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Navigating the World of Dental Insurance Terminology

March 15th, 2023

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at Fallbrook Family Dentistry. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Dr. Jeffery Spahr and Dr. Janna Spahr, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

  • If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

  • This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

  • Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Dr. Jeffery Spahr and Dr. Janna Spahr or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Lincoln, NE office.

Lip Service

March 8th, 2023

When you think of Dr. Jeffery Spahr and Dr. Janna Spahr, you naturally think of your teeth. But your dental professional is concerned with more than the teeth, as important as they are. All aspects of your oral health—gums, bite, tongue, mouth—contribute to your well-being. So many elements go into creating your beautiful smile, and your lips? They’re front and center.

  • SPF—BFF

You already know that sunscreen is your best friend when it comes to protecting your skin. But don’t forget your lips when you’re slathering on the sunscreen! Delicate lip tissue is also susceptible to the sun’s damaging UV rays. Use a lip balm or lipstick with an appropriate SPF (Sun Protection Factor) for your skin type, and apply it liberally. Don’t forget to reapply every hour or two, after eating and drinking, and after going in the water. And if you’re protecting your children from the sun’s rays, check with your doctor about using sunscreen on young lips.

  • Healthy Hydrating

Dry, chapped lips are no one’s go-to look. And while moisturizers and balms can help dry lips recover, there’s a simple preventative measure you can take to avoid or reduce dryness.  You know how important water is for our bodies, and it’s essential for hydrating our lips as well. Make sure you drink the recommended amount of water each day for lips (and skin!) that are healthy and hydrated.

Not so healthy liquids? Alcohol. Alcohol is dehydrating, which undoes the benefits of that water you’ve been drinking. More than that, excessive alcohol consumption has been linked to oral cancer, especially when coupled with tobacco use.

  • Toss the Tobacco

All tobacco users have an increased risk for oral cancer. Pipe and cigar smokers are particularly at risk for lip cancers, and smokeless tobacco users have a greater risk of cancers on the inner lip surface. Need another reason to quit? Smoking leads to an increase in lip lines (wrinkles) and a decrease in lip volume.

  • Oral Exams

When you come to our Lincoln, NE office for regular checkups, you can also get regular screenings for oral cancer and other oral conditions. While irregularities are often benign, lip cancer is one of the most common forms of oral cancer, and detecting cancerous or precancerous lesions as early as possible is important for treatment. If you have a sore or lump that doesn’t go away, a red or white patch of skin, bleeding or pain, or any other symptom that concerns you, talk to Dr. Jeffery Spahr and Dr. Janna Spahr.

Protect yourself from the sun, hydrate, use alcohol in moderation, give up tobacco if you are using it, and see your dentist regularly for examinations. These simple practices are beneficial not only for your expressive lips, but for your overall health and well-being. And feel free to spread the word—healthy habits and preventative care should be on everyone’s lips!

The Secret to Fresh Breath

March 8th, 2023

Bad breath: We’ve all dealt with it. You’ve been around people who have it and, like it or not, you have had it yourself. It can be embarrassing and uncomfortable, but how do you know if you have it? There is actually a simple test you can do to see if you have bad breath.

Wash your hands well, then put your finger in your mouth, way in the back. Scrape a little saliva from the back of your tongue, and then dab it on the back of your hand. Wait for one minute, then hold your hand to your nose and sniff. Is it fresh as a daisy? Or do you need to keep reading and learn how to freshen your breath?

How Bad Breath Starts

There are several ways that bad breath starts. Knowing the causes of bad breath is a solid start toward the cure.

  • The bacteria in your mouth: Bacteria is always in your mouth. It covers your gums, hides between your teeth, and hangs out on your tongue. As it multiplies, it produces toxins that cause the foul odor in your mouth.
  • Your bad habits: If you smoke cigarettes, a pipe, or cigars, or chew tobacco, you are not only harming your mouth and body, you are creating some really smelly breath.
  • Your tonsils: If you still have your tonsils, they can be the cause of bad breath. They are pitted, so smelly substances can collect in the pits and lead to bad breath.
  • Stomach issues: A stomach virus, ulcer, GERD, and other stomach issues could be the cause of your bad breath. A low-carb diet can put your body into a state of ketosis, which causes very bad breath.
  • The foods you eat: Garlic, onion, and other pungent foods will linger with you … on your breath.

Tips for Busting Bad Breath

Achieving fresh breath isn’t difficult, but it does require a little work. Try these tips for fresher breath and a healthier mouth.

  • Brush your teeth after every meal. You can also pick up a tongue scraper to use a couple of times a day to remove any lingering bacteria on your tongue.
  • Floss once a day to remove food particles between your teeth as well as plaque. Your mouth will thank you.
  • Gargle with special mouthwash to banish bad breath. The oxygen in it will kill the bacteria in your mouth that is causing your bad breath, and leave you fresh as a daisy!
  • Drink water to avoid dry mouth, which is a common cause of bad breath.
  • Ease your tummy troubles with antacids and other remedies. Ginger tea is a great tummy tamer.
  • Chew gum that contains xylitol. Saliva keeps your mouth moist, and chewing gum makes you salivate. Bye bye, bad breath!
  • Eat yogurt. It contains “good” bacteria that helps balance your gut and gives you a healthier mouth.
  • Soothe your sinuses. Sinus infections can cause you to have bad breath. Actually, it is the post-nasal drip that causes the foul odor. Cure the infection and your breath will improve.
  • Avoid all tobacco products (cigarettes, pipes, cigars, chewing tobacco, and snuff).
  • Eat a healthy diet of fresh fruits and vegetables, lean meats, and whole grains.

And don't forget! Get regular dental checkups at Fallbrook Family Dentistry.

Are thumb sucking and pacifier habits harmful for a child’s teeth?

March 1st, 2023

Depending on how long the thumb sucking or constant pacifier use continues, and how aggressively the child sucks a thumb or the pacifier, it can indeed be an oral health issue. Generally speaking, most children outgrow these behaviors or are able to be weaned off them successfully sometime between ages two and four. When children wean off the behaviors in this age range, long-term damage is unlikely.

Why Kids Suck Their Thumb or Pacifier

Both of these habits are actually a form of self soothing that your child likely uses when he or she is very upset, or feeling stressed, confused, frustrated, or unable to properly express the emotions. If your son or daughters is a regular thumb sucker, or the child wants to use the pacifier almost constantly, it is best to try to taper off these habits at a young age.

If your child continues to suck a thumb or request a pacifier consistently after leaving toddler-hood, this could be a source of concern, and it should be addressed with Dr. Jeffery Spahr and Dr. Janna Spahr and our staff. We will be able to evaluate your child's mouth to look for any signs of damage such as palate changes or teeth shifting.

Say Goodbye to Old Habits

In the event that your child is quite reluctant to give up a pacifier or thumb-sucking habit, there are a few things you can do to discourage these behaviors.

  • When you notice that your child is not using a pacifier or sucking a thumb, offer effusive praise. This type of positive reinforcement can be much more effective than scolding the child.
  • Consider instituting a reward system for giving up the habit. If the child goes a certain amount of time without this behavior, award him or her for being such a “big kid.”
  • Employ the help of older siblings or relatives that your child admires. When a child’s role model says that he or she stopped sucking thumbs at a certain age, your child is likely to try to emulate that.