Why doesn't my insurance pay for certain dental procedures?

This is a great question!

Your dental plan is a contract between your employer and an insurance company. They agree on the amount the plan pays, the fees they will pay, and what procedures are covered. In many cases, patients need dental procedures not covered by these plans. Insurance companies seldom consult dentists regarding treatment recommendations and fees. So, if there is more than one way to treat a dental problem, the insurance company will always pay for the least expensive treatment. This is wrong because the least expensive option is NOT ALWAYS the best treatment for you!

Remember, your health is a very important thing. Your dentist's main goal is take care of you and your family in the best manner possible. You and your dentist should decide on treatment-not an insurance company contract! Always talk to your doctor about treatment options best for you.

Other facts:

-Insurance companies usually discount their covered fees and very seldom match average dental fees charged by doctors in a given geographic area.

-Insurance companies seldom change their reimbursement amounts, keeping them the same for years. That's why if your dental bill is higher than the insurance company's set rates, they have either sold a discounted plan to your employer, or have made up their own free schedule.

-PPO (Preferred Provider Organizations) and HMO (Health Maintenance Organizations) are contracts between certain dentists and dental clinics and insurance companies. The insurance company agrees to send patients to a dentist, or clinic, in exchange for a reduction in their fees (often as much as 50%). In my opinion, if the average dental office has a 60% overhead, you cannot reduce your fees by 50% and remain in practice!Many of these signed up offices have to offer dental cleanings in 15 to 20 minutes, inferior dental restorations from foreign labs, reductions in educated staff and opt to use less than the best dental materials in order to make ends meet. Our office will NEVER be a part of these PPO and HMO organizations! You are entitled to the best dental care and treatment we can provide for you and your family!


Root Planing and Scalings

If you have periodontal (gum and bone disease) there is both good and bad news. The bad news? Periodontal disease can be treated, but is never completely eliminated due to bone loss that cannot be regrown. The good news? Treatment can increase your chances of keeping your teeth, reduce the chance of extra bone loss, and decrease the chances of even more serious health problems!

The advantage of root planing and scaling is that it is a "non-surgical" procedure. It involves a special cleaning to remove food and tartar deposits on both the tooth and root surfaces. This helps tissues to heal and tissue pockets to shrink. Dentists often refer to this as a "periodontal" or "deeper cleaning." This special scaling may be scheduled for one or more visits, and it might be used with a mild local anesthetic. Many patients can avoid a more costly and sensitive periodontal surgery with successful root planing and scalings.

So to sum up...

During your "special cleaning," your dentist/hygienist will carefully remove plaque and tartar in each gum pocket. That is the "scaling part."

Next is to clean and smooth your teeth's root surfaces. Smoothing helps your gums to heal and often reattach to the tooth. It also shrinks the pocket depths. This is the "planing" part of the "special cleaning."


What are Re-care Appointments (Cleaning and Exam) and why are they necessary?

Our Re-Care Appointments include...

1. Oral cancer exam

2. Blood, pus and diseased gum pocket detection

3. Tooth decay detection

4. Root resorption observation

5. Bone loss around your teeth noted

6. Loose shifting or drifting teeth checked

7. Bite and occlusion changes noted

8. Tooth wear and abrasion observed if present

9. Joint changes or problems discussed

10. Cosmetic changes (ex. darkening of teeth)

11. Cleaning and polishing of your teeth

No "cleaning" should ever be only 10 or 15 minutes long (as many of the big, corporate dental groups suggest). It is just not possible to perform all of the above in so little time. Remember, our dental re-care appointments, along with necessary radiographs, are key to our patients' long term dental health.

Depending on your dental condition, a 6, 4 or 3 month re-care appointment will help to keep your teeth, gums and bones healthy, and slow the breakdown of those important oral parts.


Why should I see a dentist? Nothing hurts in my mouth?

Unlike other body parts, dental diseases often don't hurt until they are far along and harder to treat. Early diagnosis and treatment of dental problems costs less and saves our patients time, discomfort and extra visits.

How can your office be absolutely sure that I need certain dental procedures done?

Our office has 7 intraoral cameras that take pictures of your teeth. We can actually show you cracked fillings, broken teeth, unhealthy gums and other dental concerns. The saying, "A picture is worth a thousand words" really applies here! Cameras have helped our practice grow by building a lasting trust between us and our patients. They have also helped us educate and enable our patients to make good decisions regarding their health and treatment.

