Looking for Dental Insurance?

January 29, 2014

Several patients have been looking for dental insurance for the new year; so we thought it was time to write another blog about dental insurance.



Where to Look

The first place to look for dental coverage is through your employer. Often companies can get better rates for dental insurance for their employees because they contract for a large group of people.


If your employer does not offer dental insurance, or you are self-employed, you will have to search to find either a medical plan that includes dental, or a stand-alone dental plan. In years past, stand-alone dental insurance was difficult to find for individuals. These days, an internet search for dental insurance will bring up several different places you can shop online for dental insurance, such as eHealthinsurance.com. Additionally, with the implementation of the Affordable Care Act, you can enroll in stand-alone dental insurance through healthcare.gov.


What to Look For

With these and other similar websites, you will be presented with many different options for dental insurance. This may be a bit overwhelming, but our Evanston dentist office is here to help!


There are three types of dental insurance: HMO (sometimes DMO), PPO (sometimes DPO), and indemnity.

  • HMO insurance requires you to go to an in-network dentist to get coverage. If you already have a dentist that you enjoy seeing, such as Dr. James or Dr. Robert, then it is best to contact your dentist to find out if they are in-network before purchasing an HMO insurance.
  • PPO insurances allow more flexibility, as you can see any dentist that you would like to see. These insurance plans provide different coverage for visits to in-network and out-of-network providers.
  • Indemnity plans allow for the most flexibility. These plans allow you to see any dentist that you would like to see without any changes in coverage.


Additionally, you should look at the maximum benefits. Unlike medical insurance, where you pay for your portion up to the maximum and then insurance covers everything after; dental insurance covers you at your contracted rate until you reach the maximum benefits, then you are responsible for the costs of any treatment above the maximum. So, a dental plan with a maximum of $500 wouldn’t cover as much as a dental plan with a maximum of $3,000.


Finally, look for an orthodontic option. Some insurance plans include an orthodontic option that you can opt in or opt out. If you are not planning on having orthodontic work – such as braces or Invisalign – you may opt out of this option to save yourself some money. If you are planning on orthodontic work or are unsure, it is best to opt-in. However, make sure it is a benefit and not a discount option. Your dental office may not participate in a discount plan, especially if they are out-of-network.


Things to Watch Out For

There are several different things to watch out for when you are purchasing dental insurance. The first thing to be aware of is a waiting period. Some insurance plans will have a waiting period before they will cover basic or major services. If you are looking for dental insurance because you have treatment you pending, look for a plan that does not have a waiting period.


Secondly, some insurance plans may have a ‘missing-tooth’ clause. This is similar to the ‘pre-existing condition’ clause in medical insurance plans. With a missing-tooth clause, insurance will not cover a replacement for a tooth that was missing prior to you having insurance with them. In some cases, the missing tooth clause is waived after a certain period of time. Check your plan to see if there is a missing tooth clause, and if so, when it may be waived.


Finally, most insurance plans have a ‘replacement’ clause. On average, insurance will cover a replacement for a crown or bridge once every five years. You should peruse your insurance plan and see what the specific limitations are on replacement of restorations. If you are planning on having major restorations replaced – such as a crown, onlay, inlay, or bridge – find out the date when the restoration was originally placed so you are prepared when your insurance requests the information.

 

Purchasing dental insurance can be overwhelming, but it doesn’t have to be. Take the time to learn what you are buying to make sure it works for your needs. If you have more questions about dental insurance, check out our other insurance blog posts. If you are purchasing insurance to use at our office, feel free to call our Evanston dental office with any questions. Our staff would be happy to help answer any of your questions.

June 24, 2025
Pregnancy is a time of excitement, anticipation, and transformation. As your body adapts to nurture new life, your needs evolve—including your dental care. At Stephens Dentistry, we’re passionate about supporting expectant mothers through every stage of this journey. Understanding the connection between oral health and pregnancy is not just important for your smile, but for the wellbeing of both you and your baby.  How Pregnancy Impacts Oral Health Pregnancy brings about a surge in hormones, especially estrogen and progesterone, which can have a profound effect on your gums and teeth. Many women notice changes in their oral health during pregnancy, including increased sensitivity, swelling, or bleeding gums. These shifts aren't just uncomfortable—they can also signal conditions that need attention to safeguard your overall health. Pregnancy Gingivitis: What You Need to Know One of the most common dental issues during pregnancy is pregnancy gingivitis. According to the Centers for Disease Control and Prevention , up to 60–75% of pregnant women develop gingivitis, which is characterized by red, swollen, and bleeding gums. This occurs because hormonal changes heighten the body’s response to the bacteria in dental plaque. If left untreated, gingivitis can progress to periodontitis—a more serious gum infection that can cause tooth loss and has been linked to health risks beyond the mouth. Oral Health and Birth Outcomes The importance of oral health during pregnancy goes beyond comfort and aesthetics. Research has shown a significant link between maternal gum disease and adverse pregnancy outcomes, such as preterm birth and low birth weight. A systematic review published in the Journal of Dental Research found that women with periodontal disease may be more likely to deliver prematurely or have babies with low birth weights. Although more research is ongoing, the potential connection means that taking care of your gums and teeth is an essential part of prenatal health. Why Dental Care Shouldn’t Wait Some expectant mothers worry about dental treatments during pregnancy. The good news is that routine dental care—including cleanings and necessary treatments—are not only safe but recommended during pregnancy. The American College of Obstetricians and Gynecologists confirms that preventive dental work is important and can be performed safely, especially in the second trimester. Delaying care can allow small problems to become bigger ones, and untreated infections can pose a risk to both you and your baby. If you are planning to become pregnant, scheduling a dental checkup beforehand is an excellent way to get ahead of any issues. Practical Tips for Expectant Mothers Maintaining oral health during pregnancy doesn’t have to be complicated. Here are some tips to keep your smile healthy throughout your pregnancy: Brush and Floss Regularly: Aim to brush twice a day with fluoride toothpaste and floss daily. This helps remove plaque and reduce your risk of gingivitis. Eat a Balanced Diet: Focus on nutritious foods rich in calcium, vitamin D, and protein, which support both your oral and overall health. Manage Morning Sickness: If you experience vomiting, rinse your mouth with water or a fluoride mouthwash rather than brushing immediately afterward, as stomach acid can soften tooth enamel. Stay Hydrated: Drinking plenty of water helps wash away food particles and bacteria, and can also help combat dry mouth, which is common in pregnancy. Schedule Regular Dental Visits: Let your dental team know you are pregnant so they can tailor your care. At Stephens Dentistry, we take extra precautions to ensure your comfort and safety during each visit. Learn more about our preventive dental services . Recognizing When to Call Your Dentist While mild gum sensitivity is common, it’s important to reach out to your dentist if you notice persistent bleeding, swelling, or pain. These symptoms could indicate an infection that needs prompt attention. If you develop a dental emergency during pregnancy, don’t hesitate to contact your dentist—timely care is always the best choice for both you and your baby. Supporting Your Health at Stephens Dentistry At Stephens Dentistry, we’re committed to providing compassionate, personalized dental care for every stage of life—including pregnancy. Our team stays up-to-date on the latest guidelines and safety protocols to ensure you receive the best care possible. For more information on how we support our patients during pregnancy, visit our dental care for families page. Pregnancy is a beautiful journey, and your smile should be a part of it. Prioritizing your oral health is a gift to yourself and your growing family. If you have questions or want to schedule your next dental visit, contact our office —we’re here to help you every step of the way.
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