor seems rushed, the staff is not as friendly (because they are rushed and tired), you are spending more time in the waiting room, and your dentistry doesn’t look as good as you want it to. It boils down to the fact that the customer service is not as good as it could be. And this is not true of every practice that accepts PPOs. We accept a couple PPOs that allow us to acquire some new patients yet still keep our quality at a high level. As a patient, you can save a little money by going to a provider that participates with your insurance that your employer purchased or pay more to get the quality that you are hoping for. It just depends on your lifestyle and your priorities. Obviously, I’m biased and do not like the insurance companies, but it always aggavates me when I see and hear stories about sub-par dentistry and the customer service provided. So thank you for letting me rant. Dental benefits can be confusing so if you have any questions, just let us know.

Well it’s taken me a week or so to get back to normal, but my Guatemala hangover is over now. While things are still fresh in my head, I wanted to post some of my experiences and lessons learned. First, I would like to thank Dr. Byron Henry, his wife, Stacy, and all my new Free to Smile friends for making it such a fun and productive trip. Just a brief synopsis of what we did. Both a dental and surgery team went on the trip, about 30 of us all together. Both teams went to the surgery center the first two days where we triaged the cleft lip/palate kids to make sure they were healthy enough for surgery. Then the dental team went out the next four days to some of the villages in the mountains to do extractions and fillings (even a handful of cleanings). Then the last day we came back together and did some relaxing and sightseeing (most of the sightseeing for me was about 400ft up on a zip line…awesome!)
The Guatamalans were very appreciative that we were there. And I could go on about the several hundred teeth that the dental team took out. And many said that we have changed their lives for the better and those experiences I had with those people were amazing. But I want to talk a little about the cleft lip and cleft palate surgeries. Those parents who kids had their cleft deformities fixed were the most amazed and appreciative. In the States, cleft lips and palates are things that are corrected within the first couple months of life, but in Guatemala, kids might not get those deformities fixed until much later in life. Speech problems, chewing difficulties, and negative social stigma can occur through the years. Some folks that live in the remote areas of Guatemala feel these kids are possessed by bad spirits or demons. So when the surgeons use their skills to correct these clefts, it really is an amazing thing. I posted a few photos here and on our Facebook page (search Distinctive Smiles of Dublin). You may be surprised to see the extent of the deformity.

This is why this work that Free to Smile is doing is so important. If you or anyone you know wants to help out with donations to even go on one of these trips, please let me know. It really is a great adventure!