A guide to dental insurance for infants and children
When a child is born, getting medical coverage is a priority. But it’s also important to have dental insurance, too. This guide to dental insurance for children helps provide everything you need to know.
When and why to get coverage
Babies usually start getting teeth around 6 months of age and cavities can develop as quickly as teeth appear, so consider getting dental insurance as early as possible. Your dentist will check to see if your child’s smile is off to a good start and provide useful information about dental disease prevention, nutrition and dental development.
Unfortunately, children can develop cavities by their first birthday. Childhood cavities can cause pain, difficulties eating and speaking, and infections that can damage permanent teeth developing underneath their gums. If these cavities are severe or extensive, very young children may need to be treated in a hospital while under general anesthesia. This can have an emotional and financial effect on parents.
By age 5, more than 20% of children have had cavities and almost 10% have untreated decay. Poor dental health in childhood is likely to carry into adulthood. Fortunately, most childhood dental disease is preventable through good oral hygiene, proper nutrition and regular dental visits.
Dental insurance makes care more affordable and children with dental insurance are twice as likely to receive dental services than those without it. And a healthy smile is even important for learning, as students with poor oral health usually have lower grades and are absent more often than those students with good oral health.
What to look for in coverage
Coverage varies among plans. As you compare plans, make sure you review what is and isn’t covered. Consider your children’s ages and their needs over the next year. Look for plans that cover all or most of the cost of preventive care (exams, cleanings, X-rays) and basic care (fillings, tooth extractions). Most plans cover fluoride treatments and dental sealants for cavity prevention in children, but check to make sure that they are included.
Add the total potential costs, including deductibles, out-of-pocket limits and co-insurance or co-payments (i.e.; the percentage or share you pay for a procedure), and make sure your dental insurer has a large network of dentists, including pediatric dentists and specialists. To take full advantage of in-network savings, see if your preferred dentist is in-network.
Future needs to consider
Your children’s permanent teeth will begin to come in around age 6. Coverage for dental sealants is vital at this time because permanent back teeth (molars and premolars) should be sealed right away.
Around age 7 your dentist may suggest your child visit an orthodontist to assess future needs. If your child is likely to need braces, you may want a plan that partially pays for major dental work and orthodontics.
How to get coverage
- Employer coverage: If you or your spouse have a dental plan through your employer, you may be able to get a family plan during open enrollment. Also, having a baby is a qualifying life event, so you can add your newborn to your benefits within a period determined by your plan.
- Individual and family coverage: You can purchase a plan to fit your family’s needs from companies like Delta Dental.
- Medicaid or the Children’s Health Insurance Program (CHIP): These state-funded plans are available to low-income families.
Sources:
1//www.mouthhealthy.org/en/az-topics/b/baby-bottle-tooth-decay
2Impact of early childhood caries on quality of life: Child and parent perspectives. Singh N, Dubey N, Rathore M, Pandey P J Oral Biol Craniofac Res. 2020 Apr-Jun;10(2):83-86.
3//www.cdc.gov/nchs/products/databriefs/db307.htm#fig1
4//jada.ada.org/article/S0002-8177(16)30904-7/fulltext
5//www.cdc.gov/oralhealth/basics/childrens-oral-health/index.html
6//blog.getinsured.com/answers/health-insurance-basics/cc-pediatric-dental/
7//www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/
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While it’s recommended that every child has an established dentist by the age of 1, it can be difficult to afford regular dental cleanings and checkups (or even emergency services) without insurance.
However, there are resources out there for you and your family that include free or reduced-cost dental care. Most of these services include cleanings and X-rays, as well as treatments such as root canals, cavity fillings, and tooth extractions.
Finding reduced-cost or free dental care for your child may feel overwhelming at first, but consider these resources to help get you started.
If you’re unable to access affordable dental coverage, you may consider looking into Medicaid or CHIP. These are state-run programs that help families obtain health and dental coverage for their families. Most Medicaid services are covered for children under the age of 21.
You must apply and meet the income qualifications to obtain this coverage. Review the application and requirements here.
Once approved, you may use your coverage at any private dentist who takes Medicaid. About 43 percent of U.S. dentists accept Medicaid, but be sure to ask before making an appointment for your child.
You can also look here or call (877) 543-7669 (KIDS-NOW) to find Medicaid-participating dentists in your area.
Occasionally, you may be able to find community dental events in your area where you can access free teeth cleanings and check-ups.
One example is the annual Give Kids a Smile event, where volunteer dentists and hygienists perform free cleanings, screenings, and education.
This community event is held every February in conjunction with National Children’s Dental Health Month. In 2020, there were 1,500 events across the country.
For future events, check out the Give Kids a Smile website or call (844) 490–4527 (GKAS).
There may also be free dental events other times of the year in your community. Be on the lookout for information from community clinics, as well as your child’s school. Keep in mind that appointments may be limited, so give yourself a reminder on your phone or calendar when it’s time to sign your child up for services.
Community health clinics run by the Health Resources and Services Administration help provide health care services to those who cannot afford it. While not widely advertised, the majority of the 1,400 nationwide clinics provide reduced-cost dental services, too.
You can find the closest community health clinic in your area here or call (877) 464-4722 (ASK-HRSA).
All services at community clinics are done by licensed and experienced professionals. Be sure to call ahead as soon as possible, as appointments may book up quickly.
Both dental and dental hygienist schools offer reduced-cost dental cleanings and treatments. Not only can this help offset the costs of dental care for your family, but it also provides aspiring dentists and dental hygienists with the hands-on training they need to complete their degrees.
While the providers at these schools haven’t completed all of their training yet, all services are supervised by experienced and licensed dentists. Also, unlike community clinics and other events, you may have more appointment options available at dental schools.
Be sure to ask about the costs in advance of your child’s appointment. Click here to find dental schools in your state. You can also find dental hygienist schools by state here if you’re looking for basic cleanings and preventive care.
For more extensive dental care that goes beyond the scope of cleanings and X-rays, you may consider looking at current clinical trials.
If eligible, your child may be able to receive free or reduced-cost services while also participating in critical studies with the National Institute of Dental and Craniofacial Research (NIDCR). You can check out current trials and enrollment details here.
It’s important to know that clinical trials with NIDCR look for specific dental conditions and diseases, and there are certain eligibility requirements for each study. This option won’t cover cleanings and other common preventive measures.
While dental visits are important, they’re just one aspect of your child’s oral health. You can help your child keep their teeth and gums healthy between visits to prevent cavities, gingivitis, and other dental issues.
Start with the following tips:
- Make sure your child gets their free toothbrush, toothpaste, and floss from every dentist appointment.
- Have your child brush their teeth twice a day, and make sure they floss at least once a day.
- Only use fluoride-containing toothpaste, and teach your child how to spit it out and rinse properly. Also, make sure your child uses a pea-sized amount each time they brush after the age of 3. Before the age of 3, use a smear or rice-sized amount of fluoridated toothpaste.
- Supervise your child’s brushing habits until they are between the ages of 6 and 8. Younger children may need help with brushing technique, as well as how to spit out toothpaste correctly. Help them with flossing too.
- Cut down on your child’s sugar intake. This includes candies and sticky snacks, as well as fruit juices and sugary cereals.
Dental care is an essential part of your child’s overall health, but services can be expensive without dental insurance.
However, there is a range of cost-saving options you may be able to find in your area, including reduced-cost services at dental schools and community clinics, as well as free services at occasional community events. You may also be eligible for Medicaid based on your income.
On top of free or reduced-cost dental care services, you can help boost your child’s oral health with good hygiene practices. Teach your child that taking care of their teeth now can reduce the risk of complications later in life.