Frequently Asked Questions
Have a Question? Check Out Some Popular Questions We Receive, Below!
Do I need a dental checkup?
Yes. Everyone needs regular dental checkups to prevent oral disease, decay and tooth loss. Your Port Credit dentist can identify potential oral health problems and provide appropriate treatment. Even if you brush and floss daily, your teeth and gums still need regular care from a dental professional. The frequency of recall examination depends on the individual, but our practice often recommends every 6 months at least.
This will prevent problems from progressing and causing pain and possibly tooth loss. Frequent preventative visits will also help establish a better relationship and communication between you and your oral health providers.
What is involved in a dental checkup?
A dental checkup at Port Credit Smiles will usually involve a review of your medical and dental history, past or new x-rays, overall examination of your facial and intra-oral tissues, such as your teeth, gums, tongue, cheeks, and palate, professional dental cleaning including scaling if indicated, polish to smooth and remove stain, fluoride treatment, pointers on your hygiene and home care, diagnosis of cavities and any other recommended treatment options explained to you by your dentist. Please feel free to ask questions about your dental checkup or recommended treatments at 905-274-4151.
Do I need dental x-rays?
Dental x-rays allow the dentist to check areas of the teeth and tissue that are not visible during an oral clinical exam. With x-rays, we can see decay, location and condition of existing fillings and crowns, etc., the condition of the tooth root, unerupted teeth and underlying bone to ensure that there is no infection or bone loss, and the location of impacted wisdom teeth. Digital x-rays are available in our office to reduce the amount of radiation exposure even further than traditional dental x-rays. In addition, you wear a protective lead apron and thyroid to elimination unnecessary exposure. You should inform your dentist if you recently had multiple medical x-rays or if you are pregnant.
What causes tooth decay? If it doesn’t hurt, why do I have to get a filling done?
Tooth decay is caused by bacteria in the mouth that feed on sugar to produce acid. This acid eats away at the enamel layer on the tooth creating a cavity. You may not experience any discomfort at this point. However, if left untreated the bacterial acid will continue to destroy more tooth structure until it reaches the nerves and blood vessels (called pulp). At this point you will experience discomfort such as sensitivity to temperature and pressure, swelling and possible abscess or infection.
A root canal and a crown will become necessary at this point or a of the tooth as the worst case scenario. The financial cost as well as the loss of tooth structure is much less when a cavity is small than when it is left untreated until you are in discomfort. Getting a filling done is a proactive approach instead of waiting until the cavity hurts.
What payment options are available?
Non-Assignment is payment in full by cash, Interac, Visa or MasterCard due at time of service
Assignment is the direct billing of your insurance policy provided we have previously confirmed applicable coverage is in place. Any amount due for services not covered by our insurance policy are due at time of services.
Pre-authorized Visa or Mastercard installment payments is a financial option to certain patients where they have established a trust with the office. Talk to our administrative personnel for details.
How do you determine your fees?
Every dental office determines a fee schedule outlining the fees charged for specific services. We have determined our fee structure based on the professional guidelines set out by the Ontario Dental Association and specific information related to operating this office. These fees are the same for all patients in our office. Every insurance provider also determines a fee schedule outlining the maximum they will pay for specific services.
Most insurance providers base their fee schedule on information published by the Ontario Dental Association. Port Credit Smiles uses the current year’s suggested fee guide to make up for insurance lag and as a cash courtesy to patients. However, if the ODA fee schedule is difference than the fee schedule used by your insurance provider, you are responsible for the balance owing.
My insurance company pays 80%. Can you write off or adjust the balance so I don’t have to pay anything?
Port Credit Smiles cannot write off or adjust the amount charged for services provided for two reasons. We have determined our fee structure by considering the professional guidelines currently set out by the ODA. These are the same for all patients, regardless of insurance consideration.
If we could adjust fees and still remain economically viable, we would do so for all patients, not just insurance subscribers. Many insurance companies use a co-payment plan where part of the dental fee is covered by the insurance company and part is covered by the patients.
Through these plans, the patient is legally liable for his/her portion of the fee. Writing off or adjusting the fee means the insurance company assumes responsibility for a higher percentage of the total – this constitutes insurance fraud.
Dental fee is $100. The insurance pays 80% and therefore covers $80, leaving the patient to pay the remaining $20. If we reduce the total amount owed by $20 by writing the patient portion off, your insurance provider has ended up paying the full $80 fee, or 100%. The insurance provider is now responsible for 80% of the $80 or $64. Writing off the original patient portion of $20 defrauds the insurance company of $16.
Can you directly bill my insurance company?
Yes, provided we have previously confirmed applicable insurance coverage is in place. Contact your insurance provider for a comprehensive description of covered services and claim processes.
I have insurance coverage. Why do I have to pay up front?
Some insurance providers have a direct billing option while others require you to pay up front and submit your receipts for reimbursement. Depending on the insurance provider, we can submit your receipts for reimbursement directly from our office or you may have submit them manually yourself. Regardless of the billing or reimbursement process, your insurance policy may not completely cover some services and/or fees. Contact your insurance provider for complete details on dental procedures covered by your policy and the claim process.
Can you get my insurance information for me?
No. The privacy laws governing both the dental practice and insurance providers limit our ability to access or request specific details about your policy coverage. Insurance companies do not have a legal obligation to provide us with thorough or accurate information about a patient’s coverage. Any information we receive from insurance companies is provided in general terms as a courtesy only. Contact your insurance provider for a comprehensive description of covered services, fee schedules, deductibles, and claim processes. We can send off for estimates and pre-authorization for your recommended dental treatments.
I am covered by more than one insurance policy (a primary and a secondary). Why do I still have to pay?
Most insurance providers will pay for dental services up to a specific amount, based on a fee schedule. Your primary insurance provider will cover dental services up to its maximum, based on its fee schedule. Your secondary insurance provider will often cover what your primary provider does not, subject to the fee schedule maximum of your secondary provider. If the fee schedule for Port Credit Smiles is different than the schedules used by each provider, you may still owe the balance after both insurance providers have pain.
A certain treatment costs $950. The patient has three insurance policies: A, B, and C. Each policy will cover 50% up to the fee schedule maximum of $800. Policy A and B will each pay 50% of the maximum ($400) to total $800. Policy C, however, will not cover anything as policies A and B have already covered everything up to policy C’s maximum. The patient is responsible for the outstanding $150.
Why do you provide/offer procedures that are not covered?
As dentists, we are responsible for providing you with the best clinical care and treatment options with your health concerns in mind. We do not know with complete certainty which procedures will be covered. If we based our treatment options on the limitations of insurance coverage, we would not be able to provide you with the quality dental care you deserve.