Articles: Frequently Asked Questions About Common Dental Terms. Table of Contents

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1 Articles: Frequently Asked Questions About Common Dental Terms Table of Contents Frequently Asked Questions About Radiographs (X-rays).1 Frequently Asked Questions About Preventive Care for Members.3 Frequently Asked Questions About Dental Crowns 5 Frequently Asked Questions About Using Your Dental Plan..7 Frequently Asked Questions About Periodontal Disease.8 Frequently Asked Questions About Dental Sealants 10

2 Frequently Asked Questions About Radiographs (X-rays) What are radiographs? Radiographs, sometimes referred to as x-rays, are pictures that allow your dentist to see what s happening under your gums and in other areas of your mouth that are not visible clinically to the dentist. Why does my dentist need radiographs? Radiographs help your dentist evaluate your teeth and supporting bone, and help to diagnose dental disease. If you re experiencing pain or another dental problem, radiographs can help your dentist understand the cause of your discomfort. Your dentist may recommend that radiographs of your mouth be taken for many reasons, including to look for areas of tooth decay, check for infection to the bone surrounding your teeth, identify periodontal disease, and, in children, to see the secondary (adult) teeth before they come in. 1 Radiation from dental X-rays is extremely low. However, your dentist will take every precaution to minimize your exposure. A leaded apron placed over your midsection will minimize exposure to the abdomen and should be used when any dental radiograph is taken. In addition, a leaded thyroid shield (also known as a thyroid collar ) can protect the thyroid gland from radiation, and should be used whenever possible. 1 What are the different kinds of dental radiographs? There are four types of dental radiographs Bitewing When taking these radiographs, the patient bites on a paper tab. The resulting radiograph shows the crown portions (the part of the teeth that is outside of the gum tissue) of the top and bottom teeth together. Periapical This type of radiograph shows one or two complete teeth from crown to root (that is, the entire tooth above and below the gum tissue) Palatal (also called occlusal) This radiograph captures all the upper and lower teeth in one shot while the film rests on the biting surface of the teeth. Panoramic (also called panorex) Using a special machine that rotates around the patient s head, this radiograph captures the entire jaws and teeth in one shot. It s generally used to plan treatment for dental implants, check for impacted wisdom teeth, and detect jaw problems. 2 What does the American Dental Association (ADA) say about radiographs? American Dental Association guidelines recommend that dentists limit radiographs to the areas that are needed for diagnosis and treatment. These guidelines also recommend that dentists not prescribe routine dental radiographs at regular intervals (such as once a year) for all patients. Different patients have different needs and should therefore have radiographs on an as-needed basis. Based on the dentist s clinical judgment, the patient s risk for disease and other factors, the ADA guidelines suggest that dentists should minimize their patients exposure to radiation by limiting survey x-rays and taking x-rays only at a frequency that is necessary to diagnose oral disease based upon risk. 3

3 I m pregnant. Are radiographs safe? As with all other patients, your dentist should only prescribe dental radiographs if they are of potential benefit. It s also important to remember that neglecting a dental problem during pregnancy is not recommended by the ADA, as some studies have shown a link between dental disease and pregnancy problems. 4 What questions should I ask my dentist about radiographs? Based on your assessment of my risk for dental disease how often do you expect to need radiographs? I m pregnant. What are the benefits of having a radiograph now versus waiting until after my baby is born? 1 American Dental Association. X-rays (Radiographs), Accessed MedLine Plus. Dental X-Rays, Accessed American Dental Association Council on Scientific Affairs. The Use of Dental Radiographs, Accessed Deborah Studen-Pavlovich, DMD and Dennis N. Ranalli, DDS, MDS. MetLife Quality Resource Guide: Women s Oral Health Concerns, Second Edition. This brochure is intended for your general knowledge. This information is not a substitute for visiting a dentist nor does this information replace advice given to you by your physician or dentist. By making this information available to you, MetLife is not engaged in rendering any medical or dental advice. Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Please contact MetLife or your plan administrator for complete details Peanuts Worldwide LLC Metropolitan Life Insurance Company, New York, NY L [exp0813][All States][DC,GU,MP,PR,VI] Group Dental Page 2 of 2

