FYI

Dentist blog from Delta Dental

Tag: benefits (Page 1 of 4)

Too few kids are getting fluoride treatments: What you can do

Dental fluoride treatments are among the most effective and efficient techniques for hindering tooth decay in children. But despite their proven effectiveness, and despite the fact that such treatments are often covered by insurance, too few children are getting them.

Very few privately insured young children receive recommended dental fluoride treatments at health wellness visits, according to a study published in the Journal of the American Medical Association (JAMA) Network Open. The study’s analysis of more than 328,000 well-child visits for privately insured 2- to 5-year-olds found that fluoride treatment was done in fewer than 5% of visits between 2016 and 2018.

Parental refusal and clinical intervention strategies

One common reason that children aren’t getting fluoride treatments is parental refusal. In a survey, nearly 80% of dentists said they believed fluoride refusal was a problem. In one study, refusal of fluoride was found to be correlated with refusal of vaccines, and as many as 51.5% of parents refused topical fluoride treatments.

“Tooth decay is the number one disease of early childhood, and fluoride plays a critical role in strengthening the enamel and preventing cavities,” said Dr. Jessica Buehler, Director of Dental Affairs at Delta Dental. “Unfortunately, in today’s world of information overload and patients getting their news through social media, there are many families that oppose or do not understand the value and importance of fluoride.” 

Reasons for parental refusal

Parental attitudes and beliefs about health are important determinants of fluoride refusal. Most common is the belief that fluoride is unsafe. Such concerns are often spread and amplified through social networks, the media and the internet. Other factors may include religious beliefs, a desire for autonomy and concerns about the true intent of fluoride treatments.

Clinical interventions

The following clinical strategies can help you improve communication with parents about topical fluoride treatments:

  • Assess parents’ knowledge, beliefs and attitudes early. Screen for possible fluoride hesitancy at the start of preventive visits by asking open-ended, non-judgmental questions, such as “Do you have any questions for me about fluoride?” This can help you assess beliefs and start a conversation.
  • Ensure your team is prepared. Make sure your staff of dental assistants and hygienists understands how fluoride works and why it’s important, as they will likely be the ones applying fluoride treatments. Acknowledge that parental refusal can be a problem and assure your staff that you are there to support them. “Auxiliary staff should not engage in an argument when a parent refuses fluoride,” suggested Dr. Buehler. “They should inform the dentist so that she or he can answer any questions the family may have.”
  • Obtain information about why parents are refusing fluoride. Avoid a pro-fluoride “sales pitch.” Instead, ask questions about what’s motivating a parent’s decision to opt out. Listening is key and can help build trust. Reassure the parent that you respect their health care decisions. Some parents may reconsider their decision after several discussions over time. Document conversations with parents so that future discussions can be framed appropriately.
  • Incorporate specific caries risk factors into discussions. Provide parents with an explanation of why fluoride is important based on the unique risk factors associated with each child. For instance, white spot lesions on the child’s teeth should be pointed out to the parent, with a description on how fluoride helps to prevent white spots from turning into cavities that require fillings.
  • Discuss alternative fluoride sources and behavioral strategies. Parents who refuse fluoride during dental and medical visits may be open to use of at-home fluoride products. Discuss alternative sources of fluoride that could be used at home, like fluoridated toothpastes and fluoride mouthwashes. Remind parents about the benefits and safety of fluoride in water. For parents who refuse all fluoride-containing products and water, emphasize that reducing dietary sugars and acids becomes even more critical in managing caries risk.

Fluoride treatments, your pediatric patients and you

Fluoride varnish is recommended by the U.S. Preventive Task Force and the American Academy of Pediatrics for all infants and children starting at tooth eruption through age five years. All children in this age category should receive fluoride varnish application at least once every six months, according to the recommendation. Most private insurers cover the procedure, and coverage with no cost-share for families is mandatory under the Affordable Care Act.

