Does Health Insurance Cover Wisdom Teeth Removal?

The third molars, more commonly known as the wisdom teeth, are situated in the very back of the mouth. These teeth come later than the rest of the adult teeth, usually during the teenage or early adult years; in fact, they’re called “wisdom teeth” because supposedly, when they grow in, people are presumable “wiser” .

wisdom teeth removalThe wisdom teeth are notorious, as they often have to be removed. Why do they have to be extracted? Often, it’s because there isn’t enough room in the mouth to support the teeth. As such, they can cause a number of problems. For example, they can:

  • Fail to erupt from the gums. When this happens, they are trapped – or impacted – within the jaw. Impacted wisdom teeth can cause serious problems, such as an infection or the development of a cyst that can ultimately damage the roots of surrounding teeth or the jaw bone.
  • They emerge only partially; only the front or the back of the teeth erupt from the gums, while the other part remains hidden within them. When that happens, they can be very difficult to clean and can become a haven for bacteria growth, which, over time, can lead to infections and gum disease.
  • They can grow in completely; however, they can overcrowd the mouth, which can result in shifting teeth. If the teeth shift enough, their appearance can become distorted. Additionally, other teeth that are shifted can become less structurally sound, as their roots can be affected by their movement.

In other words, the wisdom teeth can cause extensive dental health problems. Not all people will face these issues, but the majority do. If you are suffering from any of the above-mentioned problems, it is likely that your dentist will recommend wisdom tooth extraction.

What is Wisdom Tooth Extraction?

Wisdom tooth extraction, as the name suggests, is a procedure that involves the removal of the wisdom teeth. Some or all of the teeth may need to be removed. It’s a surgical procedure that is done by an oral surgeon. Usually, the treatment is completed the office of an oral surgeon.

Generally, local anesthesia, sedation anesthesia, or general anesthesia is administered prior to surgery to make the patient more comfortable; the method used will be recommended by your medical professional and will based on your specific condition and needs.

During the procedures, an incision will be made in the gums, which exposes the wisdom tooth and the bone. The bone that is blocking access to the root of the tooth is removed, and then the tooth is split into sections and removed. Once the tooth is completely removed, the site is thoroughly cleaned and sutures are put in place to close the opening and facilitate healing.

Is Wisdom Tooth Extraction Covered by Health Insurance?

Considering the fact that the costs of all types of healthcare – including dental health – seems to be constantly rising, if you have been told that you require wisdom tooth extraction, you are probably wondering if your health insurance will offset the cost.

The answer, of course (and like everything related to medical insurance) is: it depends. Generally, dental insurance does cover the cost of routine checkups and cleanings; however, it may or may not cover other types of procedures, including wisdom tooth extraction. There are a variety of factors that will determine whether or not your insurance will cover the procedure. Those factors include:

  • The type of health insurance you have
  • If the procedure is considered medically necessary
  • The specifics of the procedure

If your insurance does cover wisdom tooth extraction, it’s important to find out exactly what it does cover. For example, while it may cover the procedure, it may not cover all aspects; for instance, local anesthesia may be covered, by general anesthesia may not.

It’s also important to note that if your policy does cover the removal of wisdom teeth, you may have to see an in-network oral surgeon. If you fail to see someone who is in your network, you will likely have to pay the entire cost of the procedure out of your own pocket.

Summing It Up

Wisdom teeth removal is a routine surgery that is performed on millions of people each year. Because it is so common and since it is often considered medically necessary, health insurance companies usually do cover at least a portion of the procedure. As always, it’s important that you speak with your health insurance company before you schedule an appointment to have your wisdom teeth removed so that you are fully aware of the specifics of your policy.

If you do not have insurance, speak to a reputable agent. Together, you can find an affordable policy that will offer coverage for wisdom tooth extraction.

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