Dental Insurance That Covers Periodontal Cleaning Explained

Periodontal cleaning is a crucial part of maintaining good oral health, but it can be expensive. Some dental insurance plans cover this procedure, but not all do.

Many dental insurance plans, like those offered by Delta Dental and Cigna, cover periodontal cleaning as part of their preventative care benefits. This means that if you have one of these plans, you can get periodontal cleaning at a lower cost.

Routine periodontal cleanings are usually covered 100% by insurance when done every 6 months. This frequency helps prevent periodontal disease and gum recession.

Insurance coverage for periodontal cleaning varies, but regular cleanings are often covered under dental insurance. Typically, dental insurance covers around 50% of the cost of scaling and root planing, a procedure considered medically necessary for gum disease.

To get insurance coverage, your dentist may need to provide proof of the procedure's necessity, usually through X-rays or diagnostic tests showing inflammation or damage.

If you have dental insurance, check with your provider to find out what your out-of-pocket costs may be. Some insurance plans may limit how often you can have a scaling and root planing procedure done.

If you have a chronic condition like diabetes or heart disease, you may qualify for additional teeth and gum cleanings under SmileWay Wellness Benefits Delta Dental PPO plans, which cover 14 chronic conditions.

Here's a list of covered conditions:

The cost of periodontal cleaning can vary depending on several factors. The national average cost of scaling and root planing per quadrant is $242, but can range from $185 to $444.

In some cases, additional costs may include X-rays, antibiotics, and follow-up care. It's essential to note that these costs can add up quickly.

The cost of scaling and root planing can also vary based on your geographical area, the number of teeth being treated, and your dentist's level of expertise. This means that prices can differ significantly depending on where you live and who you see.

Typically, dental insurance covers around 50% of the cost of scaling and root planing. However, your insurer may limit how often you can have this procedure done.

In some cases, medical insurance may cover the procedure if it's deemed medically necessary. This can be the case if your periodontal treatments coincide with a type of oral surgery that's medically necessary.

Here's a breakdown of the estimated costs for scaling and root planing:

Keep in mind that these costs are estimates and can vary depending on your individual situation. It's always best to consult with your dentist or insurance provider to get a more accurate estimate of the costs involved.

Periodontal cleaning insurance coverage is a crucial aspect of dental insurance that can make a significant difference in maintaining good oral health.

SmileWay Wellness Benefits, offered by Delta Dental PPO, provides expanded coverage for periodontal cleanings, including 100% coverage for one periodontal scaling and root planing procedure per quadrant per year.

Enrollees with qualifying chronic conditions, such as ALS, cancer, or diabetes, can receive up to five cleanings per calendar or contract year.

Delta Dental PPO members with qualifying chronic conditions are eligible for extra routine and periodontal cleanings, including 100% coverage for up to four procedures from the following list (any combination) per year: Periodontal scaling and root planingProphylaxis (routine cleaning)Deep cleaningDebridement (removal of plaque and tartar)

Regular dental maintenance and care can help prevent further health complications among people with chronic conditions, making periodontal cleaning insurance coverage a vital benefit for those with qualifying conditions.

To enroll in SmileWay Wellness Benefits, group clients can add the benefit to their mid-size and large group Delta Dental PPO plans, and enrollees with qualifying chronic conditions can opt in online or call Customer Service to access the expanded coverage.

Preventive scaling and root planing is typically done on an entire set of teeth to protect teeth and gums from possible infection and decay.

Scaling and root planing can be done therapeutically to treat existing periodontal disease.

For those with periodontal disease, therapeutic scaling and planing may be recommended two times a year or more.

The procedure can also be administered as needed in specific areas of the mouth called quadrants: upper left, upper right, lower left, and lower right.

If you have swollen and irritated gums, receding gum line, bad breath, pus between teeth and gums, recent irregular bite, sensitive gums, or loose teeth, you may need Periodontal Maintenance Cleanings instead of Routine Cleanings.

These conditions are signs that you may have periodontal disease, which requires more frequent cleanings to keep it under control. A deep cleaning, also called scaling and root planing, is usually necessary to treat periodontal disease.

Periodontal Maintenance Cleanings are typically done 3-4 times per year, and the frequency is determined by your hygienist or dentist based on several factors, including inflammation, how quickly tartar and plaque build-up, and how stable the present condition is.

A good home care plan is crucial to maintain the overall health of your mouth after a deep cleaning and periodontal maintenance cleanings begin.

Here are some signs that you may need Periodontal Maintenance Cleanings:

The frequency of Periodontal Maintenance Cleanings will depend on your individual needs, but it's essential to maintain regular cleanings to prevent periodontal disease from progressing.

Smileway Wellness Benefits offers enhanced dental coverage for Delta Dental PPO members with qualifying chronic conditions. These conditions include Amyotrophic Lateral Sclerosis (ALS), Cancer, Chronic Kidney Disease, Diabetes, Heart Disease, HIV/AIDS, Huntington’s Disease, Joint Replacement, Lupus, Opioid Misuse and Addiction, Parkinson’s Disease, Rheumatoid Arthritis, Sjögren’s Syndrome, and Stroke.

Delta Dental PPO members with qualifying chronic conditions can receive up to five cleanings per calendar or contract year. This is a significant increase from standard dental insurance coverage.

To be eligible for Smileway Wellness Benefits, members must opt in online or call Customer Service. This expanded coverage is available to all mid-size and large group Delta Dental PPO plans.

Members with qualifying chronic conditions can receive 100% coverage for one periodontal scaling and root planing procedure per quadrant per year. This deep cleaning helps treat gum disease.

Up to four additional procedures can be covered per year, including any combination of the following: periodontal scaling and root planing, and other procedures.