Wisdom tooth surgery is a common dental procedure that many individuals undergo in their late teens or early twenties.
The cost of this surgery can vary significantly based on several factors, including whether you have dental insurance. This article will provide a comprehensive overview of the costs associated with wisdom tooth removal when you have insurance, including what to expect, how insurance coverage works, and tips for managing expenses.
Why Remove Wisdom Teeth?
Wisdom teeth may need to be removed for several reasons:
Impaction: Wisdom teeth can become impacted, meaning they do not fully emerge through the gums. This can cause pain, swelling, and infection.
Crowding: If there isn’t enough space in the mouth, wisdom teeth can push against neighboring teeth, causing misalignment.
Cavities and Gum Disease: Wisdom teeth are located at the back of the mouth, making them difficult to clean. This can lead to cavities and gum disease.
Preventive Measures: Some dentists recommend removal before problems arise, especially if the teeth are positioned in a way that could lead to complications.
see also: When Do Wisdom Teeth Stop Coming In?
Average Costs of Wisdom Tooth Removal
The cost of wisdom tooth removal can vary widely based on several factors, including:
Complexity of the Extraction: Simple extractions of fully erupted teeth are generally less expensive than surgical extractions of impacted teeth.
Geographic Location: Costs can differ significantly based on where you live. Urban areas may have higher costs due to increased demand and cost of living.
Type of Anesthesia Used: Local anesthesia is usually included in the cost, but sedation or general anesthesia may incur additional charges.
Cost Breakdown
Simple Extraction:
Average cost: $75 to $300 per tooth.
Total for all four teeth: $300 to $1,200.
Surgical Extraction:
Average cost: $225 to $1,100 per tooth, depending on the complexity.
Total for all four teeth: $900 to $4,400.
Additional Costs:
X-rays: $20 to $250.
Exam fees: $50 to $200.
Sedation: $100 to $500.
How Insurance Covers Wisdom Tooth Removal
Dental insurance can significantly reduce the out-of-pocket costs associated with wisdom tooth surgery. However, the extent of coverage depends on several factors, including your specific insurance plan, whether the extraction is deemed medically necessary, and the type of provider you choose.
Types of Insurance Coverage
Dental Insurance: Most dental plans cover a portion of the costs associated with wisdom tooth removal. Coverage typically ranges from 50% to 80% of the total cost, depending on the plan.
Medical Insurance: If the extraction is deemed medically necessary (for example, if it is causing pain or infection), your medical insurance may cover some costs. However, dental procedures are often excluded from standard medical insurance plans.
In-Network vs. Out-of-Network Providers: Insurance plans often have a network of preferred providers. Using an in-network dentist or oral surgeon can result in lower out-of-pocket costs.
Average Costs with Insurance
When you have insurance, the average cost for wisdom tooth removal can be significantly lower. Here’s a breakdown of expected costs:
With Insurance:
Average cost per tooth: $450 to $641.
Total for all four teeth: $1,800 to $2,564.
Without Insurance:
Average cost per tooth: $720 to $4,000.
Total for all four teeth: $2,880 to $16,000.
Factors Affecting Insurance Coverage
Medical Necessity: If your dentist determines that the extraction is medically necessary, insurance is more likely to cover a larger portion of the costs.
Type of Extraction: Surgical extractions may have different coverage levels compared to simple extractions. Be sure to clarify this with your insurance provider.
Plan Limitations: Some plans may have specific exclusions or limitations regarding wisdom tooth removal. Always check your policy details.
Tips for Managing Wisdom Tooth Surgery Costs
Consult Your Dentist: Discuss your concerns about costs with your dentist. They can provide estimates based on your specific situation and may help you navigate insurance coverage.
Get Multiple Quotes: If possible, consult several dental providers to compare costs. This can help you find the most affordable option.
Payment Plans: Many dental offices offer financing options or payment plans that allow you to pay for the procedure over time.
Flexible Spending Accounts (FSAs): If your employer offers an FSA, you can use pre-tax dollars to pay for your dental expenses, including wisdom tooth removal.
Discount Plans: Consider dental discount plans, which can provide reduced rates for various dental services, including extractions.
Conclusion
Wisdom tooth removal is a common procedure that can prevent various dental issues. Understanding the costs associated with this surgery, especially when you have insurance, is crucial for managing your dental health and finances. While the average cost of wisdom tooth removal with insurance ranges from $450 to $641 per tooth, factors such as the complexity of the extraction, geographic location, and insurance coverage can significantly impact the final bill.