Does dental insurance cover dental implants?

If you have damaged or missing teeth, your dentist may recommend a dental implant. But without dental insurance coverage, an implant could put a big dent in your budget especially if you’re on a fixed income.

A single implant can cost between $3,000 to $4,500 without insurance.¹ If you need several implants, the costs can skyrocket quickly.

Insurance coverage for dental implants

The cost of dental implants can be substantial. However, the cost of the implant may be worth it when you consider that implants typically last a lifetime, function like natural teeth, give you back a better smile and allow you to eat and speak with confidence. 

Implants cost more than bridges because of the surgery involved and the expense of the implants themselves. Placing implants requires your dentist to get special training and equipment to perform the procedure. 

If you want to get dental implants to replace missing teeth but the cost is out of reach, you should consider getting dental insurance. Some dental insurance plans may cover a part of the cost of dental implants.

Depending on the reason you need implants, either your dental, your medical insurance, or both might provide coverage. Here are some factors that can help as you consider financing implants:

• If you have implant coverage from your dental policy, ask about the plan’s annual limits. You might need to plan for one phase of the treatment completed at the end of one year and a second phase in the next.

• The crown or bridge that attaches to the implant might be covered by your dental insurance while the implant itself may not. The implant might be covered by your medical plan.

• If there are medical problems related to the loss of a tooth, some medical insurance plans will cover implants.

• If your tooth loss was due to an accident or injury, the implant might be covered through an accident insurance policy or medical plan.

The cost of implants and implant-supported restorations vary from region to region. Only your dentist can give you a definite cost estimate for your particular case. After a consultation, contact your dental insurance company to find out if you have coverage and, if so, how much your out-of-pocket expenses will be. Some dentists and oral surgeons can set up payment plans or have special financing available.

How Guardian Direct insurance covers dental implants

Guardian Direct® dental insurance can help with the cost of implants. Guardian Direct Dental Advantage Achiever and Core PPO plans cover 50% of implants after a 12-month waiting period. 

What is a dental implant?

One of the strongest devices available to replace missing teeth, dental implants are artificial tooth roots that support crowns, bridges, or dentures. A popular replacement for missing teeth, over 500,000 people in the U.S. get dental implants each year.²

Tooth roots are the foundation for natural teeth. Roots anchor the teeth into the jawbone. If there is no root because a diseased or dead tooth was removed, a dentist can replace the missing root with an implant. Dental implants supply the support needed for a dentist to build a new false tooth. Once the implant is set, an artificial tooth is attached that looks and functions like a natural tooth.

A dentist places an implant into the upper or lower jawbone where the natural tooth was removed. Over a few weeks, the bone and gums grow around and through the implant, anchoring it in place. Your dentist then places a crown, bridge, or denture over the top of the implant. 

Types of dental implants

There are several types of dental implants. The type that is right for you depends entirely on your health, the condition of your teeth, gums, and bone as well as the location and number of teeth you need to have replaced. The different types of dental implants include the following:

• Endosteal: Endosteal implants are like screws that are placed directly into the jawbone. This type of implant relies on screws or cylinders as the foundation of the new tooth. The screws are made of metal, such as titanium. These are the most common type of implant done in the United States.³

• Subperiosteal: Subperiosteal implants made of a metal framework and sit on top of the jawbone and under the gums. Unlike the endosteal implant that is screwed directly into the bone, subperiosteal implants sit directly on top of the jawbone with small posts that protrude through the gums. Crowns, bridges, or full dentures attach to these posts. Typically, subperiosteal implants are recommended for patients who are not eligible for endosteal implants and are unable to tolerate removable dentures. If you have a lot of bone loss or other advanced oral disease and there is not enough bone left to attach an endosteal implant, you may need a subperiosteal one.

• All-on-4®: If you are missing all your teeth on the top or bottom and need a full denture, the All-on-4 implant can be an ideal solution. Four implants are placed into the bone and angled to take advantage of the thickest available area. On the same day the All-on-4 procedure is done, your dentist places a temporary denture on the implants. You can eat and speak naturally with the temporary denture for several weeks while you wait for healing to take place. After you have healed, your dentist attaches a permanent denture on the implants. This ensures that the denture stays in place and will not float in your mouth.

• Mini implants: Tiny, almost like a toothpick, mini implants require a less invasive type of surgery to place in the jaw. Their small diameter makes them ideal for patients who have little bone structure left. Many dentists use these to help stabilize dentures for patients who have worn them for many years and can no longer eat or speak without the denture moving around in the mouth.

• Immediate load implants: Sometimes called Teeth-in-a-Da®, this type of implant allows your dentist to place the implant and a crown on top of it on the same day they pull the natural teeth. Reducing the time between having teeth pulled and having an implant placed is a benefit for most patients. This is an excellent choice for patients who have healthy, strong jawbones.

What is involved in getting an implant?

There are many options for replacing missing teeth, but most dentists agree that implants are the only option that preserves the natural bone, supports the cheek and facial muscles, and function like natural teeth. Here are some aspects of what you can expect when you decide to get implants.

• Consultation: Before your dentist begins any treatment, they will examine your teeth, bone, and gums. X-rays as well as 3-D scans are needed so they can see the bone thickness and find the ideal areas to place the implants. Costs and insurance benefits should be a part of this initial consultation. This may take two trips to the dental office: one for gathering the needed x-rays, scans, and other data for the dentist to use to evaluate your case and a second to explain their recommendations to you as well as your options and the expected costs.

