Q: Does medical insurance pay for any type of gum treatment or periodontal treatment?
A: Periodontal disease, gum and bone loss around teeth, has no symptoms until it’s too late. This makes it tough for me to motivate patients to accept periodontal treatment, when they can’t see for feel it. (Buying wind insurance is a tough sell for me, as I just can’t picture my home drifting into the air and landing on a farm in Kansas or Oz.) Some of the pieces of equipment in our office are so expensive and delicate that we have separate insurance policies for one single part on the machine; not even the whole machine! Ridiculous.
Full mouth gum surgery to eliminate deep periodontal pockets greater than 5 millimeters is rarely done anymore. If a tooth is loose, has massive bone loss and a poor prognosis, often it is more intelligent to remove the tooth and replace it with an implant. However, if the tooth is solid, but the X-rays show bone loss and/or 5+ millimeter pockets, you need to do SRPC (scaling, root planning, and curettage.)
Your hygienist will get your gums numb with a topical gel, or occasionally with local anesthetic injections, and go deep under the gum line to remove spicules of tartar that cannot be removed by your floss or a routine “check-up-type” cleaning, called a prophylaxis. The end of the visit consists of injecting granules of Arestin (minocycline) into the pockets to kill off the bone-eating bacteria.
SRPC will attempt to arrest the disease process of periodontitis. You will be given a follow up visit in a few weeks to re-probe these areas for pocket measurements and a prophylaxis.
It is possible for your medical insurance to knock off $800 off your fees, as Arestin is covered by many medical plans. Since they are paying for the actual drug, you will still be charged for the placement of the antibiotic. The hygienist will use a specialized syringe to insert the material under the gum line.
At my next seminar, below, I dedicate a small portion of the program on this very topic. Details below.
Dr. Mitchell Josephs practices Implant, Cosmetic and General Dentistry with an emphasis on implants, porcelain veneers, and complex crown and bridgetreatment. He is on staff at JFK Medical Center and is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. He completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.