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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 Pediatric Dental Specialists of Central Oklahoma. 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. Brent Moody and Dr. Somer Heim, 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. Brent Moody and Dr. Somer Heim 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 Oklahoma City office.

Have you ever watched to see if your child is breathing through his or her mouth? Breathing through the mouth instead of the nose may lead to trouble for youngsters. Kids who typically breathe through their mouth—most often children who suffer from allergies—experience problems getting enough oxygen into their blood, a condition that affects their weight, size, sleep, and even their performance in the classroom and daily life.

Mouth breathing as a child can also lead to sleep apnea, behavior and learning problems, delayed speech, dental and facial abnormalities, and even breathing problems as your child grows. There are a multitude of reasons for an individual to mouth breathe, such as enlarged tonsils, adenoids, and deviated nasal septum, but the cause is usually allergies.

As bad as the condition sounds, we want you to know mouth breathing is a treatable condition. Doing so, though, requires early diagnosis and treatment. Since our team at Pediatric Dental Specialists of Central Oklahoma sees our patients every six months, we may be in a position to identify the symptoms of mouth breathing.

If you suspect your child is a chronic mouth breather, please give us a call at our convenient Oklahoma City office to schedule an appointment with Dr. Brent Moody and Dr. Somer Heim.

Watching the clock tick down the final seconds until midnight, many of us- Pediatric Dental Specialists of Central Oklahoma included- feel nostalgic about the passing year and hopeful about the new one to come. New Year’s Eve is one of the most widely celebrated holidays in the world, with over-the-top celebrations taking place in dozens of countries. The Gregorian calendar, which is widely used in Western nations and around the world, was implemented in 1582. Since that time, December 31st has marked the final day of the year, with midnight heralding the beginning of a brand new year. In the United States, New Year’s Day is a public holiday; government offices, schools, public organizations, and many businesses are closed for the day. Ponder the following fun facts as you think about your plans for the holiday:

• Approximately one billion people watch the New Year’s Eve ball drop in Times Square, New York City. This televised event is one of the most iconic New Year’s celebrations in the world. For many years, watching the ball drop meant tuning in to Dick Clark’s Rockin’ New Year’s Eve, an iconic television special dear to the hearts of many viewers.
• The idea for the New Year’s Eve ball came about because of a citywide ban on fireworks. Before 1907, when fireworks became illegal in New York City, celebrations included an elaborate fireworks show. The large, glittering, illuminated ball was developed as an alternative. Although the first ball was heavy at 700 pounds, the modern New Year’s Eve ball is made of Waterford crystal and tips the scale at six tons!
• The top five New Year’s resolutions are: to lose weight, quit smoking, get a new job, return to school, or increase personal savings. However, approximately 88% of New Year’s resolutions fail. But don’t let that discourage you! Resolutions are most likely to succeed when they are clear, achievable goals. Setting out a concrete plan to achieve your resolution also boosts your chances of success.
• Eating black-eyed peas on New Year’s Day is said to bring good fortune in the new year. Collard greens, cabbage, and ham hocks are also considered lucky foods to enjoy. Just steer clear of the chicken or turkey dinners; eating poultry is a bad omen for the year to come.

Whether you plan to stay in Oklahoma City, or head out into the crowds to watch the ball drop in Times Square, New Year’s Eve is a time to enjoy friends and family. Send your loved ones well wishes for the New Year, and look for that special someone to share a midnight kiss with for good luck!

Here is some surprising yet worthwhile advice you might be hearing for the first time: Brushing can be incredibly bad for your child’s teeth if done right after eating certain foods.

Enamel is an extremely hard mineral on the exterior of each tooth. It’s actually the hardest substance in the human body: It’s even stronger than bones! Its only weakness is that acids in the food we eat can easily destroy enamel.

Healthy teeth thrive in an environment that has the proper pH balance. That ensures the mouth doesn’t start the process of demineralization—the process when alkaline turns into acid, which attacks and softens the enamel on the surface of your child’s teeth. Pores and fissures form, and that’s when the harmful bacteria go to work.

A mouth’s pH level fluctuates depending on what is eaten throughout the day. Examples of the most common highly acidic foods include citrus fruits, soda, and sugary foods. Highly acidic foods tip the balance of pH in the mouth from a healthy alkaline to a dangerous acid.

Can brushing your child’s teeth immediately after a meal lead to even more damage? The answer is yes!

Eating highly acidic foods causes your child’s teeth to be more susceptible. If your child brushes when the teeth have been weakened by acids, even more destruction can happen to the enamel. Your child’s toothbrush bristles will actually wear away some of the enamel. So it’s healthier for your child to wait at least an hour after eating or snacking to brush.

Good preventive measures to take instead of brushing after your child eats include:

• Rinsing or drinking water
• Chewing sugarless gum
• Consuming dairy or non-acidic foods to conclude a meal

These practices help produce saliva, which in turn restores a healthy pH level in your child’s mouth and coats the teeth with minerals they need.

Once your child’s mouth is restored to a healthy pH level, he or she may brush normally. Keep in mind that acidic foods can weaken the enamel on the teeth and take the right measures to prevent spiking pH levels.

Still have questions? Call our Oklahoma City office and schedule an appointment for your child with Dr. Brent Moody and Dr. Somer Heim.