Cosmetic dentistry involves dental procedures aimed at improving the look of a person’s smile by altering their gums, teeth, and bite. However, some cosmetic treatments can also help with dental problems affecting teeth’ appearance or function. These dental procedures focus on enhancing the appearance rather than the functionality.

Cosmetic dental procedures can be costly. On average, a person may spend over $1,000 on cosmetic dentistry, a significant expense. Insurance usually excludes coverage for cosmetic dental procedures, like teeth whitening. However, specific dental plans can provide an allowance that pays for a portion of the cost of the procedure. Some cosmetic procedures that insurance may cover include:

Orthodontic Treatments

Orthodontics is a dental specialty that deals with fixing misaligned teeth and jaws, known as malocclusion. Common treatment methods used in orthodontics are clear aligners, retainers, and braces. Many people in the U.S. are choosing orthodontic treatment. Most patients are 18 or younger, but around 1 in 3 adults have straightened their teeth or use braces.

After treatments such as Invisalign or standard braces, patients frequently experience:

  • An improvement in appearance
  • Increased confidence and self-esteem
  • Enhanced oral health

However, many are uncertain if their insurance will cover the treatment. Most dental insurance policies cover 80 percent of dental fillings and other basic operations and 50 percent of major medically essential restorative procedures such as dentures or crowns. The patient pays for the remaining amount, and these percentages could vary. Some of these insurance plans have a deductible that a patient needs to pay before operations are covered or an annual maximum that only covers up to a specific sum annually.

Cosmetic dentistry is often excluded from coverage unless it is medically required. Crowns and fillings can also be subject to limitations or restrictions. For example, your insurer can cover crowns or fillings made of silver or resin amalgam but not gold and porcelain fillings.

What Orthodontic Treatments Are Covered?

Dental insurance can lower the cost of orthodontic treatments, but coverage varies by plan. Generally, insurance covers treatments that are medically necessary rather than cosmetic. Here are some common orthodontic treatments that your insurance may partially cover:

Braces

Traditional metal braces consist of metal brackets and wires that help straighten teeth and correct bite problems like overbites, underbites, or crowding. Since braces are often necessary for better oral health and preventing future dental problems, many insurance plans cover part of the cost, leaving patients to handle copays or deductibles. Some plans may also cover clear or ceramic braces, which are less visible than metal ones.

You should find out if your insurance plan has a lifetime cap on orthodontic care, which limits the total amount covered.

Clear Aligners

Clear aligners like Invisalign are popular for people who want a more discreet alternative to traditional braces. These aligners are specially made, removable trays that gradually shift teeth into the right place. Although insurance coverage for clear aligners may differ from metal braces, many plans acknowledge them as a legitimate option for fixing teeth alignment and bite problems.

Certain insurance plans may cover only a part of the expenses for clear aligners or impose age limits, typically targeting children. Always confirm if your plan includes aligners as a covered service.

Retainers

After finishing orthodontic treatment, retainers are essential for keeping your teeth in place. Whether fixed or removable, retainers are necessary for preserving your new smile. Many dental insurance plans cover retainers, mainly when they are part of a complete treatment that involves braces or clear aligners.

In some cases, your insurance may also help you obtain new retainers if you lose or damage the originals. You should confirm whether your insurance plan covers the first retainer or if it also includes replacements.

Palatal Expanders

Palatal expanders are tools used to widen the upper jaw in children, especially when a narrow jaw leads to crowding or bite problems. This treatment is common in younger patients because their jaws are growing and can adjust more quickly. Since it often addresses serious orthodontic issues, it is usually seen as medically necessary and frequently covered by insurance.

Dentists often include palatal expanders in a longer treatment plan and combine them with other devices like braces.

Surgical Orthodontics

In more complicated cases, jaw misalignment might need orthognathic surgery. This surgery corrects skeletal problems that braces or aligners cannot fix. Patients with severe bite issues, facial asymmetry, or jaw problems may need surgical orthodontics. Many insurance plans cover some costs of surgical orthodontics since they are generally seen as medically necessary for better oral health.

These surgical procedures may need pre-approval from your insurance, so check with your orthodontist and insurance provider to confirm coverage before moving forward.

Dental Crowns

Dental crowns involve placing a protective cap over a damaged tooth. Dentists make them from strong materials like metal, ceramic, or porcelain. They then custom-fit them to the tooth to strengthen it and prevent further damage.

