If you’re here, it’s probably because you suspect that you grind your teeth at night, or maybe your dentist has confirmed it and told you that you have bruxism. I understand exactly what it feels like to be in this position because I was there, and now I wear a night guard every night. There are many things to consider when you first realize you have bruxism, and as with any diagnosis, it can be frightening and overwhelming. The most important consideration is to find out where you will get a night guard, and more importantly, how much night guards cost and does dental insurance cover night guards?
Wearing a night guard can not only alleviate the unpleasant side effects of bruxism, such as jaw pain or tooth sensitivity, but it can also help protect your teeth from chipping, cracking, or wearing down over time. Bruxism can also cause disorders of the ATM, causing pain and even difficulty eating and opening and closing the jaw. Fortunately, night guards help resolve these issues, keeping your mouth and jaw pain-free and functional.
Unfortunately, night shifts can be expensive, especially if they are not covered by your dental insurance policy. Read on to learn how to find out if your dental insurance covers night shifts, what to do if they don’t, and what your dental insurance policy is for night shifts.
Does dental insurance cover night shifts?
When your dentist first tells you that you need an overnight call, the dental office can advise you whether or not your insurance company will cover the cost. While your dental office has expertise in this area, all dental plans are different, so you’ll want to check with your insurance company to confirm coverage. If your dental office tells you that night guards are covered, but you later find out they aren’t, you will still be responsible for the cost of the night guards.
To be sure, check with your insurance company. In most cases, you can review your plan online, or you can call your dental insurance customer service and have a representative explain your benefits. he or she will be able to tell you if the night guards are fully covered, partially covered, or not covered at all.
Most dental insurance plans cover preventive care, like cleanings and X-rays, but not all plans cover major care, like crowns and night guards. If your plan covers other major care, like crowns, bridges, or dentures, it will likely cover night guards, but always be sure and check first.
Once you find out if your plan covers night shifts, you’ll also need to check how much they’re covered. night guards are often covered at 50%, which means you will be responsible for paying half the price of the night guard (or your plan’s allowance for night guards, whichever is cheaper) while your company Insurance pays the other half. If your dental provider (also known as your dentist) is out-of-network, you could end up paying more than half even if your plan covers night calls at 50%.
sounds like a lot of nonsense? We get it, insurance is confusing. let’s see examples. For both scenarios, we will assume that the total cost of the night call without insurance is $1,000 and that your insurance plan’s allowance (the amount they will allow your dentist to charge) for night calls is $800.
Scenario 1: Your dental provider (also known as your dentist) is in-network (meaning they participate with your insurance plan) and your insurance covers night shifts at 50%. This doesn’t necessarily mean you’d pay half the price for your night watch, because allowance also plays a role. with a participating provider, you will pay half the allowance, not necessarily half the cost of the night shift. so, in this case, you would pay $400.
Scenario 2: Your dental provider (also known as your dentist) is out-of-network (meaning they don’t participate with your insurance plan) and your insurance covers night shifts at 50% . in this case, you would still pay half of the allowance, which would be $400, but you would also have to pay the difference between the full cost of the night watch and the allowance, which is $200. In this scenario, you would pay a total of $600 out of pocket for your night shift.
The amount of coverage, allowances and dollar limits of dental insurance plans depend on your particular dental insurance provider and your specific plan, so it is always best to check with your dental insurance provider what is covered and how much insurance covers. The bottom line in your situation is that you can end up spending a lot of money on a night guard if you buy it through your dentist, whether it’s covered by your insurance or not.
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your options when your insurance doesn’t cover night watch
Finding out that your insurance doesn’t cover night guards is a huge bummer. His teeth are literally craving relief, but the number his dentist quoted him to pay out of pocket for a night guard is astronomical. If this is his situation, he has two main options that won’t break the bank: over-the-counter mouth guards and custom-fit night guards.
over-the-counter mouth guards
This first option is probably very tempting because you can go to your local pharmacy or visit amazon and quickly have a night guard for a fraction of the price your dentist quoted. Unfortunately, while cheap and convenient, this option is not ideal.
Over-the-counter night guards claim to be one size fits all, but that’s not true in reality. Some over-the-counter night guards use the “boil and bite” technique to try to mold the guard to your mouth, but you won’t get the perfect fit you’ll get with a custom night guard.
If you’ve ever had to wear a boil and bite mouth guard for a sport, you’ll remember how they tend to shift or fall off because it’s simply impossible to get that perfect fit with a product designed to accommodate every mouth.
In addition, over-the-counter night guards are more likely to cause negative side effects, such as pain, tooth shifting, or jaw misalignment. these are probably the exact problems you are trying to fix by getting a night guard. Fortunately, you can order custom night guards online; they’re a better option than over-the-counter night guards, and they’re still affordable!
customized night protectors
Instead of being one-size-fits-all, custom online night guards allow you to take impressions of your teeth just like your dentist would in the office. By ordering them online, you cut out the middleman, so it’s much cheaper than it would be if you went through your dentist, and you can do it all from the comfort of your own home.
The process is simple: order your impression kit, follow the instructions to take your impressions at home, mail your impressions in the prepaid envelope, and then wait for your personalized night guard to arrive at your door. protooth guard also makes adjustments free of charge until your nightguard fits your mouth perfectly, so you’re much less likely to experience the negative side effects you might if you had to use an over-the-counter nightguard.
the end result
Night guards aren’t cheap, but neither are dental restoration work. Fixing chipped or fractured teeth is expensive and not much fun either. If you want to protect your smile and are tired of the negative side effects of clenching and grinding at night, it’s imperative that you get a quality night guard that fits your mouth and protects your teeth.
Especially when night guards are not covered by insurance, you want to weigh your options with the goal of getting a quality night guard at a price you can afford. don’t take chances with an over-the-counter night guard that may or may not fit your teeth. Opt for a custom night guard that’s comfortable and guaranteed to fit.