Dental Benefits 101

Extractions, including simple and complicated removal of erupted teeth, partially or completely bone impacted teeth, extra teeth in an unusual position, or residual roots.

X-ray taken from the side to show the crown area of both the upper and lower teeth.

During a dental checkup or recall exam, your dentist is trained to look for oral health problems that you can’t always see or feel – problems like deterioration of fillings, early signs of gum disease or oral cancer, and other problems that could affect your general health.

Removal of plaque, calculus and stain from removable dentures.

A single x-ray of the full mouth (upper & lower jaws)

A material is placed in the pits and fissures of teeth in order to prevent or arrest the development of dental caries. Treatment is eligible on permanent molars (theses are your back teeth) only, for children 16 years of age and under and only if molar-type tooth.

A maintenance exam performed once every year following the initial oral examination. They help to prevent tooth decay, gum disease or other dental disorders that could have developed over the year. A recall exam typically includes:

• Polishing: Smoothing the tooth surface in order to make it difficult for plaque to accumulate on the surface area.
• Scaling: Removal of dental plaque and calculus from the surface of a tooth.

Ortho-like appliance, used on children’s teeth, to keep the space open to enable the permanent tooth to erupt properly.

Fluoride helps prevent tooth decay (cavities) by strengthening the enamel (outer layer) on your teeth. Fluoride can help young teeth develop tough enamel and can also help restore the strength of the enamel on your teeth.

An appliance to help prevent involuntary gnashing, grinding or clenching of the teeth.

May include surgical exposure movement, remodeling and recontouring, surgical excision, surgical incision, treatment of fractures and treatment of some maxillofacial deformities such as cysts and tumours.

Removal of calcium deposits (plaque, tartar, calculus, and stone) from around the tooth above and below the gum.

Also known as endodontic or having the nerve removed. It is the removal of infected pulp (abscess/pus) from within the crown and root mechanically, with files and reamers. After mechanical and medicinal cleaning, the root canal is filled and sealed.

A splint to correctly balance the position of the lower jaw to the skull. This is used to treat TMJ syndrome – acute muscle spasms believed caused by biting imbalance and can be induced by psychological stress. Principle symptoms are pain in the ear region, limitation of chewing and moving the jaw, clicking, cracking, ringing, buzzing sounds in the joint.

A custom device anchored to neighboring teeth that replaces one or more missing teeth. When a lost tooth is replaced with a bridge, the teeth on either side of the missing one must be prepared as crowns to serve as abutments to hold the prosthetic (replacement) teeth in place. This procedure is necessary when a permanent tooth is lost; whether as a result of decay, gum disease, injury or accident, which can cause many serious problems for your neighboring teeth (remaining teeth may begin to shift).

A tooth-like covering placed over a carefully prepared existing tooth. It is sometimes called a “cap” and is used to strengthen, restore or improve the appearance of your natural tooth. A crown is placed on an individual tooth much like a thimble over your finger. One of the most common functions is to support the tooth when there is no longer sufficient tooth structure left to place a filling. Crowns may also be used to protect the structure of a tooth that is fractured or broken.

A dental implant is a titanium cylinder that the dentist surgically places into the bone where a tooth is missing to become the foundation for a replacement tooth. The dentist either screws the replacement tooth into the implant and cements crowns or bridges into the implant, or uses special attachments on the implant to adhere a removable denture.

Made for people who are already missing all their teeth as opposed to an immediate denture (which is made before the teeth are extracted) or overdenture (where the root canal treated remnants of teeth or implants remain under the denture to aid in stability)

A cosmetic substitute to the conventional metal braces as the clear brackets – made of ceramic or plastic – blend in more with the tooth’s natural colour.

These braces are gold coated stainless steel, often recommended for patients allergic to nickel or who prefer the look of gold over traditional silver-coloured metal.

Clear removable aligners used to gradually shift teeth to the desired positions. Typically progressive braces are not used in complex orthodontic cases.

Most conventional form of braces which are typically made of stainless steel, sometimes in combination with nickel titanium.

A policy applied to all coverage that has crown and /or bridge treatment as a benefit, to determine the amount payable. The attending dentist and patient choose the course of treatment, but payment for the procedure may be based on the "limited treatment" principle. Basically, if two procedures treat the same condition, payment may be limited to the most cost effective treatment. The Alternate Benefit Clause is simply a financial limitation and not intended to dissuade from the treatment recommended or performed by a dentist. In the application of this, both courses of treatment must be an eligible benefit.

When multiple fillings or periodontal services are done at one appointment, there may be a reduction in time spent by the dentist and therefore the benefit should be passed along to the patient in the form of reduced fees. It applies only when six or more restorations (fillings) are done in the same appointment. And if the dentist has not reduced the fee for these multiple services, we will reimburse the first restoration as submitted, according to the dental plan, and then reduce the remaining restorations by 20%.

A term used in the dental industry to describe a common practice whereby dentists (including general practitioners and dental surgeons) put their patients to sleep, via general anesthetic, for regular dental treatments (i.e. crowns, bridges, fillings, cleanings, etc.). GSC's policy clearly states that general anesthesia and intravenous sedation (aka sleep dentistry) are eligible only in conjunction with oral surgery or if deemed medically necessary. The reality is that patients generally do not need to be put to sleep for routine procedures such as fillings, periodontal treatments or root canals.