4 Frequently Asked Questions About Preventive Dental Care for Members What is preventive dental care? Preventive dental care is all the things you do (or should do) to take care of your teeth and gums: brushing, flossing, eating a healthy diet, and seeing your dentist regularly to help avoid dental disease. Why is preventive dental care important? When it comes to the health of your teeth and gums, preventive dental care is smart. Brushing and flossing help to remove plaque from the surfaces and in between teeth, keeping your teeth looking and feeling clean. A healthy diet, one low in sugar and other refined carbohydrates, helps keep your whole body, including your teeth and gums, in good shape. And routine dental exams and regular cleanings may help prevent the incidence of higher-cost treatments such as periodontal surgery, root canals, extractions and fillings. After all, early detection and prevention are key to minimizing your need for more serious dental treatment. How often should I see my dentist? There are no clear guidelines stating how often a person should see the dentist. Some studies suggest once a year, others say every three or six months. Depending on your current dental health, your dental history, your risk factors for dental disease and your personal preference, your dentist will recommend the frequency of visits that s right for you. What does the American Dental Association (ADA) say about routine dental care? The ADA recommends the following steps for good dental health 1 : Brush your teeth twice a day with an ADA-accepted fluoride toothpaste. Replace your toothbrush every three or four months, or sooner if the bristles are frayed. Clean between teeth daily with floss or an interdental cleaner. Eat a balanced diet, and limit soft drinks and between-meal snacks. Visit your dentist regularly for professional cleanings and oral exams. What questions should I ask my dentist about routine dental care? Which toothbrush, toothpaste, floss and/or other products do you recommend for my teeth? Based on my dental history and current oral health condition, how many cleanings do you recommend I have each year, and why? Am I at risk for any dental diseases? If so, why? What changes should I make in my routine dental care to help control this risk? For information about the IEEE Member Group Dental Insurance Plan and how to enroll call IEEE(4333) or visit

5 1 American Dental Association. Cleaning Your Teeth and Gums, Accessed This article is intended for your general knowledge. This information is not a substitute for visiting a dentist nor does this information replace advice given to you by your physician or dentist. By making this information available to you, MetLife is not engaged in rendering any medical or dental advice. Like most group benefits programs, benefit programs offered by MetLife contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Ask your MetLife group representative for costs and complete details Peanuts Worldwide LLC Metropolitan Life Insurance Company, New York, NY L [exp0813][All States][DC,GU,MP,PR,VI] Group Dental Page 2 of 2

6 Frequently Asked Questions About Dental Crowns What is a dental crown? A dental crown, commonly called a cap, is a tooth-shaped restoration that is made by a machine usually in a dental laboratory. It is designed to cover the entire tooth and strengthen the tooth. Why might I need a dental crown? There are different reasons why your dentist may recommend a crown for one of your teeth. Sometimes a crown is placed over a tooth that has had a root canal, or one that has had a large filling, to help keep the tooth strong for biting and chewing. Crowns can also be used to hold a dental bridge in place or to cover a dental implant. A dentist may also recommend a crown to protect a weak or discolored tooth or cover a broken one. 1 What types of materials are used to make crowns? There are a wide variety of materials that your dentist may recommend for a crown. Metal Alloy Dentists may choose to use a metal alloy (a mixture of metals) for a crown, including gold alloy (also known as noble or high noble) or a base-metal alloy, which gives a silver appearance. Metal crowns are very strong and therefore tend to last longer than other crown materials. Porcelain (including ceramic and glass-like materials) This type of crown is the most natural looking since its color and translucency can be designed to closely match surrounding teeth. Because it is not as strong as metal, porcelain crowns may break or fracture due to heavy biting or grinding. Porcelain-Fused-to-Metal Your dentist may recommend porcelain-fused-to-metal crown. Covering a metal crown with porcelain creates a more natural-looking crown. The metal provides an additional level of strength to the crown, even though the porcelain may still be prone to fracture. 2 What is involved in placing a dental crown? Placing a permanent dental crown typically takes two dental office visits, but some new technology allows crowns to be produced in one day. During the first visit, the dentist will numb the tooth and surrounding gum tissue, and then shape the biting surface and sides of the tooth to allow space for the new crown (restoration) to be placed. Then, an impression of the prepared tooth and jaw is taken. An impression of the opposite jaw may also be taken to help create the proper bite relationship. If the tooth is very decayed or otherwise too small to hold the crown, the dentist may build up the tooth to hold the crown. A dentist builds up a tooth by using bonding composite material. Once the tooth is shaped, the dentist makes an impression of the tooth to send to the dental laboratory that will make the custom crown. If the dentist is placing a porcelain or porcelain-fused-to-metal crown, he or she also will determine a shade of porcelain to match the surrounding teeth. During this first office visit, the dentist will make a temporary crown to cover the prepared tooth until the permanent one is ready. This temporary crown is typically made out of a plastic-type material, and your dentist may ask you to refrain from chewing gum or sticky substances while your temporary crown is in place. At the second visit, the dentist will remove the temporary crown and test the fit of the new crown. If the new crown fits and the color is correct, the dentist may numb the tooth and surrounding gums and cement the crown in place. The dentist will then evaluate your teeth to make sure the crowned tooth fits with the bite of your other teeth. After the new crown has been added, you may need additional dental visits to adjust the crown so it fits comfortably. 3