I went to a large dental clinic for an advertised free exam and x-rays. After a 15 minute cleaning, the nurse there told me I have to get 8 fillings. Since I had a great check up just 6 months ago at another dental office, how do I know the fillings are really needed?

Unless your health, eating habits or oral hygiene has radically changed, in my opinion, the clinic may be mistaken. Why not get a second opinion from one of your family member’s, co-worker's or friend's dentist, whom they've known for a long time and trusted? It's never a bad idea to get another opinion!

What causes tooth decay and gum disease?

Your teeth are covered with a film of bacteria called plaque. After a meal or snack, these bacteria convert sugar in foods to acids. These acids attack the enamel, your tooth's hard outer layer. Plaque can also build up overnight while you are sleeping causing your enamel to break down. Both of these can lead to cavities.

Your saliva reduces plaque by cleansing the mouth and helping to digest food when you chew. But, if there is not enough saliva (or if it's not watery), the number of bacteria in your mouth will increase, along with the amount of acid they produce. This lack of saliva flow is called "dry mouth" and can be caused by certain medications or chronic diseases, such as diabetes. Dry mouth (Xerostomia) may also increase your risk of tooth decay.

If you brush twice a day and floss once a day at night time, you can remove most of the harmful plaque and bacteria. But if plaque stays on the teeth, it will eventually harden into tartar. Tartar can build up near and below the gum line. Since tartar cannot be brushed or flossed away, it gives the bacteria a place to adhere, and the tartar can grow without being disturbed, causing further gum/bone damage.

Plaque can also irritate and inflame your gums, making them swell, turn red, or bleed. This is called gingivitis, an early stage of gum disease. The good news is that gingivitis can be reversed with a professional dental cleaning and good oral hygiene at home.

If gum disease is left untreated, it can cause your gums to move away from your teeth and bone, becoming infected. In advanced stages of gum disease, bone loss can occur and teeth may become loose, fall out or have to be pulled out. The gingivitis has now become periodontal disease and can be controlled, but not eliminated or cured!

Remember it is much easier and less expensive to prevent tooth decay and gum disease, than to treat them or maintain a mouth with periodontal disease.

-ADA American Dental Association 2015 Brochure W135-

I heard on TV a large Dental Box Store advertise getting "Teeth in a Day," can they really do that? If not, why do they make this claim?

In my opinion, NO! Remember if something sounds too good to be true, it probably is! Large Box Corporate Dental Stores make this claim to get patients in their door. Once in, they often tell the patient that they can't get their teeth in a day because their case is 1. Too complicated 2. Needs more time to complete 3. Is not a one day case. Also, remember that someone has to pay for the huge radio and television advertisements these clinics employ in their quest to get patients to come in.

Do all children have to go to a Pedodontist (a dentist who specializes in children's teeth)?

The answer is no! Many dentists enjoy treating children, including us! Kids bring a lot of warmth and laughter into a dental office. However, we agree that children with special needs, illnesses or behavior issues are often best seen by a children's specialist. You should expect to pay more per visit to see a specialist than you would for a general family dentist. In many cases, when children reach a certain age, they have to find a family dentist anyway! So if you're in need of a dentist for your children, ask if your dentist treats children before looking for a Pedodontist.


Where's dentistry headed in the future?

Dentistry will continue to play a bigger role in helping people maintain optimal health for their mouth AND body. Science has already shown that diseases of the mouth can spread to and affect other body parts, including heart, lungs and tissues. Even now, physicians enlist the help of dentists to eliminate dental problems before they attempt medical operations, like cardiac procedures or artificial knee replacement on their patients.


Manual vs. Motorized Tooth Brushes?

In the hands of a health conscious person, either brush works the same. But if a person has medical problems handling a brush, or is a little bit careless with time and technique, the motorized brush works best. However, many motorized brush users feel their teeth are cleaner than when they used a manual brush and would never go back to using one.


Toothpastes vs. Fluoride Rinses-Necessary?

Toothpaste and fluoride rinses are both helpful in removing food and plaque from tooth surfaces. However, thorough brushing with just water is acceptable. Tooth paste with whitening and tartar control should be avoided if a person's teeth become sensitive to cold or air after using them for an extended period of time.


