Mouth injuries are widespread, notably in kids. Around 25% of school children experience mouth injuries (Chirine Abdel Malak, Carole Chakar, Alain Romanos, Samar Rachidi, 2021). Mouth Injuries can cause cuts to the tongue, lower lip, or upper lip. It can affect the tooth, jaws, lip, tongue, inner cheeks, gums, the roof of the mouth, neck, or tonsils. Injury to the dentoalveolar area (containing teeth, alveolar bone, and gingival lacerations) might result in maxillofacial fractures or soft tissue injuries (Alessandro Ugolini, Giovanni Battista Parodi, Claudia Casali, Armando Silvestrini-Biavati, Flavio Giacinti, 2017). A mouth injury may appear worse than it is. Due to the abundance of blood arteries in the head and neck region, even a little cut or incision inside the mouth may cause significant bleeding.
- In certain severe conditions, a tooth can be damaged after falling. Falls, which were involved for 55.8% of the injuries, were the primary source of dental injuries (Durl W.O’Neil, Michael V.Clark, James W.Lowe, Marilyn S.Harrington, 1989).
- It may also occur while playing a sport. As stated by 49% of the respondents who had anterior tooth injuries, sports-related activities were the most frequent cause of the damage (Pavan Baldava, Nagaraj Anup, 2007). The two most common locations for injuries were playgrounds at schools (40%) and homes (36%) (Amir Shayegan, Viviane De Maertelaer, Astrid Vanden Abbeele, 2006).
- In this study, violence was one of the factors contributing to oral injury in children and adolescents (Chirine Abdel Malak, Carole Chakar, Alain Romanos, Samar Rachidi, 2021).
Mild mouth injuries can be addressed at home to lessen pain, halt bleeding, speed healing, and eliminate the infection. ADA says that simple injuries can be healed within one to two weeks. Sometimes, tooth avulsion may occur. Quick first aid and dental care are required when a permanent tooth is knocked out. Before getting treatment for any mouth injury, it is better to know if your dental or health insurance will pay for that treatment; otherwise, you will be responsible for paying the fee. Therefore, we have discussed some crucial facts about mouth injuries and details about the concern that will dental insurance cover mouth injuries.
Dental coverage for mouth injuries
Many studies have found that traumatic orofacial injuries in children and adolescents are widespread (Amir Shayegan, Viviane De Maertelaer, Astrid Vanden Abbeele, 2006). Therefore, prevention and treatment are necessary things, either under the coverage of insurance or not. Unless it is medically essential, it is unlikely that your health insurance will pay for the restoration. The cost of the necessary therapy might be high depending on the kind, severity, and duration of a TDI (Kate P. Kenny, Peter F. Day, Mohammad O. Sharif, et al., 2017). The cost may be covered by your dental plan, though, if you need major reconstruction following an accident or injury. Most dental insurance providers commonly divide dental operations into three primary categories:
- Preventative: Many insurance plans offer 100% coverage for preventive care and oral hygiene management procedures like fillings, cleanings, and crowns.
- Basic: Dental insurance often covers 50–70% of essential operations.
- Severe: Up to 50% of major services like surgery can be reimbursed by your insurer.
Still, it is essential to keep in mind that coverage might differ considerably depending on the provider and plan type.
Health insurance coverage for mouth injuries
There are considerable social, psychological, and financial implications associated with dental injury for kids and their families (Margaret O’Malley, David Evans, Antonia Hewson, Jenny Owens, 2012). At this point, people consider having insurance coverage. This is not a surprising fact that insurers cover only those treatments that are considered medically necessary. Each insurance provider may have a somewhat different conception of medically necessary dental treatment. Some oral injuries, including those listed below, are covered by specific health insurance plans.
- Fractures and jaw dislocations
- X-rays and diagnostic procedures following an injury
- Tooth replacement or repair provided that the harm to the mouth that resulted in the loss or damage was not a result of chewing or rotting
- Several conditions that can harm your oral health
- A condition that necessitates the removal of teeth
Dental work after trauma
According to epidemiological research, dental trauma occurs annually in roughly 4.5% of the world’s population (R Lam, 2016). Dental injuries, direct or indirect, are frequently torturous, unsightly, and costly to treat (Sujatha .Ba, Sai Sankar .A.Ja, Manoj Kumar .M.Ga, Sree Devi .Ea, Sridhar .M, 2010). You may need dental services to get your mouth back to how it was before the severe dental injury. In such circumstances, most health insurance companies will pay for dental surgeries and treatments that recover your teeth’ functionality and appeal. Services offered are:
- Any form of restorative care
- Dental implants, surgery
- Root arcs
- A bone transplant
- Crowns
- Dental operations that preserve natural teeth
How to minimize the risk of mouth injuries
The risk of dental injury can significantly be reduced with the aid of mouthguards (Margaret O’Malley, David Evans, Antonia Hewson, Jenny Owens, 2012). This protective equipment annually helps prevent tens of thousands of oral injuries. A mouth protector is described by the American Society for Testing and Materials as a robust tool or appliance put within the mouth to decrease mouth injuries, specifically to teeth and adjacent tissues (Srikanthan Sriram, Arasan Nandhini, Parangimalai Diwakar Madan Kumar, 2018). Mouthguards come in a variety of styles, such as (Srikanthan Sriram, Arasan Nandhini, Parangimalai Diwakar Madan Kumar, 2018)
- Stock mouthguards:
- Off-the-shelf
- Inexpensive
- Less preferred
- Boil and bite mouth guards:
- Also known as Mouth-formed mouthguards
- fit into the athlete’s mouth and provide specialized protection by holding to their teeth
- Custom made mouthguard:
- Personalized mouthguards created by a dentist
- More comfortable
- Most preferred
- Slightly costly
In the case of night guards, it is advisable to confirm with your insurance provider whether or not night guards are covered. If your dental insurance will not pay for the expense of the night guard and you require one to secure your teeth or cure a problem like TMJ or Bruxism (which is a common concern for a lot of people (Nicholas Longridge, Alex Milosevic, 2017)), your medical insurance could. It could be a good idea to find out from your medical insurance whether they would cover the cost of any customized dental implants or appliances you require to treat a severe condition. Chewing and social interaction difficulties are more common in those with untreated oral injuries (Kausar Sadia Fakhruddin,Herenia P Lawrence,David J Kenny,David Locker, 2008)
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