Our Blog

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 Pediatric Dental Health Associates, Ltd. 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 Drs. Joanne Oppenheim, Marilia Montero, and Mary J. Hayes, 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– Drs. Joanne Oppenheim, Marilia Montero, and Mary J. Hayes 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 Chicago office.

Drs. Joanne Oppenheim, Marilia Montero, and Mary J. Hayes and our team know how overwhelming it can be to pick the right dental products for your children. When you visit the dental aisle at the grocery store, you see too many options to choose from. We want to help you make an informed decision based on your son or daughter’s needs.

First, you should consider your child’s age and where he or she is in terms of development. Most kids are unable to floss properly until around 12 years of age because of the necessary dexterity. If your youngster is under 12 years old, make sure to assist with flossing every night.

Another option is to use flossers for children. This will make the exercise a bit easier for your little one, because flossers have different-sized handles to fit all ages of hands.

When you’re looking for a child’s toothbrush, the head should be a little bigger than the top portion of your son or daughter’s thumb. If a toothbrush is too big, it won’t be able to reach small areas in the mouth properly. Battery-powered toothbrushes are also recommended because they improve overall brushing quality for both adults and children.

If your child is too young to spit, he or she should use toothpaste without fluoride. Small children tend to swallow toothpaste, even when they don’t intend to. Try looking for a toothpaste that has xylitol listed as the first ingredient. This is a natural sweetener that is beneficial to teeth.

You should also try to identify a flavor that appeals to your child. Same as adults, children like to brush more if they enjoy the flavor that lingers in their mouth after brushing.

It’s smart to look at the ingredients in a toothpaste for the benefits your child needs. Some toothpastes contain sodium fluoride, which fights effectively against cavities. If your child has a sweet tooth, or has already had a cavity, we recommend buying a toothpaste with this ingredient.

Stannous fluoride is another popular ingredient that discourages cavities and includes anti-bacterial properties. You should also watch for the ingredient triclosan, which also suppresses bacteria. These ingredients are both recommend for children who have a high risk for cavities.

Anti-sensitivity toothpaste should also be easy to find in the dental aisle of the store. It contains potassium nitrate to help with sore gums and teeth.

If you’re still unsure which dental products your child should be using, contact our Chicago office. Once we have general information about your child and his or her dental health, we can guide you in the right direction.

When it comes to picking the right toothbrush, toothpaste, floss, and mouthwash for your child, Pediatric Dental Health Associates, Ltd is always here to help.

Because babies’ teeth don’t appear until around six to eight months of age, it’s a natural misconception that they don’t need dental care. But the steps you take as the parent of an infant can help your baby maintain good oral health and develop healthy dental habits in the future.

It’s easy to take care of a baby’s teeth and gums, especially when oral hygiene for your infant becomes part of the normal daily routine. Learn more about how you can promote good dental health for your baby with these tips and considerations.

Taking Care of Baby’s Oral Hygiene

• Dental Hygiene for Birth to Six Months. Cleaning your infant’s gums is as important as cleaning teeth will be later. Hold your baby in your arms, and with a clean, moistened washcloth wrapped around your index finger, gently massage his or her gums.
• Dental Hygiene for Six to 12 Months. After teeth begin to appear, it’s time to switch to a soft, children’s toothbrush for teeth cleaning. New research has shown that fluoride toothpaste is safe and recommended for use once your baby’s first tooth arrives. Gently brush your baby’s teeth after each feeding, in the morning, and before bedtime, just as you did before teeth appeared.
• Good Bedtime Habits. One of the most important things you can do to protect your infant from tooth decay is to avoid the habit of putting baby to bed with a bottle. Use other soothing bedtime activities, such as rocking and lullabies, to help your baby drift off to sleep.
• A Note about Dental Decay. Many people are unaware that dental decay is transmissible. Avoid placing your baby’s bottle, sippy cup, or pacifier in your own mouth to test the temperature. Likewise, don’t share utensils with your baby.

Partner With Your Dentist

Your baby should receive his or her first dental health checkup by the age of six months. Even though your infant may not have teeth yet, Drs. Joanne Oppenheim, Marilia Montero, and Mary J. Hayes can assess the risk your baby might face for oral diseases that affect hard or soft tissues. Drs. Joanne Oppenheim, Marilia Montero, and Mary J. Hayes can also provide you with instructions for infant oral hygiene, and explain what steps to add as your baby grows and develops.

Pediatric Dental Health Associates, Ltd is your partner for good oral health, and we’re here to make caring for your baby’s dental hygiene and health easier and more enjoyable for you.

At Pediatric Dental Health Associates, Ltd, we know how tempting candy can sometimes be on our sweet tooth, but it’s important to remember that every candy and sugary treat you consume elevates your risk of developing tooth decay, which can break down your teeth.

While not all bad in moderation, when eaten in excess, candy can lead to big problems, especially if good oral hygiene habits are not followed. We have a few helpful tips if you just can’t stay away from all those treats:

1. Consume candy and other sweets during meals when your saliva can help neutralize the acids that are found in some candies, especially the sour variety.

2. Avoid sticky or hard candies, which can stay in your mouth longer than you think, resulting in acids being constantly exposed to your teeth. That leads to cavities and tooth decay.

3. Make sure the water you drink is fluoridated. Water that is fluoridated has been shown to help prevent cavities.

4. Make sure to maintain your daily oral hygiene habits. This includes brushing twice a day, and flossing at least once.

5. Visit our office twice a year for regular dental checkups and cleanings with Drs. Joanne Oppenheim, Marilia Montero, and Mary J. Hayes. During your visit, we can help catch problems such as cavities early to reduce the effects they have on your teeth, as well as give you tips for improving your oral health.

We hope these tips have helped! To learn more about cavity prevention, or to schedule your next visit at our convenient Chicago office, please give us a call!