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Does dental insurance cover tooth extractions?

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

13 minute read
Key highlights
  • A tooth extraction can cost up to $4,0001
  • There are two types of tooth extractions: simple and complex/surgical
  • A simple dental extraction may be covered at up to 70%2

Having a tooth pulled, also called a tooth extraction, can be a painful but necessary part of dental care to remove an infected tooth or make room for other teeth. 

Losing baby teeth is less complicated because your permanent tooth underneath usually push them out naturally. But permanent teeth have long roots, and the molars in the back of the mouth can have as many as three to five roots that are firmly attached to the bone and gums. A tooth extraction as an adult can be not only be painful but also costly without dental insurance.

Tooth extraction costs

The cost of a tooth extraction is determined by many factors. One main factor is the type of extraction that you need.

A simple extraction is one where the tooth has grown all the way through the bone and gums and that the dentist can see in your mouth. Your dentist can usually extract this type of tooth in one piece. An X-ray will show if the roots are straight or have crooked places that might snap off, causing the extraction to become more complex. An X-ray will also show your dentist the position of the roots in the bone and how close they are to the other teeth and nerve supply. If your dentist does not foresee any expected complications, a simple extraction  may be all you need. 

If the tooth is still under the gums or bone—either partially or fully—then the tooth requires a surgical or complex extraction. These are more costly and invasive than simple extractions because your dentist must cut away the gums and bone to get to the tooth. 

Surgical extractions can vary in cost depending on the complexity of the surgery, the type of anesthesia needed, and whether a general dentist or an oral surgery specialist extracts the tooth. 

If a general dentist can use nitrous oxide and local anesthesia to pull the tooth, this will minimize the cost. If the surgery is complex and you need a higher level of anesthesia, the cost can get much higher. 

A simple tooth extraction can cost up to $200 per tooth. A complex tooth extraction can cost up to $4,000 or more depending on what other dental care you receive.3

A lot of factors determine the total cost of a tooth extraction, including location, credentials of the dentist, and the type of anesthesia used. Costs vary widely from state to state, region to region, and dentist to dentist. 

In addition to the extraction, there may be additional charges for examinations, X-rays, scans, anesthesia, or other necessary services. 

Dental insurance for tooth extractions

Traditional dental insurance policies may cover part of simple and complex tooth extractions. Guardian Direct’s Dental Advantage Gold plan covers simple extractions at 70% after a six-month waiting period and complex extractions at 50% after a 12-month waiting period. The Dental Advantage Bronze and Silver plans both cover simple extractions at 50% after a six-month waiting period. The Silver plan also covers complex extractions at 50% after a 12-month waiting period. 

Why teeth need to be pulled

Adult or permanent teeth need to be pulled for many reasons. Among the most common reasons are cavities that are too deep to fill, advanced gum disease, infections in the nerves of the tooth, trauma or injuries to the mouth and face, and the lack of space in the mouth for wisdom teeth to erupt naturally. Occasionally, a dentist must remove permanent teeth to make space for braces or to prepare the mouth for dentures or partial dentures.

Dentists always prefer to save a tooth whenever possible. However, some circumstances and conditions make saving teeth impossible, even for the most skilled dentist. 

Tooth extractions are unavoidable when a tooth develops frequent infections that do not respond to treatments such as root canals or antibiotic therapy. 

Deep decay is another reason a tooth may need to be pulled. When cavities develop in areas that a dentist cannot access to place a filling or a crown, such as the backside of a wisdom tooth or between teeth that are not in normal alignment with the others, an extraction could be the only choice to relieve ongoing problems and pain.

How do dentists extract teeth?

When you go see a dentist with a toothache or they find an unrepairable condition during a routine dental visit, you must make the difficult decision to have your tooth extracted. Other than having your baby teeth pulled, you may have never experienced a tooth extraction and are nervous about the procedure. Your dentist will go over instructions with you before and after they pull the tooth to ensure that your experience is as comfortable and safe as possible.

After taking necessary X-rays, scans, and other diagnostic tests needed to see the position of the nerves and roots of the tooth, your dentist may put the tooth and gums surrounding it to sleep. They might use a simple injection of a local anesthetic beside the tooth. This type of numbing puts the tooth and gums to sleep quickly.