Most Delta Dental PPO™ and DeltaCare® USA plans cover fluoride treatments for children up to age 12, and many cover such treatments up to age 18, and for adults, as well. The specific codes for fluoride treatments are:

  • D1206 Topical application of fluoride varnish
  • D1208 Topical application of fluoride excluding varnish

Preventive dental care is important at any age, and we encourage you to give regular fluoride treatments to your pediatric patients. Developing a clinical workflow that includes fluoride application can greatly improve the oral health of children within your practice.

COVID-19 by the numbers

The early days of the pandemic brought a tidal wave of changes to the dental industry. Doubtless you felt the impact on your practice’s day-to-day operations. Here’s a high-level view of the way COVID-19 impacted patients, dentists and the dental insurance industry based on claims data, patient surveys and expert opinion.

The rise of teledentistry

During the early stages of the pandemic in the United States, dental offices were closed for weeks. This led to a massive surge in the popularity of teledentistry services.

Synchronous appointments (those with live phone or video interaction between dentists and their patients) saw a 3,000% increase between 2019 and 2020, according to Delta Dental claims during that period. Asynchronous appointments (where patients took photos or videos that were sent to a dentist for later review) saw a 1,000% increase in the same time period.

The use of teledentistry has declined as the pandemic has worn on and dentist offices have reopened, but 2021’s synchronous and asynchronous appointment numbers still remain six times and two times higher than 2019 levels, respectively.

More states also updated their teledentistry laws during the pandemic. Based on Delta Dental’s internal tracking, fourteen states added teledentistry regulations to their laws or expanded existing regulations, including states like Texas, which had previously not allowed the practice of teledentistry at all.

Most importantly, in a phone survey of teledentistry patients during the pandemic, patients expressed widespread satisfaction with their options. This aligns with pre-pandemic expectations that patients had about teledentistry. Of those surveyed before the pandemic, 78% expected to use teledentistry within the next five years, and that working people, children and people with disabilities would benefit the most from teledentistry.

Dentists also had praise for teledentistry, with over 80% of dentists nationwide identifying it as useful for improving access to oral care, increasing specialists’ access to rural and underserved communities and as a time-saving technique. Virtual visits may not replace in-person checkups, but they remain a valuable tool in your arsenal.

Mitigating the costs of COVID

The beginning of the pandemic was marked by profound economic uncertainty as dental practices closed and patients sheltered in place. General practitioner income dropped nearly 18% in 2020 compared to 2019.

Fortunately, Delta Dental was able to assist with loans, reimbursements for personal protective equipment (PPE) costs and free teledentistry tools that allowed dentists to see patients remotely.

Loans offered in partnership with Provide (formerly Lendeavor) allowed dentists to make practice acquisitions, expand to new locations, purchase commercial real estate and equipment, build out their practices and refinance existing practice and commercial real estate debt. These loans featured favorable terms and conditions, like covered interest for up to 24 months, deferred payments for six months, repayment terms of 10+ years and working capital of up to $200,000.

Delta Dental also offered a supplemental reimbursement for qualifying evaluations and consultations during the second half of 2020. This Return to Care reimbursement led to an additional $80 million for dentists last year to help offset the costs of PPE and enhanced office sterilization.

As another way of helping dentists deal practice safety, two teledentistry options were rolled out: Delta Dental – Virtual Consult and Toothpic.

  • Virtual Consult is a synchronous service where members can use a smart device to have a live video chat with a Delta Dental dentist.
  • Toothpic is an asynchronous service that allows members to take photos of problem areas and get an assessment from a Delta Dental dentist within 24 hours.

As a network dentist, you can join for free to grow your patient base and to assist patients who may have difficulty making it to in-person visits.

How patients used their benefits

The early stages of the pandemic saw a sharp decline in the number of patients going to the dentist’s office. One of the main reasons for the decline was that the sharp economic shutdown led to over 20 million Americans losing their jobs and their dental coverage as well.

This decline in visits to the dentist office had a profound effect on patients’ oral health. In 2019, the most common procedures according to Delta Dental claims data were either diagnostic and preventive care or evaluations for specific issues. This shifted in 2020, when the most common procedures included fillings and root planing, which help address the effects of dental neglect.