7 Will I need a root canal if I get a crown? No. Not all teeth that get crowns need to have a root canal. Normally if a root canal is needed, the root canal should be completed before a crown is permanently placed on the tooth. Typically, teeth that have been treated with a root canal do need to have a crown placed on the tooth. How long is a dental crown expected to last? Contrary to popular belief, dental crowns don t last forever. But with good care they can last a long time! It is important to remember that just like a real tooth, the life of your crown depends on how you care for it. You should continue to follow good dental hygiene practices, including brushing twice a day, flossing, and seeing your dentist on a regular basis. If you tend to clench or grind your teeth, ask your dentist how this could affect your crown. In general, you should try to avoid chewing hard or sticky foods. This may cause your crown to break or come loose. Questions to ask your dentist about dental crowns: Are there any other treatment options you would recommend instead of a crown? What type of material do you recommend for a dental crown and why? Are there any special instructions I need in order to best take care of my dental crown? I would like to understand what my potential costs will be. Can you please obtain a pretreatment estimate from my dental insurance carrier? 1 American Dental Association. Oral Health Topics A-Z, Accessed 6/05/12. 2 American Dental Association. Comparison of Indirect Restorative Dental Materials, Accessed 6/05/12. 3 Cleveland Clinic Center for Health Information. Dental Crowns, hic_dental_crowns.aspx. Accessed 6/05/12. This article is intended for your general knowledge. This information is not a substitute for visiting a dentist nor does this information replace advice given to you by your physician or dentist. By making this information available to you, MetLife is not engaged in rendering any medical or dental advice. Peanuts Worldwide LLC 2012 Metropolitan Life Insurance Company, New York, NY L [exp0813][All States][DC,GU,MP,PR,VI] Group Dental Page 2 of 2

8 Frequently Asked Questions About Using Your Dental Plan Next time you visit your dentist, there are a few items you may want to consider to get the most out of your dental benefits. Know Your Plan. Your Certificate of Coverage includes information about your MetLife dental benefits plan. The Certificate of Coverage includes coverage types, coinsurance costs, deductibles, annual maximum benefit amounts (which is the maximum amount this insurance will pay for all Eligible Dental Expenses in any calendar year), and the Plan s lifetime maximum benefit information. It is important to understand how your dental plan works so you can make informed decisions about your treatment options. Consider a Pre-treatment Estimate. Your Plan Administrator can verify your Plan coverage by calling IEEE, or online at You may want to request a pretreatment estimate for more costly services (those over $300), so you will know what your out-ofpocket costs will be. To receive a pre-treatment benefit estimate, have your dentist submit a request online at or call MET-DDS9 (this phone number and website are for dental professionals only). Submitting a Claim. Most MetLife network dentists will bill MetLife directly for any covered services. However, we recommend that you speak with your dentist about payment arrangements before treatment begins. If you need a claim form, you can call MetLife or download a copy online: Download a claim form at Enter the name Institute of Electrical & Electronics Engineers, Inc. Call the automated voice response system at to have a form sent to you. You don t have to speak with a representative to order a claim form; you can call 24 hours a day, seven days a week to use the automated voice response system. Claim status can also be accessed through the automated voice response system. With the MetLife Preferred Dentist Program (PDP), there are no dental I.D. cards required when you visit your dental provider. Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Please contact MetLife or your plan administrator for complete details Peanuts Worldwide LLC Metropolitan Life Insurance Company, New York, NY L [exp0613][All States][DC,GU,MP,PR,VI]

