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How insurance works in a dental emergency

Knowing what to do in a dental emergency – specifically when it comes to insurance coverage – is important to ensure financial assistance.

Does health insurance cover a dental emergency?

A dental emergency is when you need immediate care to relieve pain, prevent infection, or repair or save a tooth.

Whether it's from a major accident or a seemingly simple incident, like a playful headbutt from an infant, immediate attention can make all the difference.

In some cases, your medical insurance may cover part of your treatment for a dental emergency. Trauma, infections, draining abscesses, or dental conditions related to a medical condition may be covered under medical insurance.

How dental coverage works

Your general dentist, an emergency dental clinic, or a hospital can help you determine whether to file for medical insurance or dental insurance.

Dental insurance plans often cover emergency dental care, but your out-of-pocket costs vary by coverage. For example, you may have limits on crowns or veneers to fix a broken tooth.

You may also be referred to a specialist, such as an endodontist for a root canal.

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Knowing when it's an emergency

Severe pain, visible damage to teeth, and uncontrollable bleeding of your gums or mouth can be signs that you need care right away.

Symptoms of an emergency
Severe tooth pain or sensitivity

This pain may be felt constantly, when chewing, or when the tooth is exposed to heat or cold.

Knocked-out tooth

Sometimes teeth can be saved, but you may also have gum damage that needs immediate attention.

Broken teeth

Although you may be able to wait, it's best to have these looked at to avoid more severe problems.

Loose or dislodged teeth

Gum swelling can cause a tooth to feel loose. While it may get better over time, it's still best to have the tooth checked out if it's painful.

Abscesses or oral infections

Trauma to the mouth can allow bacteria into the gums and cause painful infections.

Cuts, bleeding, or bruising of the mouth and gums

Even when teeth look unaffected by an accident, damage to the gums and tissue in the mouth can be a dental emergency.

Where to go in a dental emergency

First, call your dentist or visit an emergency dental clinic. The dentist will take immediate steps to reduce pain, prevent or treat infection, and stabilize the damaged tooth.

If your dentist can't see you, you can visit an urgent care center or hospital emergency room. The physicians in urgent care or ER cannot repair the tooth, but they can stop bleeding, control pain, and take steps to treat or prevent infection.

After emergency care, schedule a follow-up with your dentist to ensure proper healing.

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