Crowns are often needed for teeth badly damaged from decay or injury, have large fillings, or have undergone root canal treatment.

Most dental insurance plans will cover the cost of crowns if a tooth is weak or cracked, but not for cosmetic reasons. Other cosmetic treatments include whitening, veneers, and bonding, which the patient must pay for.

The cost of crowns varies based on the material, ranging from $500 to $3,500 each. Typically, insurance covers about 50% of the cost, leaving the patient responsible for the rest. Dentists can give initial cost estimates, and many offer payment plans. Additionally, dental credit plans provide low-interest financing, and some dental schools offer affordable procedures. Employer-sponsored plans often have lower premiums due to group coverage.

Here are some ways to benefit the most out of your dental insurance for crowns.

  • Understand your plan’s specifics, including what is covered and what is not.
  • Talk to your dentist about the procedure and consider other treatment options.
  • Take advantage of your plan’s preventive care benefits, as regular cleanings and check-ups can help avoid the need for crowns.
  • Be aware of any waiting periods in your plan. Some may require you to wait before crown coverage.
  • Feel free to compare different plans and look for affordable treatment options within your network

Dental Implants

A dental implant is a reliable method to replace a tooth that is lost or damaged. It is a bone-like material that a dentist inserts into the jaw. Your dentist will support it with titanium and place an artificial crown on top. Dental implants are a permanent solution for many people with missing teeth.

Once in place, you will not need to remove the dental implant for eating or cleaning.  There are two main types of dental implants, which vary based on the desired outcome including: 

  • Endosteal Implants

Endosteal implants are the most common type of dental implants. Your dentist can place the implant directly into the jawbone by drilling a small hole. 

  • Subperiosteal Implants

If your jawbone is too weak or shallow for a regular implant, a dentist can place the implant on top of the bone. This is called a subperiosteal implant. It provides support similar to an endosteal implant.

Anyone can receive an implant if they have healthy jawbones and gums. However, those with a shallow jawbone may need to have it augmented/regenerated before the procedure. People with chronic illnesses like diabetes and leukemia may heal more slowly after receiving an implant. Additionally, dentists recommend avoiding smoking because it increases the risk of losing another tooth and slows down healing.

When Medical Insurance Might Cover Dental Implants

Medical insurance may cover dental implants in certain situations:

  • Accidents or trauma—If you lose teeth due to facial injuries from an accident, insurance may help cover the cost of implants as part of reconstructive surgery.
  • Medical conditions—Conditions like osteoporosis or oral cancer that cause jawbone loss can make dental implants necessary, and insurance might cover some or all of the costs.
  • Congenital conditions—If you have a birth defect affecting your oral health, such as a cleft palate, insurance may cover dental implants as part of your treatment.
  • To maintain oral health—Some insurance plans may cover implants if they help keep your oral health, such as preventing jawbone loss.

Fillings

Fillings are dental treatments that restore the structure and functionality of teeth damaged by fracture or decay. The main goal of a dental filling is to restore the teeth to their natural form and function while also preventing further deterioration by removing potential entry points for bacteria.

A hole can develop on the surface of a tooth due to decay or injury. You need to fill the hole to prevent it from worsening and causing bacteria to grow inside the tooth. If the decay reaches the inside, it may require more serious treatment, like a root canal.

You can tell if you need a filling if you feel sensitivity to hot or cold in that tooth. Other signs include pain when biting or if the tooth feels rough, chipped, or broken.

When you go to the dentist for a filling, they will check your tooth to find out what caused the problem and may take an X-ray. Before filling, the dentist will numb the area and drill out the decayed part. This process usually takes a few minutes.

The numbing effect on your tooth will last a few hours with minimal risks. Contact your dentist if you have any issues.

Types of Fillings

There are various tooth-filling options, each with advantages and disadvantages. Your decision will depend on your insurance coverage, costs, and personal preferences. Here is a list of the types of fillings you can choose from.

  1. Amalgam Fillings

Amalgam has been a popular choice for dental fillings for many years. This dental filling material is strong and works well for filling back teeth, like molars. It consists of several metals, which makes it noticeable when you smile. Amalgam fillings are generally the least expensive option available.

  1. Composite Fillings

Composite fillings, also known as filled resins, are typically made from a mix of quartz or glass. This material allows them to blend well with the natural color of your teeth. They are durable and suitable for areas with light chewing, such as the front teeth.

