Does Dental Insurance Cover Wisdom Teeth Removal | Extraction Cost

Does dental insurance cover wisdom teeth removal?

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Many dental insurance plans have some level of benefits for wisdom teeth extractions.

Wisdom teeth, also known as the third molars, are four teeth that grow at the back of each corner of your mouth sometime between the ages of 17 and 21. Because they grow so far back, they can cause problems like crowding out other teeth, becoming trapped under your gum line, or causing tooth decay because they are hard to reach and clean.

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Dental insurance can help you cover a portion of the costs of removal so you can maintain your health and avoid more extensive tooth problems later in life.

Wisdom teeth removal cost

How much is wisdom teeth removal? Without dental insurance, wisdom teeth extractions can cost anywhere between $200 and $1,000 per tooth¹. If you happen to need all four wisdom teeth pulled, the bill can quickly add up. 

Costs and plan coverage can differ, it’s best to have your dentist submit a Pre-Authorization prior to having this procedure. That way, you know what is covered, how much is covered by insurance and what your estimated portion is going to be.

Type of extraction

If the tooth has fully erupted in the mouth, the cost may be less than if it must be surgically removed from beneath the jawbone². The time involved in extracting an erupted wisdom tooth is typically less than for an impacted tooth³. Equipment such as surgical drills and medicated dressings needed for surgical extractions can add to the cost.

Type of anesthesia

General anesthesia, which requires additional training and equipment for the oral surgeon and their staff can increase the cost. Likewise, sedation, which many general dentists and oral surgeons use, adds to the cost due to the equipment needed to administer and monitor you while sedated.

Credentials of your dentist

If your general dentist can pull your wisdom teeth, the cost may be less than it will be at an oral surgeon’s office. Oral surgeons often have years of specialized training, over and above that of general dental school. They sometimes have a nurse anesthetist or anesthesiologist on staff as well as specialized equipment for surgical procedures that are not found in a general dental office. The need for this extra equipment and staff adds to the cost for services.

If an oral surgeon is required, confirm they are in-network for possible cost savings.

Additional costs

Along with the basic fees for the actual extraction, there can be added fees for X-rays, scans, anesthesia, and medications. These can add several hundred dollars to the bill, especially if CT scans are needed.

Wisdom teeth extraction cost with dental insurance

Does dental insurance cover wisdom teeth removal

Does dental insurance cover wisdom teeth removal? Many dental insurance plans do offer some level of benefits for wisdom teeth extractions. Benefits for wisdom teeth extractions can typically range from 50% to 80% of the dentist’s or oral surgeon’s fees. They are typically also subject to deductibles and co-pays. Yearly maximum limits on the amount the insurance will pay each year also apply to wisdom teeth extractions. For example. if your annual limit is $1,000 and you receive a total bill of $4,000, your yearly maximum is quickly met with no benefits left for the rest of the year.

Some policies have a waiting period before wisdom teeth extraction costs are covered. If you have only recently become covered by your dental insurance policy, make sure to verify that any waiting period is met before scheduling your wisdom teeth extraction

Does Guardian Dental® Insurance cover wisdom teeth removal?

Does Guardian Dental Insurance cover wisdom teeth removal? Yes, but the exact benefit amounts vary depending on your plan.

Guardian Direct Dental top-tier and mid-tier PPO plans cover up to 50% to 70% of the costs of tooth extraction after a waiting period.

Guardian Direct Dental Top Tier Plans (PPO)

  • Simple extractions: up to 70% after a six-month waiting period

  • Complex extractions: up to 50% after a 12-month waiting period

Guardian Direct Dental Mid Tier Plans (PPO)

  • Simple extractions: up to 50% after a six-month waiting period

  • Complex extractions: up to 50% after a 12-month waiting period

Average cost of wisdom teeth removal

Wisdom teeth do not always have to be removed. If they have room to go in straight and aligned with the other teeth, healthy wisdom teeth can help you chew without causing any problems to your bite or oral health. However, if your mouth is not large enough to make room for another molar or if your wisdom teeth do not grow straight up into the mouth, this can lead to crowding, cysts, or infection requiring wisdom teeth removal⁴.

Wisdom tooth removal can cost anywhere from $200 to $1,000 per tooth⁵. You may end up paying more if the tooth is impacted or if you have multiple wisdom teeth that need to be pulled, among other factors.

When to contact the dentist about wisdom teeth removal

If you notice any of the following scenarios, you may want to contact your dentist about wisdom teeth removal.