• Surgery: After you and your dentist decide if you are a good candidate for implants and determine which type of implant will best fit your needs, your next appointment will be for the surgery to place the implants. Your dentist may use local anesthesia and/or IV sedation to ensure you are comfortable during the procedure. They will place the implants into your jawbone and use stitches and special dressings to protect the area for several days. You can expect some bruising and soreness, but most patients return to work the next day. Over-the-counter pain medications are normally all that is needed to ease any lingering pain or soreness.

• Bone regrowth: This is the process where your implant and jawbone grow together. It may take several weeks or even months, depending on your health and condition of the jawbones prior to surgery. During this time, you can go about your normal daily life, taking care to eat mainly soft foods to avoid damage to the implant, gums, or temporary crowns.

• Abutment placement:  After the implant has fully grown into your jawbone, an abutment—a small knob-like connector—is placed on top of the implant. For some patients, this abutment is attached on the same day the implant is placed.

• Crown placement: When your gums and jawbone are healed, your dentist makes an impression of your implant abutments and remaining natural teeth to make a custom-designed crown, bridge, or denture. These may take a few days to manufacture. When they are ready, your dentist permanently attaches them to the implant abutments.

• Maintenance: Implant-supported crowns and bridges require routine maintenance just like natural teeth. Regular cleanings and check-ups at intervals determined by your dentist are important to ensure the implants and crowns last for a lifetime.

Benefits of dental implants

Missing teeth are not just a cosmetic problem. They can cause misalignment of your bite and jaw and make it difficult to chew properly. Having missing teeth can also cause your face to look drawn or sunken. There are many benefits to using a dental implant to replace a missing tooth or teeth.

• Natural look, feel, and fit: Unlike removable dentures and partials, implant-supported crowns and bridges function and feel just like your natural teeth. They do not move or float around in your mouth while speaking or eating. You can deliver a presentation at work and enjoy a buffet with confidence.

• High success rate: With a history of over 30 years, implants are one of the most successful methods of replacing missing teeth. In a 2018 study, researchers reported a five-year success rate of over 98%. Patient satisfaction was 99%.⁴

• Improved ability to bite and chew: When teeth must be pulled due to decay, gum disease, or trauma, it becomes hard to chew food effectively. Implant-supported crowns, bridges, and dentures can restore that ability.

• Improved facial tissue and bone support: Natural teeth supply support for the cheeks and facial muscles as well as the upper and lower jaw bones. When teeth must be pulled, that support is lost, and the cheeks and facial muscles begin to sag. Having those teeth replaced with implant-supported crowns or bridges restores the tone and firmness in the face and protects the facial bone and tissue from premature sagging and aging. 

• Easy to clean: You can clean a tooth replaced with an implant and crown just like a natural tooth. Using a toothbrush and dental floss, you can clean around and between the teeth without having to use the special cleaning devices required by fixed bridges.

Risks of dental implants

Although the surgery to place an implant is usually completed in one visit, it can take several weeks or months for enough healing to take place for the final implant-supported restoration to be cemented. This is a disadvantage for implants when compared to standard fixed bridges, which are completed in just two visits about one week apart.

Dental implants have a lot of benefits and, for many people, they are the best treatment option for missing teeth. However, they are not right for everyone. Here are some risks and possible side effects to consider before you get dental implants:

• Difficulty healing: Patients with weak jawbones due to chronic gum disease may have trouble integrating an implant. Those who needed bone grafts or who have narrow ridges, patients with poorly controlled diabetes, and smokers may also have problems with post-operative healing.

• Broken or loose implant: Over time, the motion of chewing and pressure from biting and eating can cause implants to loosen or break. If the abutment or attachment device is loose, your dentist can retighten those during a routine dental visit. If the implant becomes loose due to failure of the jawbone to fully integrate, the implant may need to be removed so your dentist can perform a bone graft in the area before replacing the implant.

• Broken framework: Subperiosteal implant designs include implants connected to each other under the gums by connector rods called the framework. The risk of broken framework is similar to the risk of loose or broken screws. If you have a subperiosteal implant, fixing or replacing the framework could require another oral surgery.

• Loose cement: If the cement holding the crown to the implant comes loose from the pressures of chewing and biting, your dentist can probably recement the crown. This is a common occurrence, and it is unlikely that the entire implant would need to be replaced.

• Change in bite: If the implant is not positioned perfectly in alignment with your teeth, it can cause your bite to shift, which can be uncomfortable. It may also cause pain when you bite. This problem can usually be improved with simple bite adjustments.

• Chipped or fractured porcelain coating: During normal chewing, the white coating on a crown or bridge can chip or fracture. This is usually just a cosmetic problem that can be easily repaired.

• Jaw pain: Aching or soreness in the jaw after an implant is placed usually goes away after the implant has settled, and the surgery site has healed. Some people continue to experience intermittent jaw pain. If the pain is severe and does not go away after using over-the-counter medications, your dentist may be able to help.

• Cost: The cost of implants can be considered a downside, but there are ways that you can get help paying for implants. Many dental insurance plans can help cover the costs.

Are dental implants right for you?

After doing your research on dental implants, make an appointment to see your dentist for a consultation. Only your dentist can help you decide if implants are the best choice for your situation.

Also, consider reviewing your dental insurance benefits to see if you have coverage for implants. This knowledge can help you and your dentist decide if implants are an option for you.