In addition to economic hardships, COVID also increased mental and emotional strain. Since the pandemic began, the number of adults reporting symptoms of anxiety or depressive disorders has risen from about 10% in 2019 to over 40% in 2021.

These symptoms can manifest in jaw clenching and teeth grinding. Based on Delta Dental claims data, the number of patients requiring occlusal guards to prevent damage from bruxism rose nearly 10% in the second half of 2020 compared to the same period in 2019.

Anxiety and depression can also worsen an unhealthy diet or substance abuse, which can lead to oral health issues such as cavities. This may also help to explain the surge in fillings and scaling and root planing procedures in 2020.

Health and safety in the dental office

Even though COVID-19 is spread by exhaled aerosolized droplets, visits to the dentist’s office proved safer than visiting any other medical professional during the pandemic. 

Nearly 100% of dentist offices rapidly adopted enhanced infection control measures like pre-appointment screenings, in-office air purification and antiviral mouthwashes. 

Once available, vaccines saw widespread adoption among dentists, even before state and federal mandates. By fall 2021, over 94% of dentists had received at least one vaccination shot for COVID-19.

Patients also view dentists as valuable sources of information about their overall health in addition to their oral health. Two-thirds of dentists reported receiving questions from patients about the COVID-19 vaccine, according to the American Dental Association. 

Dentists rose to the occasion, with over 80% reported feeling prepared for these discussions and 95% who said it was important to have such discussions with patients.

What did we learn from COVID-19?

Here are three key takeaways for you and your practice as you look to the future.

  • Develop contingency and resiliency plans for your practice. Even if we don’t see another global pandemic within our lifetimes, disruptions from natural disasters like hurricanes, earthquakes and wildfires remain a possibility. Discussing emergency plans with staff ahead of time can help everyone to feel more secure and prepared when crises arise. Be sure to follow the news, Delta Dental and professional organizations to learn what resources are available to help your practice mitigate the costs of disasters.
  • The right tools and technology can mean the difference between staying open and having to close. Patients will come to your office if they feel safe doing so, but the right resources can empower your more hesitant patients. Invest in effective and visible infection control measures to let patients understand that your practice is taking steps to ensure their well-being. For patients who simply don’t feel safe coming into the office, teledentistry can provide you with another way to stay in touch with your patient base — and even grow it.
  • Make the most of your status as a trusted health professional to your patients.  It can be easy for patients to compartmentalize their oral health from their overall well-being. As a health professional, your opinions and advice are especially important for patients who may be getting information from misinformed or unreliable sources like social media. Advising on wellness and current topics, such as the safety and efficacy of vaccines, can go a long way towards building lasting relationships with your patients and your community. Explore ways to foster trust with patients who may have concerns for their safety, come from a different cultural background than you and your staff or may simply benefit from feeling seen and heard.

Access thousands of patients with NY Select

Gain access to over 200,000 NY members with 100% benefits for covered services when you enroll as an NY Select dentist! When you participate in the NY Select network (formerly known as NYPPO), you can help provide your fellow New Yorkers with dependable, quality dental care.

This network is specific to New York state and is the only in-network option for members of two large union health plan/funds:

  • DC37 is the largest public employee union in New York City, with 150,000 members serviced by the District Council 37 Health & Security Plan. DC37 members help make New York run by working in over 1,000 titles — everything from accountants to zookeepers.
  • 32BJ is a branch of Service Employees International Union (SEIU) that is headquartered in New York City. The Building Service 32BJ Health Fund services over 75,000 of New York’s property service workers.

DC 37 and 32BJ’s NY members are benefited 100% for covered services with NY Select participating dentists.

Delta Dental ensures that members are able to find your office by providing special dentist directories especially for DC37 and 32BJ patients.

Everything you’ll need for administration, including how to register for direct deposit, view treatment history and obtain claim status, is available in your Provider Tools account. 

