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Does dental insurance cover dentures?

Dental insurance may help cover part of the cost of partial dentures or full dentures.

8 minute read

Tooth loss can happen at any age but that shouldn’t stop you from smiling, talking, eating, or laughing. Dentures can replace your teeth and repair your smile. But, without dental insurance, dentures can cost over $4,0001. Dental insurance can make partial or full dentures more affordable.

How much do dentures cost without insurance?

The cost for dentures varies based on materials used, where you live, whether your dentures are full or partial, as well as if getting fitted for dentures required any tooth extraction. According to Dental Economics, an upper full denture costs between $1,795 to a high of $3,056.2 This fee is for only one denture—either upper or lower. If you are missing all your teeth on the top and bottom, double those fees since you will need two full dentures.

Less expensive types of dentures are available from clinics that use templates that come in basic sizes and are not custom designed to fit your mouth. While these may be significantly less than custom dentures—as little as $300 each—they are of lower quality and need to be replaced frequently. Some dental labs are using 3-D printers to make more affordable dentures,3 but this technique is so new that the quality and longevity of these dentures are not known.

Those fees include only the cost of the denture itself. Additional services that dentists must perform increase the costs. Other procedures such as examinations, X-rays, scans, tooth removals, and relines can add a significant amount to the total cost.

Additional fees can add up quickly. Examinations average $100, X-rays can add another $150, and tooth removals range from $75 to $200 or more per tooth4. To get a true sense of how much dentures cost, you must add around $550 to the denture fee plus another $100 or so for each tooth you need pulled. This brings the total cost of dentures without insurance to well over $4,000 for a full set that includes both an upper and a lower denture. 

Does dental insurance cover dentures?

Depending on the policy details, the type of insurance, and the plan's restrictions, most dental insurance plans cover part of the costs of dentures.

Dental Preferred Provider Organizations (DPPOs) may pay a percentage of the dentist’s fee depending on how the plan categorizes dentures. If your plan is a Dental Health Management Organization (DHMO), a flat fee for dentures, rather than a percentage of the fees, is the norm. Insurance companies usually provide a fee schedule that policyholders can use to see how much the plan will pay on each service needed.

Most dental insurance plans have an annual maximum benefit. This means that the plan will pay a certain amount for your dental treatment in a calendar year. If your full set of dentures costs $3,000 and your plan pays 50%, you can quickly use up all your benefits for the year and may have to pay the rest out of your own pocket.

While dental insurance does not pay the entire dental bill for dentures, it can help defray much of the cost, making getting dentures more affordable. 

Types of dentures

Dentures come in several forms. Dentists design dentures to either replace all your upper or lower teeth, or to replace only a few missing teeth. Here are some of the different types of dentures you might encounter when talking to your dentist about replacing missing teeth.

Partial dentures

If you have healthy teeth left, your dentist may outfit you with partial dentures. These dentures hook onto your remaining healthy teeth to fill in gaps of one or more teeth. They have a base that keeps the false teeth in place and blends in with your gums so they’re natural-looking and unnoticeable.

Partial dentures, also called dental flippers or bridges, are often meant to be permanent, though they can be adjusted to compensate if you lose more teeth in the future.

In some cases partial dentures are temporary, such as after tooth extraction and before implants. However, some people may use them on a long-term basis if they or their dentist decide surgery is not a good option. 

Full dentures

Full dentures may be a good option for you if you only have a few remaining teeth left or none. If your remaining teeth are healthy, your dentist can create overdentures, which are a full set of dentures that can be placed over top of your existing teeth. These teeth can help keep the dentures in place.

If your remaining teeth aren’t healthy, however, your dentist might recommend extracting the teeth to avoid the development or spread of infection. In this case, they could offer temporary dentures that you can wear as your gums heal after extraction so you don’t have to go six months without a smile. After your gums are healed, they will begin creating your permanent dentures. 

These permanent dentures can either sit right on top of your gums or on top of mini dental implants, which are small, titanium screws attached to the bone that act as anchors for dentures.

There are three basic choices when considering full dentures.

  • Conventional full dentures: After all the teeth are pulled and the gums and bone have completely healed, your dentist makes a mold of your gums. This mold is used to make a denture to replace all your teeth, either on top, bottom, or both.
  • Immediate full dentures: This type of denture is placed in your mouth on the same day that the dentist pulls the last of your natural teeth. Although you do not have to wait for healing initially, immTooth loss can happen at any age but that shouldn’t stop you from smiling, talking, eating, or laughing. Dentures can replace your teeth and repair your smile. But, without dental insurance, dentures can cost over $4,000 . Dental insurance can make partial or full dentures more affordable.
  • Full overdentures: If a few of your teeth are healthy enough to be saved, your dentist might design a denture that uses your remaining teeth for support. These function much like implants to keep the denture stable. 

Implant-supported dentures

Many dentists recommend placing implants—metal pegs that are screwed into the jawbone and protrude through the gums—to support dentures. These are popular for patients who do not have a large enough jawbone to create sufficient suction and retention to keep a standard denture in place. The implant-supported denture connects to the implant pegs to keep it in place during eating and speaking. 

How does dental insurance help with the cost of dentures?

When you have a dental insurance plan, you can expect some cost savings for services like getting dentures because insurance covers part of the cost. You can avoid a huge bill at the end if you enroll in dental insurance. 

Both Dental Health Maintenance Organization (DHMO) plans and Preferred Provider Organization (PPO) plans provide coverage for dentures, although the network of providers available differs, as well as the cap on annual maximums and other benefits.

If you are deciding whether or not dentures are right for you and want to save money on the total cost, explore available dental insurance plans to find out what will work for your needs and your budget.

 

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.aapd.org/assets/1/7/PolicyCenter-2013_Survey_of_Dental_Fees.pdf, 2013
2. https://www.dentaleconomics.com/practice/article/16385079/the-dental-economics-annual-fee-survey, 2018 
3. https://www.dentalproductsreport.com/view/how-digital-dentistry-and-3d-printing-are-changing-dentures, 2018
4. https://www.aapd.org/assets/1/7/PolicyCenter-2013_Survey_of_Dental_Fees.pdf, 2013

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.
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