If your family dentist has referred you to a periodontist for specialized treatment, now may be the time to invest in your oral health.
Paying the periodontist without dental insurance will prove unnecessarily expensive because both the prices and the number of procedures needed are much higher than what you experienced in the past.
Compare the costs with and without insurance for root planing and scaling, periodontal disease treatment, and the repair of receding gums to see how buying a plan right now could help.
Since you probably will need ongoing, pricey care years into the future, the math should work in your favor. The downstream benefits may exceed the upfront premiums, saving you money over time.
Periodontal Deep Cleaning Costs
Patients with gingivitis (early-stage gum disease) can treat the condition with a non-surgical periodontal deep cleaning. You may need regular maintenance three to four times per year to prevent the early-stage gum inflation from progressing to more significant problems.
Compare the cost of multiple deep cleanings annually with and without dental insurance. You should find that the numbers make sense – even if you never undergo the more expensive procedures that you might need if your condition worsens.
The cost savings of root planing and scaling with insurance will depend on your plan design, other claims submitted during the plan year, use of network providers, and how long the coverage has been in force.
- Patient cost-sharing features determine your out-of-pocket spending: deductible, copayments, annual maximum
- Annual maximums could limit what your plan pays, especially if you submitted earlier claims for checkups, X-rays, fillings, and other services
- Network providers participate with specific dental plans and agree to discount their services and accept the “Allowed Amount” as payment in full
- New plans may have waiting periods of twelve months or longer for major services, so factor the delay into your calculations
- Treatment limits could restrict benefits to one quadrant (upper, lower, right, left) every two years, for example
Compare these savings to the monthly premiums you must pay to maintain coverage. You will probably spend more in the beginning, but come out ahead in the end.
The cost of deep cleaning without insurance can be quite expensive when you include optional services that your periodontist might recommend, and factor in the level of tartar and plaque built up on your teeth.
- Charges start at $100 to $450 per quadrant
- Low: $400
- High: $1,800
- Antibiotic injections to speed healing are $35-$85 per tooth (adults have 32)
- Low: $45
- High: $2,720
- Full-mouth debridement is $75 – $150
Paying just the low-end estimate three times each year adds up quickly – a minimum of $1,200 for four quadrants. Perhaps now is the time to invest in a plan – especially if your condition worsens to full-blown gum disease.
Cost of Treating Periodontal Disease
The cost of treating periodontal disease without insurance grows, the longer you wait for treatment, and the worse your condition becomes. Prevention is always cheaper and more reliable than the cure.
Of course, patients who invested early in a dental plan will face lower out-of-pocket expenses and have less of a need to take out a loan to pay for care.
Gingival flap surgery treats periodontal disease by separating the gums from the teeth to allow the dentist to scrape tartar and plaque from the roots and bone. The average retail price of gum flap disinfection ranges from $4,000-$6,000 but can run higher for patients with extensive damage.
Most dental insurance plans cover gingival flap surgery because the treatment has a proven record of diminishing disease. Although copayments and annual maximums may limit the benefits, the in-network discounts shine most brightly with expensive procedures.
For illustration purposes, a patient might save $2,000 by choosing a periodontist that participates in-network, before the plan pays any benefits.
- Provider Charge (Retail): $6,000
- Allowed Charge (Wholesale): $4,000
Laser gum surgery is the more modern approach to treating periodontal disease. The cost of laser gum surgery is slightly higher than traditional flap procedures that use scalpels and sutures because the provider has to invest in expensive equipment.
Verify with your dental insurance company that they will cover this method. The FDA approved the Laser-Assisted New Attachment Procedure (LANAP®) in 2004, which makes it relatively new and less field-tested. Your plan might classify it as experimental and deny claims.
Cost of Fixing Receding Gums
The cost of repairing advanced gum recession through surgical techniques is different for each individual, depending on which procedure your periodontist recommends, and what your dental insurance might cover.
Your gums do not shrink overnight. It takes years of over brushing, gingivitis, and periodontitis to do the trick. You have plenty of advanced notice to invest in a policy to make these procedures more affordable.
Grafting is the traditional surgical procedure used to repair receding gum lines. The retail graft cost is $600 to $1,200 at the base of one tooth or in a small area. Also, prices can run higher if you utilize material from a tissue bank rather than the roof of your mouth.
- Your dental insurance is likely to cover a portion of your gum grafting costs. However, patients needing to restore multiple teeth or large areas could hit the annual maximum for their plan.
- The typical annual maximum is $1,500 per person. Therefore, scheduling grafts for one quadrant per year could prove more affordable.
Pinhole rejuvenation is a newer, less invasive method that innovative providers recommend to restore receding gum lines. The retail fees for Pinhole Rejuvenation surgery are about the same as grafting, but you could face much higher out-of-pocket costs related to your dental insurance.
- New and innovative sounds great to patients but often means experimental and unproven to issuing companies, resulting in denied claims
- Pinhole rejuvenation allows you to treat your entire month in one visit rather than one tooth or small area, leading to possible annual maximum exclusions
Costs of Cosmetic Gum Procedures
Your periodontist might also perform cosmetic procedures that enhance the appearance of your gums. Dental insurance will not cover any treatment performed for aesthetic reasons because it is not medically necessary.
Therefore, expect to pay for any cosmetic service 100% out-of-pocket. Buying coverage will do nothing to lower your costs.
Surgery to correct a gummy smile (excessive gingival display) is a cosmetic procedure that removes the extra tissue, repositions the jaw so that your upper lip covers more or your smile, or elongates your teeth through veneers.
Dental insurance is unlikely to cover either method because the treatment of a gummy smile addresses aesthetics and has no medical basis.
- Gum lift (gingivectomy) trims back the excess tissue, often through the use of a laser, while a gingivoplasty reveals more of the crown of each tooth and contours the remaining flesh. Costs range from $1,000 to $3,000 for the procedure.
- Bimaxillary orthognathic surgery repositions the upper jaw further into the skull to reduce the visibility of gums when you speak or smile, which is far more expensive ($8,000 or more) given the steps involved.
- Dental veneers can make your teeth appear longer relative to the size of your gums. The costs per tooth are $250 for low-end materials to $2,000 for premium Lumineers.
Gum depigmentation, also referred to as bleaching, is a cosmetic periodontal treatment that removes dark spots and patches to restore natural pink color to your smile. Your dentist might use a laser, rather than chemicals, to lighten gingival hyperpigmentation caused by abnormally high amounts of melanin.
The laser zaps away the melanocytes, which produce the dark spots on your gums. Because insurance does not cover the bleaching, expect to pay the full amount out-of-pocket of $900 to $1,500 for both your upper and lower jaw.