Fillings/Sealants/Protective Restorations Explained
The goal of any direct (one visit) dental restoration is to remove unhealthy/decayed tooth structure, retain as much healthy tooth structure as possible and to prevent further carious breakdown of the tooth. There are 3 types of direct dental restorative procedures that we perform at our office. The specific procedure that is completed depends on the condition of the tooth being restored and the extent of decay that is present. This list explains the difference between the 3 levels of direct restorative procedures and how dental benefits providers consider them for coverage/reimbursement.
Dental Sealants: Dental sealants are a resin coating that is placed into the grooves on the chewing surface of permanent molar and premolar teeth in order to prevent decay. Many patients have had these as children. For the most part, dental benefits providers consider dental sealants a pediatric procedure and do not cover them for patients over the age of 18. Drs. Forman and Fontillas offer this procedure to patients who have deep grooves in their teeth and who for various reasons may be at high risk for decay.
Preventive Resin Restoration (PRR): A Preventive Restorative Restoration is a step beyond a Dental Sealant in that decay has already been detected in the enamel occlusal grooves of molar and/or premolar teeth but has not extended into the deeper dentin layer of the tooth. Some drilling is involved in preparing the tooth for a PRR but generally, no anesthesia is necessary as the decay does not extend into the dentin. Drs. Forman and Fontillas perform PRR when early decay is detected in a tooth (or teeth) and we want to prevent the decay from extending into the deeper layers of the tooth. Unfortunately, many/most dental benefits providers do not cover PRRs. Still, Drs. Forman and Fontillas feel this procedure is beneficial in that it maintains our goal of conserving as much healthy tooth structure as possible.
Dental Filling/Restoration: When decay is detected that has extended into the deeper dentin layer of the tooth either by clinical exam or radiographic (x-ray) examination, we perform a direct filling to repair the tooth and restore it to normal, healthy function and shape. Often, local anesthesia is provided to allow the procedure to be completed comfortably. The decayed/unhealthy tooth structure is removed and the remaining tooth structure is prepared to be retentive of the restorative material that is best for the particular situation. Restorative dental filling materials are either amalgam/silver or composite resin/tooth color. Dental fillings are generally covered by dental benefits providers at a level of 70-80% and are often effected by a deductible.
Please note that we do charge a higher fee for composite/tooth color fillings compared to amalgam/silver fillings. The composite restorations are more technique sensitive when being placed and we need to have multiple shades of filling material to match the various shades of patient’s teeth. Some dental benefit providers will only cover the cost of amalgam/silver filling in posterior teeth and so will reimburse an alternative benefit when a composite resin filling is placed.
Our office will submit a claim to your dental benefits provider for all of the procedures mentioned here. If the procedure is not covered, you are responsible for the full cost. If they are partially covered, you will be responsible for the balance. Please let the doctor or business staff know if you have any questions about a procedure you have been recommended to have. As always, a pretreatment estimate can be submitted to your dental benefits provider to verify to what extent, if any, a procedure is covered.