AZ Blue Best Life Classic (HMO): Dental Services (Medicare Covered)

Proper dental care is about much more than teeth, though clean and healthy teeth are an essential start. Many people don't realize that issues with the teeth and gums lead to far greater problems than what is seen or felt on the surface. Many older adults ignore the signs and symptoms of poor dental health.

Cavities are sometimes seen and felt, though oftentimes not, and they are best addressed early, just as with any other condition. Once tooth pain is felt, drilling and filling are a certainty, and maybe more. Avoiding dry mouth (which occurs frequently in older adults) and brushing regularly are essential in preventing cavities.

Broken or missing teeth are a gateway to the tissues, vessels, nerves, and bones beneath. Those vessels and nerves, especially, are direct pathways to the heart and brain. Therefore, if an infection occurs beneath the teeth, it could travel to the heart or brain. Dental problems can actually cause heart disease and irreversible angina (chest pain caused by reduced blood flow to the heart).

Likewise with gum disease, which is why gingivitis should not go untreated. Gingivitis can lead to periodontal disease. Periodontal disease affects the tissues around the teeth, including the bone to which they are anchored. It is a risk factor for both heart and lung disease.

Dental problems can also affect speech, and cause difficulties with chewing or swallowing, leading to poor nutrition and aspiration risk (liquids or foods pass into the lungs).

Probably most importantly, poor dental care can prevent people from enjoying the foods they prefer. It takes healthy teeth and gums to process meats, fibrous foods (most fruits and vegetables), and crunchy snacks.

Dentures and implants are excellent alternatives when required, though they are expensive and not as reliable as natural teeth. They are also avoidable with proper dental care.

In general, preventive dental services (such as cleaning, routine dental exams, and dental x-rays) are not covered by Original Medicare. However, the health plan covers:

Preventive dental services:

• Oral exams

• Prophylaxis (cleanings)

• Fluoride treatment

• Dental x-rays

Comprehensive and major dental services:

• Diagnostic services

• Restorative services (fillings, crowns)

• Prosthodontics (bridges, implants, dentures), other oral/maxillofacial surgery

• Simple extractions (pulling teeth)

• Emergency treatment for dental pain

General anesthesia is covered as medically necessary in conjunction with surgical extractions only.

You do not need a referral from your provider to see a dentist.