Monday, May 17, 2010

Is gum recession COSMETIC or medical?

I have a couple teeth with severe gum recession due to over brushing. My insurance only covers necessary medical procedures...not cosmetic. Is there any chance that this is in fact MEDICAL.

Is gum recession COSMETIC or medical?
Gum recession is a medical issue and not a cosmetic one. The gums and bone comprise the socket which holds your tooth in place. If these recede, your teeth become loose, and sensitive. Your insurance shouldn't give you any problems with claiming any necessary procedures performed for your gums as long as you have periodontal coverage.





More importantly, if you have been told by the dentist that you have brushed them away, have you modified your brushing technique?
Reply:Severe gum recession is in fact a condition that makes it medically necessary to have treatment. Failure to do so puts the teeth at a significantly higher risk for loosening and loss which only leads to further health risks. Have your dentist do a preauthorization with your insurance company prior to performing any procedures. If the insurance company denies coverage, have your dentist write a letter to the company that describes your condition (actual measurements and x-ray or photographic evidence helps) and includes a request for coverage for it. This added measure is often all that is required for insurance coverage. More than likely, your request for coverage will NOT be denied.


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