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Dental care
A healthy smile is linked to a healthy body. So you’ll want to see your dentist every six months. Just be sure to show your member ID card at every visit.
Dental benefits
Dental benefits
You don’t need a referral to see a dentist in the network. And you can change your dentist or dental group any time during treatment. Here are some facts about dental services:
- They must be medically necessary
- You may need prior authorization (PA) — approval from your health plan in advance, or afterward in emergencies).
- You must go to an in-network dentist.
We cover these dental services for members age 21 and over:
- Teeth cleanings (1 each year)
- Periodic oral exams (1 each year)
- Restorations
- Complete dentures
- Crowns
- Extractions
- Sedation
We cover these dental services for members under age 21:
- Teeth cleanings (1 every 6 months)
- Dental services provided in school dental programs
- Oral exams (1 every 12 months)
- Fluoride treatments (1 every 6 months, ages 3 to 20)
- Oral surgery
You can also get these dental services before the birth of your baby:
- Teeth cleaning (1 every 6 months)
- Periodic oral exams (1 every 6 months)
- Periodontal work (care of the gums and bone supporting your teeth)
You can find a dentist:
Online
Find an in-network dental provider that’s close to you.
By phone
Call us at 1-800-416-9185.
Help for dental emergencies
Help for dental emergencies
Just call your dentist. Go to the emergency room for medical emergencies when your life is in danger.
Find a dentist in emergencies
Is your dentist office closed? Or maybe you don’t have a dentist? To find a dentist:
- Call us at 1-800-416-9185.
- Visit the DentaQuest website
For emergency dental care, you still need to see an in-network dentist. Your services may also need prior authorization (PA) or approval from your health plan afterward.
Special settings
Special settings
Sometimes people need to be in a hospital setting or surgical center for dental care. This may happen for:
- People with special health care needs
- Children under age 5.
If your dentist can’t provide this service, you can:
- Call us at 1-800-416-9185.
- Visit the DentaQuest website
They can help you find a dentist and arrange your care.
Types of dental emergencies
Some examples are:
- A broken natural tooth
- A lost filling or crown
- A permanent tooth is knocked out
- Very bad pain in the gum around a tooth
- Mouth or face swelling or infection
Dental visit tips
Dental visit tips
- Be 15 minutes early for your first appointment with the dentist.
- Be 5 minutes early for all other dental visits.
- Call the dentist at least one day ahead if you can’t keep your appointment.
- Bring only the family members that have an appointment to the office.
- Stay in the waiting room during your child’s visit if your dentist asks you to.