9 Frequently Asked Questions About Periodontal Disease What is periodontal disease? Periodontal (gum) disease is an infection of the soft and hard tissue that supports your teeth. This condition is caused when plaque a sticky film of bacteria builds up on the teeth and hardens into tartar. In early stages, the gums become inflamed, and there may be some bleeding evident when brushing and/or flossing. This stage is called gingivitis. Gingivitis can be reversed with treatment from your dentist and good oral hygiene. If gingivitis is not treated, the disease may progress into periodontitis, where plaque and tartar build up below the gum-line. Irritation and inflammation of the gums occur, creating pockets (increased space between your teeth and gums) that are infected. As periodontitis worsens, the pockets get deeper, and the bone that supports the teeth is lost. If left untreated, this will eventually lead to tooth loss. 1,2 How is periodontal disease diagnosed? If you ve ever heard your dentist or dental hygienist calling out numbers and noting them in your dental chart at your regular checkup, then you ve experienced pocket probing or charting. As part of a routine checkup, the dentist completes a periodontal examination to measure the depth of the spaces ( pockets ) between your teeth and gums, and checks for bleeding. Detection of bleeding and pockets of four or more millimeters in depth are one way for your dentist to identify gingivitis and periodontitis. 1 What are some of the treatments that my dentist might recommend for periodontal disease? Your general dentist may treat your periodontal disease or refer you to a periodontist. A periodontist is a dentist who has received additional training and specializes in the care and treatment of the gums and bone surrounding the teeth. Your dentist or periodontist may recommend a nonsurgical procedure called scaling and root planing, also known as a deep cleaning. During a regular cleaning, your dentist or dental hygienist will use special tools to scrape off the tartar and plaque from above and just below the gum line. In a deep cleaning, the dentist or hygienist scrapes the tartar and plaque (the scaling part) as in a regular cleaning, and he/she will also smooth the exposed tooth root surfaces (root planing) where the plaque and tartar form, to help get rid of the bacteria that contribute to periodontal disease. 1 If nonsurgical treatments are not effective or if the amount of bone loss is severe, periodontal surgery may be recommended. This treatment involves the surgical opening and later suturing of gum tissue in order to remove the tartar, plaque, bacteria, and diseased tissue from deep below the gum line. Once the periodontal disease is under control, your dentist or periodontist may recommend bone or tissue grafts in order to help regenerate any bone or gum tissue destroyed by periodontal disease. In this type of procedure, the dentist surgically places a small piece of mesh-like fabric or bone material between the bone and gum tissue. This fabric or bone material allows new bone and connective tissue to grow. 1 What happens after I receive treatment for periodontal disease? Your dentist or periodontist will prescribe an ongoing treatment plan to help prevent periodontal disease from recurring. This is known as maintenance therapy. As part of your maintenance therapy, you ll have

