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Periodontist, Does Medicare Cover Periodontal Disease- Financial Assistance for Treatment

Author: | Posted in Gov Health Info No comments

There are a few professions out there that we haven’t heard before on a regular basis. In dentistry, there are diseases that need to be looked at by none other than a specialist.

When certain circumstances occur, we need to get professionals to help us out. A specialist in a certain disease would be the best choice to take. But what about the cost, how do we find them? In this article, we will be figuring out just that about Peridontist and Periodontal Disease.

What Is Periodontist?

A periodontist is a dentist who has gone on to complete another two to four years of college in the specialty of gum disease (periodontia). Most universities that offer dental school programs have the specialties as well. Depending on the specialty chosen, the school may have a waiting list. However, some universities require that the specialty is gained in the residing state. This waiting list may be several months to several years and so the dentist may choose another school with less of a wait to enter classes. Most dentists who choose this field of dentistry have worked in general dentistry for a while and then have decided to continue on to gain a college degree in the specialty and open an office designed just for gum disease. The Periodontist is a specialist who will be able to repair the gum tissues and bone that has suffered from Periodontal Disease.
Some procedures include:

  • bone grafts,
  • tissue grafts,
  • removal of excess gingival tissue,
  • repair from trauma will also be done by what is Periodontist.

What is Periodontal Disease?Image result for periodontal disease

Periodontal disease is when the tissue that surrounds and supports the teeth is infected or affected by infection or another disease. This can lead to tooth loss, bone loss, and other serious infections that may cause permanent damage to the jaw bone. There are several stages of Periodontal Disease. The beginning stages are called Gingivitis.


Gingivitis has a few stages and progresses pretty quickly if not stopped. This is what is Periodontal Disease comes into play. Usually, gingivitis is caused by an excess of plaque on the tooth that irritates the gingiva (gums). This causes redness of the gingiva and progresses to bleeding. If left to continue, the plaque will calcify and become calculus or tartar. If this occurs it will continue to irritate the gingiva and cause extreme irritation and the gingiva will recede or pull away from the affected area. Thus causing exposure of the root portion of the tooth. This root portion (cementum) is highly sensitive and will cause pain when hot and cold are introduced. Sometimes a sensitive toothpaste will help ease the pain or other dental office procedures to desensitize the cementum will work. There are other skin grafts and other surgical procedures that can work as well but are only used in extreme cases. You and your dentist can discuss referring you to a Periodontist. Once the referral is done then you can check into insurance coverage and payment options.

How Do I Prevent Periodontal Disease?

Periodontal disease can be prevented by keeping the calculus (tartar) build up and plaque off of your teeth. Some disease may be caused by medicines that are taken for health care reasons and not caused by poor oral hygiene. If this is the case then the Periodontist procedures may be covered as medically necessary. However, with daily brushing and flossing to keep food particles from turning into plaque, you can prevent periodontal diseases.

Steps to Take Before Things Get Worse

As stated above, several stages of periodontal disease occur and can be stopped by keeping your teeth clean. Proper oral hygiene instruction and common practice at home will prevent gingivitis (swelling of the gums) and bleeding after flossing. Using a mouthwash and consistent proper brushing techniques will keep plaque to a minimum. The plaque will turn into calculus (tartar-hardened plaque) within about twenty-four hours of the plaque being visible on the tooth. Brushing and flossing the plaque away at least once a day will prevent the plaque from calcifying (hardening). Plaque when soft is easily removed from the tooth and gums by brushing.

Why It is Important to Keep Up With Your Cleaning

This should be done after every meal or snack to remove the food particles before they turn into plaque. Calculus or tartar is hardened and can only be removed by a dental healthcare provider. If not removed then it keeps irritating the gums and makes the other more serious periodontal disease start. Bone loss is measured by marking how deep space is between the tooth and gum. 0-3 millimeters is a normal periodontal pocket. Anything higher is considered periodontal disease and this is what periodontal disease is and needs to be treated. As discussed, the progression is easy to stop yet left untreated can turn into extreme cases and need extensive care.

How Do I Care For My Mouth After A Periodontal Surgery?

Depending on the procedure that has been done the after-care or post-operative care is going to be just about the same. To keep bleeding to a minimum, place gauze pads on the surgical site, do not use a straw,  do not smoke, and this will keep the blood clots in place. Warm salt water rinses the next day will help the healing process. Also, keeping follow up appointments to check on healing and remove any stitches that might have been placed. Taking any medicine that might have been prescribed will also prevent infection and promote healing as well. This is what periodontal disease is.

Will Medicare Cover Periodontal Disease?Image result for periodontal disease treatment

Medicare does not cover dental procedures such as preventative, restorative, or specialty care. Medicare Part A and Part B only cover medical necessity procedures that are causing serious to life-threatening medical conditions such as the infection that can accompany most untreated dental ailments. Even then it is difficult to get Medicare to cover any procedure that involves the teeth and surrounding tissues.

Financial Assistance

Always have your dental health care provider check to see if the procedure you need is a covered benefit and will Medicare cover periodontal disease. Part A (hospital) Medicare will cover procedures that are done in a hospital setting to see if any of the procedures needed can be done as hospital dentistry requirements. Most hospital dentistry is extreme cases, however, some periodontal procedures can be considered in this situation. Not even dentures, partials, crowns, or bridges will be covered by Medicare. Oral surgery and periodontal care are extreme and above normal preventative and restorative procedures. This is why there is financial assistance for periodontal disease. Just talk to your dental health care professional about what the procedure is and what is covered. They can even write a letter to Medicare and explain why the benefit needs to be covered in certain situations. This answers the questions will medicare cover periodontal disease.

Financial Assistance for Periodontal Treatment?

There are several plans available to you from your employer or at the dental office. Most dental insurance coverage from your employer will include some type of periodontal coverage. Most cover procedures such as this at are covered at 80% yet some cover these procedures at only 50% but still is a coverage and help ease the cost of extensive work. In recent year.savings plans have become more popular with health and dental care. Savings plans are like savings accounts where you can open an account and put money into it to build up enough to cover expenses for treatment at a later date.

Credit LoansImage result for dentures

Also available are other credit loan and credit plans out there specifically for dental care. Some dentists even offer them in-house so that the financing is there and offered by the office. This way you can choose which one to start saving money into and begin your treatment as decided by you and your Periodontist. You can start with the smaller less expensive procedures that way you will be healing while you save up more money for the larger procedures. Check with your state to see if you qualify for your state’s medical health care supplement that will be in addition to your Medicare plans. State assistance is determined by several things such as:

  • income
  • how many people are in your home
  • what your state itself offers
  • what type of Medicare you have for financial assistance for periodontal treatment

Also, check with your local agencies to see if they have a community health organization that may offer a sliding scale for dental care or some type of deep discounts for periodontal care specifically. You can get a copy of your dental records if you have to go to a different periodontist that may be available in a community health care setting. Some dental health care coverage is offered by the insurance company at a reduced rate when you are not employed. Such as COBRA or other promotional coverage. They are offered directly from the major insurance company themselves. Just make sure that it is from them and not an affiliate that is taking a portion of the payment. The fees are sometimes based on your need and other times it is a flat rate of fees that are non-negotiable.