  • Your wisdom tooth has erupted through the gums but forms a food trap behind another tooth. This can typically lead to cavities on the other tooth.

  • Your wisdom tooth has erupted at an angle, making it impossible for you to keep clean

  • Your wisdom tooth has erupted but is crowding and putting pressure on your other teeth.

  • Your wisdom tooth is causing you to bite your cheek or tongue.

  • Your wisdom tooth only comes partially through the gums, causing chronic infection.

  • Your wisdom tooth is trapped under the gums or in the jaw.

  • A cyst has formed around your wisdom tooth.

  • You’re experiencing pain or infection in the area.

Having a wisdom tooth taken out can be a simple or complex surgical procedure depending on your personal circumstances. Your general dentist might take it out herself if the tooth is fully or partially erupted into your mouth. This means that some or all the top of the tooth can be seen and accessed with instruments to lift it out of the socket.

If the wisdom tooth is still underneath the gums or bone, your dentist might send you to an oral surgeon. Oral surgeons have training beyond dental school to learn how to handle complicated surgery for the mouth and jaw. Wisdom teeth extractions are a common procedure for oral surgeons.

Your dentist will follow wisdom teeth best practices in extracting the tooth or referring you to an oral surgeon who is better trained to do so.

If you’ve recently had one or more wisdom teeth pulled, keep an eye out for complications that may arise afterward. If you’re experiencing pain or other symptoms after your appointment, contact your dentist. It could be due to one of these common complications:

Dry sockets

These occur when the blood supply to the tooth socket does not clot properly⁶. Dry sockets can delay the healing process.

Trapped food and bacteria

The open hole, or socket, provides a trap for food debris and bacteria to accumulate. This condition typically resolves after the gums start to heal over⁷.

Nerve damage

The nerves in the lower jaw, lip, tongue, and chin can sometimes be damaged and remain numb. This may be temporary or permanent but is typically a rare occurrence⁸.

How many wisdom teeth can you have?

Most adults get four wisdom teeth, two on the top and two on the bottom. It’s less common, but still possible to have more than four wisdom teeth, less than four wisdom teeth, or no wisdom teeth at all. The American Association of Oral and Maxillofacial Surgeons estimates that nine out of 10 people have at least one impacted wisdom tooth, making wisdom tooth extraction a very common procedure⁹.

You can have one or more wisdom teeth pulled during one appointment. Many people opt to have all four wisdom teeth out at the same time, so they only ever have to go through the experience once.

While many people get one or more of their wisdom teeth extracted, wisdom teeth that can be kept clean, are fully erupted, and cause no pain or other problems may not need to be pulled.

When do I decide to have my wisdom teeth pulled out?

Your dentist will monitor the condition of your wisdom teeth and the areas surrounding them during regular check-ups. Wisdom teeth typically have the potential for flaring up and causing problems. Keeping the areas clean and having regular check-ups will help ensure that your dentist catches any issues early and provide whatever care is needed. Taking good care of your oral health at home and visiting the dentist regularly will help your dentist decide when or if to have your wisdom teeth pulled out.

We’ve compiled a few resources about dental treatment and how to help save money on wisdom teeth removal.


Links to external sites are provided for your convenience in locating related information and services. Guardian, its subsidiaries, agents and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-party sites, organizations, products, or services and make no representation as to the completeness, suitability, or quality thereof.
This is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.

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Sources

  1. https://www.authoritydental.org/wisdom-teeth-removal-cost, 2020, accessed 2021

  2. https://www.authoritydental.org/wisdom-teeth-removal-cost, 2020, accessed 2021

  3. https://www.authoritydental.org/wisdom-teeth-removal-cost, 2020, accessed 2021

  4. https://www.mouthhealthy.org/en/az-topics/w/wisdom-teeth, accessed 2021

  5. https://www.authoritydental.org/wisdom-teeth-removal-cost, 2020, accessed 2021

  6. https://www.ada.org/sitecore/content/home-mouthhealthy/az-topics/d/dry-socket, accessed 2021

  7. https://www.mouthhealthy.org/en/az-topics/e/extractions, accessed 2021

  8. https://www.nhs.uk/conditions/wisdom-tooth-removal/complications/, 2018, accessed 2021

  9. https://myoms.org/what-we-do/wisdom-teeth-management/wisdom-teeth-faq/, 2019, accessed 2021

Disclaimer:

These are the personal views of a select group of Guardian Direct's customers and may not represent the experience of other customers. These opinions are not indicative of future performance or results. Actual customer testimonials. Names may have been changed to protect customer privacy.

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Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.(exp.06/22)

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