10 scheduled follow-up visits so your dentist/periodontist can remove any new tartar or plaque and to polish your teeth to prevent new disease from appearing. Your dentist may also prescribe at-home care, such as mouth rinses or special toothpaste, to help keep your teeth healthy. Maintenance therapy is the most important part of preventing a reoccurrence of your periodontal disease. 3 What is the AAP and what do they say about these treatment options? AAP is the American Academy of Periodontology, an association of dental professionals who specialize in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. 4 According to the treatment guidelines set forth by the AAP, periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through nonsurgical procedures. 5 The AAP says, Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment, including surgical therapy. 2 Of course, further treatment is dependent on the patient keeping up with athome care and maintenance therapy. Can periodontal disease cause health problems beyond the mouth? Yes. We know that bacteria in the mouth can cause endocarditis, a heart valve inflammation; and can also compromise complicated medical procedures such as organ transplants. Impacts on other diseases are uncertain. Studies suggest that there is an association between periodontal disease and: an increased risk of heart attack or stroke; an increased risk of delivering preterm, low-birth-weight babies; and difficulty controlling blood sugar levels in people with diabetes. In the meantime, it's a fact that controlling periodontal disease can save your teeth a very good reason to take care of your teeth and gums. 6 Questions to ask your dentist about periodontal disease: Am I at risk for periodontal disease? What can I do to reduce my risk? I d like to treat my periodontal disease using the least invasive and most cost-effective treatment. What are my treatment options? Will you treat my periodontal disease, or do you recommend I see a periodontist? 1 National Institute of Dental and Craniofacial Research. Periodontal (Gum) Disease: Causes, Symptoms and Treatments, Accessed 6/05/12. 2 American Academy of Periodontology. Types of Gum Disease, Accessed 6/05/12. 3 American Academy of Periodontology. FAQs About Periodontal Disease, Accessed 6/05/12. 4 American Academy of Periodontology. Who We Are, Accessed 6/05/12. 5 American Academy of Periodontology. Periodontal Procedures, Accessed 6/05/12. 6 National Institute of Dental and Craniofacial Research. Periodontal (Gum) Disease: Causes, Symptoms and Treatments, Accessed 6/05/12. This article is intended for your general knowledge. This information is not a substitute for visiting a dentist nor does this information replace advice given to you by your physician or dentist. By making this information available to you, MetLife is not engaged in rendering any medical or dental advice Peanuts Worldwide LLC Metropolitan Life Insurance Company, New York, NY L [exp0813][All States][DC,GU,MP,PR,VI] Group Dental Page 2 of 2

11 Frequently Asked Questions About Dental Sealants Although preventable, tooth decay is a chronic disease affecting all age groups. Tooth decay, left untreated, can cause pain, tooth loss, and difficulty eating. Untreated decay and tooth loss also can have negative effects on an individual s self-esteem. What are dental sealants? Sealants are thin, plastic coatings painted on the chewing (occlusal) surfaces of the back teeth. Sealants are put on in dentists' offices, clinics, and sometimes in schools. Getting sealants put on is simple and painless. Sealants are painted on as a liquid and quickly harden to form a shield over the tooth. 1 Which teeth are suitable for sealants? Dental studies show that permanent first and second molars are the most likely to benefit from sealant application. 1 First molars usually come into the mouth when a child is about 6 years of age. Second molars appear at about age 12. The dentist will determine if sealants are recommended for the patient. If sealants are recommended, it is best if the sealant is applied soon after the molars have erupted, before the teeth are subject to decay. Why should my child get sealants? Sealants help prevent tooth decay by creating a barrier between a tooth and decay-causing bacteria. Properly applied and maintained, sealants usually stop cavities from growing and can prevent the need for expensive fillings. According to the U.S. Surgeon General s May 2000 report on oral health, tooth decay is the single most common chronic childhood disease five times more common than asthma and seven times more common than hay fever. 2 The combination of sealants and fluoride has the potential to nearly eliminate tooth decay in school-age children. 2 Should adults get sealants too? In most cases, by the time an individual reaches adulthood, the occlusal surfaces of the teeth have been worn smooth, thereby reducing the chances for occlusal decay. Also, the majority of adults have had long-term exposure to fluoride through water, mouth rinses, and toothpaste, which also help protect the teeth from decay. Lastly, oral hygiene and diet tend to be better in adults than in children. For these reasons, MetLife does not recommend including sealants for adults as a dental benefit. However, it is important to remember that the dentist may, regardless of the patient s age, recommend sealants, based on the patient s oral health history and his or her risk for tooth decay.

12 1 National Institute of Dental and Craniofacial Research. Seal Out Tooth Decay, Accessed 06/04/12 2. U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. National Institute of Dental and Craniofacial Research, Accessed 06/04/2012. This article is intended for your general knowledge. This information is not a substitute for visiting a dentist nor does this information replace advice given to you by your physician or dentist. By making this information available to you, MetLife is not engaged in rendering any medical or dental advice. Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Please contact MetLife or your plan administrator for complete details PEANUTS Worldwide LLC. Metropolitan Life Insurance Company, NY, NY L [exp0813][All States][DC,GU,MP,PR,VI] Group Dental Page 2 of 2