  1. Ceramic Fillings

Ceramic fillings are tooth-colored and less likely to stain compared to composite fillings. However, they can be costly, similar to gold fillings, and your insurance may only cover some of the expenses for their placement.

Glass Ionomer

Glass ionomer is a mix of glass and acrylic that produces fluoride to help protect teeth. This filling is not as strong as other types and may need replacement in about five years. The cost of fillings can be higher than regular dental check-ups. Here are some typical prices for fillings:

  • $50-$150 for one silver amalgam filling 
  • $90-$250 for one composite filling 
  • $250-$4,500 for porcelain or gold-cast filling 

Even though dental fillings can be pricey, many dental insurance plans cover them since they are considered preventive care. Talk to your dentist and insurance provider to understand what is covered.

Teeth Bonding

Dentists apply colored plastic or resin to bond teeth to improve their appearance. The dentist places the composite material where needed and uses a special bonding agent to secure it to the tooth.

While teeth bonding is mainly cosmetic, it can also help prevent a tooth from cracking, leading to infections. Depending on a person’s oral care habits and the amount of bonding used, bonding typically lasts three to ten years before needing replacement or touch-ups.

The price of obtaining a dental bond varies based on your location. Typically, it costs between $100 and $400 for one tooth. You should check with your insurance company to see if they can help cover some or all of your costs.

Dental Veneers

Dental veneers are specially made ceramic shells sticking to your teeth' front. Dentists apply them like nail polish, which can last long with proper care. Dentists can color the ceramic to match your skin tone. Recent improvements allow veneers to mimic the natural translucence of real teeth.

Dentists usually use dental veneers for cosmetic reasons but can also prevent issues like cracks and chips that lead to tooth decay. Veneers only suit some patients.

Those who may not be good candidates include those with:

  • Teeth grinding or clenching habits
  • Major tooth damage
  • Gum disease
  • Teeth that are too far forward
  • Severe crowding of teeth
  • Poor oral hygiene and many cavities

The cost of dental veneers varies based on the type you choose. Traditional veneers can range from $925 to $2,500 per tooth and last about ten to fifteen years. No-prep veneers typically cost between $800 and $2,000 and last around five to seven years.

Veneers are generally not covered by insurance, but some companies may offer financial help if the procedure is for preventive care.

Regular Check-Ups

Regular dental check-ups are essential for maintaining oral health and can also support cosmetic dental treatments since they include teeth cleaning. These check-ups help prevent tooth decay. You should have dental check-ups at least twice a year. If you have had any cosmetic work done, you should regularly schedule check-ups. The average cost for a dental check-up is around $288, typically including X-rays, cleaning, and an examination.

Root Canal

The term root canal refers to the inner part of a tooth located between the root and the pulp, as well as the dental procedure to remove infected material and relieve pain. The root canal contains blood vessels and nerves. This procedure is commonly performed to alleviate pain caused by decay or infection in the tooth pulp.

Root canal therapy is often necessary due to severe tooth decay that has affected the outer layer of the tooth, leading to pain. It can also occur from damage, such as cracks or chips. These damages contribute to decay and pain. Additionally, various risk factors can lead to infection of the tooth pulp.

There are a few signs that show you might need a root canal, such as:

  • Intense tooth pain when chewing or applying pressure
  • Sensitivity to hot or cold beverages
  • Darkening of the tooth
  • Swelling in the gums

The price of a root canal varies based on how hard it is to remove the root vessels and nerves. On average, a single root removal costs about $250, while removing a single leftover tooth averages around $185.

Find a Cosmetic Dentist Near Me

You should know what your insurance covers if you are looking into cosmetic dental treatments. Most dental insurance plans focus on necessary medical procedures like fillings, root canals, and extractions. Cosmetic treatments, such as teeth whitening, veneers, or bonding, which mainly improve the look of your smile, are usually only partially covered by some insurance policies.

However, there are some exceptions. Certain insurance plans help pay for cosmetic treatments if they also serve a practical purpose, such as repairing a broken tooth. Knowing the requirements and teaming up with a knowledgeable dental expert can boost your chances of securing the coverage you need. We at La Puente Advanced Dentistry can help you consider all options to make dental implants more affordable. Contact us at 626-626-7075 to discover how we can help with your insurance for an easy dental implant process.