Orthodontic Coverage’s Role in Ortho Case Acceptance

Those not in the dental or orthodontic profession don’t often realize that nearly 50% of children will need braces to address functional issues like a misaligned bite. Surprisingly, as many as 75% would benefit from braces for a straighter smile and improved facial contours. 

And as dentists and orthodontists know, it’s not just kids—many adults also value braces for correcting crooked teeth or a misaligned bite. However, the reality is that despite their health advantages, orthodontic treatments often come with a hefty price tag. This leads many patients without comprehensive orthodontic coverage in dental insurance to forego their or their children’s critical orthodontic treatment.

Orthodontic Coverage: Recent Statistics

Delta Dental’s insights from the 2023 State of America’s Oral Health and Wellness Report identified dental insurance as a linchpin for overall wellness among U.S. adults. In fact, 86% of adults acknowledge that dental coverage is integral to maintaining good overall health, while 82% view it as an indispensable component of their well-being. The report also explains the psychological benefits, with 87% expressing that dental insurance provides a sense of peace of mind.

Clearly, this shows the broader landscape of patient priorities for general dentists considering the integration of orthodontics. An astounding 81% of adults associate dental insurance with increased confidence in their smiles, and 85% recognize its role in long-term financial savings.

However, the landscape is not without challenges. Approximately 68.5 million American adults lack dental insurance, a concerning trend highlighted in the recent State of Oral Health Equity in America survey. This survey data further reveals that the number of uninsured individuals could potentially increase to an unfortunate 91.4 million by the end of 2023. 

Here’s why orthodontic coverage should be a priority.

Based on the above statistics, orthodontic coverage is a crucial dental insurance concern for many Americans. It provides a sense of security for individuals aspiring to attain straighter smiles by alleviating the financial burden of orthodontic treatments. This peace of mind is especially vital given the transformative impact orthodontic procedures can have on oral health and overall well-being.

For patients without orthodontic coverage, dental practitioners can offer financial options for individuals without such coverage yet desiring a straighter smile. One avenue is offering flexible payment plans. For in-house plans, it’s a good idea to develop a structured repayment strategy to ensure financial ease for the patient. 

Health care credit cards like CareCredit also present a viable solution by providing financing explicitly tailored for medical procedures, including orthodontic treatments. This option allows patients to pay upfront and proceed with their orthodontic journey while adhering to a manageable repayment plan.

By prioritizing orthodontic coverage and offering alternative financing solutions, dental professionals can empower their patients to achieve their desired smiles while ensuring financial accessibility and flexibility in orthodontic care.

The American Dental Association plays a key part in insurance reform.

The ADA leads impactful advocacy and reform initiatives that aim to alleviate pain points within the industry. Their mission to advance legislation and regulations reflects a commitment to enhancing the practice of dentistry and the oral health of the American public. Notably, recent legislation, including the Competitive Health Insurance Reform Act of 2020, repeals McCarran-Ferguson’s antitrust exemption for health insurance, including dental insurance. 

This legislative stride reinforces the ADA’s dedication to fostering positive change in the dental insurance landscape. Whether patients opt for dental benefit plans or remain out of network, the ADA and state dental societies persistently work toward policy reforms. 

The importance of advocating for orthodontic coverage to ensure a more accessible, inclusive, and patient-centric oral health care system cannot be overstated, and it is integral to addressing both dental professionals’ and their patients’ challenges.

The biggest benefit of orthodontic coverage is peace of mind.

The key takeaway is the peace of mind that orthodontic coverage provides Americans pursuing orthodontic care. Dental practitioners are encouraged to advocate for insurance plans to include orthodontic coverage and to bring awareness to orthodontics’ critical impact on oral health. 

Additionally, offering alternative payment options, such as health care credit cards, ensures accessibility for patients aspiring to achieve a straighter smile. By championing orthodontic coverage and providing flexible financial solutions for those without it, dental professionals contribute to their patients’ well-being, creating a landscape where orthodontic care is both attainable and empowering.

The American Orthodontic Society, a premier educational association for dentists practicing orthodontics, offers cutting-edge education, mentoring, and advocacy to empower dental professionals in their practices and communities.
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