Simply log in or register to access these handy tools:

  • Reference Library: Find your Dentist Handbook and other information.
  • My Patients: Obtain eligibility and benefits for current and new patients.
  • Submit Claims: Transmit free, real-time claims and attachments.
  • My Account: Update your directory profile to ensure patients can find you.

Interested in participating in the NY Select network? Please contact Delta Dental Network Development Representative John Wilson by email at jwilson@delta.org or phone at 628-260-4764.

Not sure if you’re already participating in the NY Select network? Or currently participating and have questions? Please contact our Provider Concierge by email at providerconcierge@delta.org or by phone at 800-592-0156.

Please note: The NY Select dentist network is separate from Delta Dental PPO™ and Delta Dental Premier®. Please review your NY Select contract and fee schedule for additional information.

SmileWay Wellness Benefits help patients stay healthy

More patients are becoming aware of the way that health issues can manifest in the mouth and oral health issues can exacerbate other medical conditions. With serious issues like heart disease being responsible for so many deaths in the U.S., your patients may be interested in learning how good dental health can improve their overall health. For patients who have medical conditions that affect their oral health, SmileWay® Wellness Benefits may be available to help meet their needs.

Who’s eligible for SmileWay Wellness Benefits?

Not all patients are eligible for SmileWay Wellness benefits. To claim these benefits, patients must:

  • Have a Delta Dental PPO™ plan
  • Belong to a group that offers SmileWay Wellness Benefits
  • Have chosen to opt in to the program

Members who have been diagnosed with any of the following are eligible for expanded coverage:

  • Diabetes
  • Heart disease
  • HIV/AIDS
  • Rheumatoid arthritis
  • Stroke

What are the benefits?

Members whose plans offer SmileWay Wellness Benefits are eligible for these added benefits each calendar or contract year:

  • 100% coverage for one scaling and root planning procedure per quadrant (D4341 or D4342)
  • and 100% coverage for four of the following in any combination:
    • Prophylaxis (D1110 or D1120)
    • Periodontal maintenance procedure (D4910)
    • Scaling in the presence of moderate or severe gingival inflammation (D4346)

If you have patients with medical issues that necessitate extra dental care, find out if they’re eligible for SmileWay Wellness Benefits. These benefits can help keep them both smiling and healthy!

Dental implants are coming to DeltaCare USA

A new kind of large group plan is coming to DeltaCare® USA plans in 2021. Effective January 1, 2021, DeltaCare USA i-series plans will be available with comprehensive coverage for dental implants. Once i-series plan rollouts are complete (there will be nine in total), they will be available in all 50 states and Washington, D.C.

These plans are designed to address the growing demand by DeltaCare USA members for dental implants. These plans will include coverage for all major codes related to the placement and removal of dental implants and abutments. Coverage of implants means you have another tool in your toolbox when it comes to recommending the best treatments for your patients.

For more information on the i-series plans, please consult your DeltaCare USA benefits book.

DeltaCare USA individual plan launched in Nevada

Did you know that dental benefits have a positive effect on patient health? For example, insured patients are 50% more likely to visit the dentist each year than the uninsured.1

Increasing access to dental care is at the core of what we do. That’s why we offer several Delta Dental plan choices for individuals — a DeltaCare® USA plan, now available in eight states and the District of Columbia,2 and two Delta Dental PPO plans.3

These plans help your patients replace plans lost to retirement or job changes. And, it’s easy to enroll online for a basic plan, or one with more inclusive benefits.

Download and save the individual and family plans overview to share with your patients.

Join us! If you’re not in the PPO and/or DeltaCare USA networks, consider joining. You’ll get the maximum in-network benefit payment directly from us, gain more insured patients through our online dentist directory and retain patients who may choose to purchase a closed network plan. Visit our website for more information.


1According to the Delta Dental Oral Health and Well-Being Survey [2014] by Delta Dental Plans Association.

2The closed network, prepaid DeltaCare USA plan is available in CA, DC, FL, MD, NV, NY, PA, TX and UT.

3The open network, fee-for-service PPO plans are available in AL, CA, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, TX, UT and WV.

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