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Can someone please explain something to me  

post #1 of 6
Thread Starter 
My son has bruxism. He grinds his teeth so hard at night that he has already broken 2 teeth. We went to the dentist over the weekend and they made a guard for him. The girl from the dentist office says that insurance won't cover it. Why, for the love of all that is good, is a mouth guard to prevent further damage not considered to be a prophalactic treatment?
post #2 of 6
I'm sorry. It seems like a lot of dental insurance is well, weird and skimpy. It seems very preventative, I've got two cavities caused by flexing at the top of my canines from grinding.

post #3 of 6
My insurance wouldn't pay $35 for me to get a diaphragm but would happily pay thousands of dollars if I got pregnant.

I think insurance companies are just nuts.

What is the guard like? Is it possible that one of the "boil and bite" mouth guards that kids use in sports would work?
post #4 of 6
If it's done to treat another disorder all together, then you might well get it paid. Did they check for seizure activity?
post #5 of 6
Thread Starter 
No seizure activity. He has a persistant allergic post-nasal drip that isn't helped by his constant sniffling and refusal to blow his nose (we've has fights over this). The meds for allergies don't help (we've tried several varieties and he has behavioral changes for the worse on them).

The guard is molded to fit his upper teeth - they coded it as a "sports guard" (I have issues with this as it is not for sports, it is for him to wear at night when he's sleeping only). The flat plate ones are too large for his mouth (he's only 7), and he's been grinding for quite a while.

Dh is going to talk to the HR person tomorrow to find out what the deal is. If they aren't helpful, we will appeal it directly with the insurance company.

What pissed me off the most is that I paid $281 in copays and deductibles on Saturday, and they asked for another $40 today for the dang guard because they screwed up on the calculations on Saturday... And between me, dh and ds we need about $5000 more work done. (dd doesn't get counted in as she is being referred to a pediatric dentist).

FTR, I really hate insurance companies and I really hate the dentist's office.
post #6 of 6
Seizure activity was ruled out with a VEEG?

Have you tried a personal steamer?

Insurance companies are well pathetic. I hear you on the dental bills. It is just OUCH even WITH the insurance.
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Mothering › Forums › Health › Health and Healing › Dental › Can someone please explain something to me