Dental Insurance for Kids: Is It Necessary?

Pediatric oral care is vital to healthy teeth and a healthy smile. A healthy mouth in children supports holistic growth, nutrition, and a healthy life. An early start can help prevent future oral complications. As more parents become aware of the importance of early oral care in children, the demand for children’s dental coverage is on the rise. This article explores dental coverage in children, the types of dental plans available, and the factors that affect coverage.

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Why dental health is important for kids

The American Academy of Pediatric Dentistry (AAPD) highlights that oral health issues in children are progressive, cumulative, and chronic. If left unmanaged, they can lead to potential infections, chronic pain, suffering, low life quality, and increased healthcare costs.

This underscores the lifelong consequences of ignoring dental health in children. Let's look at some common dental issues in children.

• Caries and cavities are among the most common oral health issues among children. Recent data reveals that tooth decay remains the leading cause of hospital admissions in children between five and nine years, with a 17% rise in tooth extractions owing to caries and tooth decay.
• Teeth fractures are often seen in kids with newly erupted teeth or teeth that are yet to erupt completely. Children are prone to accidental teeth fractures and sports injuries. Immediate professional intervention determines the prognosis of your kids’ teeth.
• Gum infections can often develop from teeth-related decay. Once an infection reaches the gums, it can spread across the soft tissues and facial structures and become cellulitis. When left untreated, cellulitis is a life-threatening condition that demands immediate professional help.
• Misaligned teeth are often seen in the early teeth eruption phases. Depending on the severity and stage of the malalignment, your dentist can advise orthodontic intervention. Orthodontics — aimed to align teeth and jaws — is one of the most expensive dental therapies for children.
• Unerupted teeth are another commonly reported dental issue among children and adolescents. Your dentist can recommend a diagnostic X-ray to determine the cause and recommend management options accordingly.

Acknowledging that early intervention can prevent most of these potential oral health issues in children, the AAPD advocates the highest possible oral care for children of all ages, adolescents, and children with special health care needs.

What does dental insurance cover for kids?

One way to cut off dental care costs for your child is to get an appropriate dental plan. Dental plan coverage for children can vary, depending on the policy you opt for and your kid's oral health status. Here is a list of dental care options a children's dental insurance can cover.

Routine care

Most dental plans cover up to 100% of basic and preventive services, including regular oral checkups, X-rays, professional cleanings, topical fluoride treatments, and sealant applications. Depending on your child's needs, cleanings can be covered twice a year. The need for fluoride applications and sealants depends on the teeth anatomy and risk of developing caries. Your pediatric dentist will guide you on this.

Major dental procedures

Extensive dental therapies can be covered if they are medically necessary. Procedures like fillings for decayed (and restorable) teeth and extractions (grossly decayed teeth that can't be restored) are deemed essential to prevent future complications — and can be covered partially. To correct misaligned teeth, expensive dental procedures like braces (orthodontics) can also be covered to an extent.

Emergency care

Knocked-out teeth, sudden dental injuries, and severe oral infections require emergency care, which is often covered under health plans. However, the extent of coverage can vary, so it's best to talk to your pediatric dentist about the scope of coverage before the emergency care starts.

When do babies need dental insurance?

Some dentists may advise getting your baby’s mouth checked by the first birthday and every six months after that. This is the best time to detect potential dental issues in kids and monitor for further care needs.

The World Health Organization strongly emphasizes early preventive oral care to reduce the risk of costly dental care later in life. Pediatric dental insurance helps improve oral care access among children, ensuring healthy oral health for children without parents having to bear hefty out-of-pocket costs.

Dental insurance for toddlers and young children

Kids in the age group of one and above often fall prey to sudden tooth fractures. Young children can’t point out the source of pain and discomfort — often leading to missed cavities and tooth decay. Parents and pediatric dentists need to monitor oral health in this age group and diagnose potential (or emerging) dental issues.

Having a dental plan for your kid ensures you get regular checkups and start preventive care at the right time. It also acts as a shield against incurring costs from repeated (and expensive) dental care once the issue spirals out of control.

When to consider getting dental insurance

Consider getting dental health plans for your child if you face any of the situations below.

• Your child has high dental care needs. This can mean your child is caries-prone or has a chance of developing severe teeth malocclusions. Children with special health care needs should also get dental plans early on.
• If you have a family history of dental issues, prioritize a dental plan for your child.
• If you face a weak financial situation, consider getting insurance for your child.

Types of dental insurance plans for kids

Pediatric dental plans focus more on preventive dental care to prevent complications in later life. The Affordable Care Act recommends that all children under age 18 should have dental care access covered by a family plan or a standalone dental plan.

Family dental plans vs. individual plans

You can opt for a family plan or a standalone dental insurance policy for your child based on the benefits, costs, and dental services you need.

A family dental plan may be an option if you want to include all members in a plan or have adult members who might need comprehensive dental care. A standalone plan is focused on catering to your child's dental issues. You can take one if you only want to get your child covered.

Factors to keep in mind when choosing a children's dental insurance

Here is what you would want to check before taking up a plan.

Deductibles, premiums, and copays can vary between health plans. Make sure you know the details of the policy you want to take. The exact cost coverage depends on your location, insurance provider, and policy statements.

Keep in mind these factors before you choose one.

Affordable alternatives

If you find the policies out of your budget, you can opt for an affordable alternative.

Medicaid and Children's Health Insurance Program (CHIP) offers low-cost coverage for children from low-income families. These programs provide oral care access to children from all socioeconomic backgrounds. Dental discount plans help provide dental care at discounted rates for a yearly fee.

Check if you are eligible for these programs and apply accordingly.

How to choose the right dental insurance for your child

Choosing the right plan for your kid can be taxing. Here is a stepwise guide on choosing the right insurance for your child.

1. Look for a pediatric dental plan that provides a comprehensive list of in-network dentists, including pediatric dentists.
2. Make sure the policy covers preventive care, emergency care, and major dental procedures that are medically necessary.
3. Compare the annual limits, out-of-pocket payments, and waiting periods from different plans before opting for the best one.
4. Talk to your pediatric dentist and policy provider to understand the exact ins and outs of your plan.

Your child's smile is precious. Dental plans for children are key to affordable oral healthcare. Parents should monitor their children's oral health and decide whether they need to invest in a dental insurance plan. It is best to visit your pediatric dentists and discuss any questions about dental insurance plans for children.