For more complex tooth extractions, such as pulling a tooth that is still under the gums and bone or that must be removed by cutting it into several pieces first, you might need a deeper form of anesthetic. 

Once the area is numb or sedation has taken effect, your dentist may use specialized sterile instruments to loosen the tooth from the gums and bone using a gentle rocking motion, much like getting a root-bound plant out of a pot for replanting in a garden. Once the membranes that attach the root of the tooth to the surrounding tissue and bone have been loosened, the dentist uses a set of forceps, designed to perfectly fit over the top of the tooth, to grip it firmly and slip it out of the mouth.

Finally, the dentist packs the open socket (hole) that remains after the tooth comes out with gauze or other material designed to assist in healing. Stitches, made of a material that naturally dissolves in the mouth after a few days, may or may not be necessary. 

Tooth extraction aftercare

After a tooth extraction, you must take care of the area to ensure optimal healing and avoid complications. Tooth extraction healing can take from several days to several weeks, depending on the type and degree of difficulty of the surgery as well as your overall physical health.

Follow all written and oral instruction your dentist gives you after completing your surgery. As a rule, dentists advise patients who have had a tooth pulled to avoid these activities: 

  • Drinking through a straw for at least 24 hours
  • Rinsing vigorously with any type of liquid such as saltwater
  • Drinking any type of beverage containing alcohol
  • Using a mouthwash that contains alcohol
  • Smoking 

Your dentist will place a thick layer of sterile gauze over the extraction site for you to bite on and provide you with an additional supply to use for the first 24 hours. 

If you need to rinse your mouth after brushing, do so very gently with plain water to avoid disrupting the blood clot and causing a dry socket. You may want to eat soft foods for a few days following a tooth extraction. During this time, chewing solid food might not only be uncomfortable but also impossible due to the temporary inability to open your mouth wide enough or to manipulate food particles with your lips and tongue normally. Furthermore, solid foods can work their way into the socket, even if stitches are in place. 

If swelling occurs, use an ice bag, and call your dentist to see if they recommend any medication. 

Continue to brush and floss the other teeth as usual. Avoid brushing the teeth and gums close to the extraction site for several days to ensure that you do not injure the site accidentally. 

Making sure you recover normally and quickly from a tooth extraction is the goal for both you and your dentist. Following his instructions helps you get back on your feet as quickly as possible. 

Avoiding teeth extractions

No one wants to have a tooth extracted. Dentists, for the most part, do not like having to pull teeth. But sometimes a tooth extraction is an unavoidable fact of life. Preventing dental disease from becoming so serious that an extraction is necessary is the best way to avoid having to get a tooth pulled.

Brushing and flossing daily can help avoid needing a tooth extraction. Every day, food debris and bacteria form a sticky covering on your teeth called plaque. If you do not remove the plaque every day, it thickens and hardens on the teeth. Over time, this hard coating, called tartar or calculus, continues to grow between the teeth and under the gums.

Once the tartar has taken hold under the gums and on the roots of the teeth, it begins to cause the bone to deteriorate, a condition known as advanced gum or periodontal disease. Advanced gum disease is one of the leading reasons that dentists sometimes have no other choice than to pull a tooth.

Daily cleaning of your teeth and gums can prevent not only gum disease but also decay. As the plaque accumulates on the teeth, the bacteria begin to feed on the tooth enamel, causing holes and weak places to appear on the tooth surface. If left untreated, the decay continues to expand into the inner nerve chamber of the tooth. This is when the pain to hot, cold, and sweets occurs and, in the worst cases, the nerves become inflamed and infected. The result of this deep decay is that you and your dentist must decide either to do an expensive root canal and try to save the tooth or to extract it.

You can avoid having to get a tooth pulled using the simple steps of daily brushing, flossing, and seeing your dentist for regular check-ups and cleanings. During routine visits, your dentist can identify small cavities and early gum disease before those conditions become more serious.

Keep your teeth for a lifetime and avoid having teeth extracted by practicing good daily oral hygiene and having regular checkups. But if you do need to have a tooth pulled, a dental insurance policy can help with the costs.

 

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. 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.

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.

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Sources:

1. https://www.healthline.com/health/tooth-extraction, 2018
2. https://www.guardiandirect.com/products/dental-insurance/guardian-dental-advantage-gold-full-plan-summary-fee-schedule-state
3. https://www.healthline.com/health/tooth-extraction, 2018

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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