Hard vs. Soft Toothbrushes

Soft brushes are recommended over hard brushes by dentists!


Sports injuries and tooth accidents in kids?

All children of any age should have a mouth protector of sufficient thickness, and should be fitted accurately to their teeth. All sports are susceptible to mouth injuries, like chipped teeth, abrasions and trauma. The price of a well fitted mouth piece can save a person thousands of dollars in dental tooth repair.


What can I do to prevent my kids (and grandkids) from getting cavities?

Watch sugar (carbohydrate) consumption, stress tooth brushing, especially at night and rinsing with water after eating whenever brushing is impossible. Avoid carbonated and sweet drinks and juices too.


Sealants-do they work?

Absolutely! They make deep grooves in teeth (that are proven to decay) shallower so food doesn't stick in them. They are also easier to brush. In our office, we use a flowable composite in the grooves, which is a better way to seal teeth pits and fissures. Other dental offices may only use brittle plastic sealer materials that need replacement ater a year. Ours last for many years and often wear instead of chipping or falling out as the brittle ones often do.


How can I talk to my dentist while he's working on me and answer his questions?

This great question always makes me laugh! But you really can carry on a conversation during procedures! However, your responses are limited to "Uh-ha" or yeah and "uh-uh" or no. Try it-both phrases can be said with your mouth wide open!


What are veneers?

Veneers are facings placed on teeth-similar to artificial nails women place on top of their fingernails. Porcelain veneers are quite expensive and have a lot of margins associated with them. Meticulous brushing must be done to keep debris and decay from occurring at these margins. Veneers can chip, crack, discolor and fall off, so they are not recommended for finger nail biters or people who grind their teeth. Lastly, veneers are not for a lifetime-and they may need to be replaced after a certain number of years!


Do fillings wear out?

Yes, fillings wear-just as your car, furnace, roof and other possessions do! During your dental exam, a patient's fillings are evaluated, and their longevity is based on the foods we eat, drink, and the care of the fillings thru brushing and flossing. Signs your fillings are wearing out and need replacement? Sensitivity to cold, sweets, sometimes air, missing parts, worn spots, and chipped areas.


Do all my silver fillings have to be replaced?

No No No No NO! If the silver filling is worn or leaking-yes. But at our office, we subscribe to a "minimally invasive" philosophy- replacing only the fillings that are failing. Sadly, quite a few patients have gone to other offices and had all their old fillings removed to find the new ones catching food, being sensitive to cold liquids and air, and having their bites off. Most of those patients say they would never do it again because, even though these fillings are newer they are more troublesome than the old ones were often they weren't having any problems with the old fillings, like they are now with the new ones. At our office, we have even had to remove some of those new fillings placed at other offices, and replaced them with ours, which include sealers and decreased sensitivity procedures under our restorations.


How can my children have healthy teeth?

Watch the things they eat and drink, be sure they are seen regularly by a dentist, practice daily good oral hygiene techniques and include foods in their diets like fresh vegetables and fruits, and decreasing foods with sugars and stickiness.


Do the doctors at Cuglewski & Associates work with other specialists?

At Cuglewski & Associates we work with dedicated and talented specialists to ensure the best treatment for each of our patients. For certain situations, if we feel you need a specialist, we will recommend one or several to you!


Dr. Jim's Case on Mouth Guards

In the United States, over 45 million school-age children play organized team sports. Safety is a major concern in all sports for players, coaches, schools and leagues. Dental trauma poses one of the biggest risks because 36% of all dental trauma injuries occur in sports participations. It's estimated that more than 5 million teeth are broken or damaged each year. In the United States, this results in costs upward of $500 million in medical and dental expenses! Many sports require the use of mouth guards-but many don't. But the American Dental Society has encouraged mouth guard use in most sports for over 30 years because they greatly reduce the risk of dental injury.

The most popular type of mouth piece is a "boil and bite" kind sold at retail stores. It is the cheapest and least effective. It is often bulky and ill fitting but it offers adequate protection than not wearing one. Custom mouth pieces made by dentists, is the best, most comfortable fit and the best protection for teeth. They typically cost between $100-$400 depending on design and thickness. Unfortunately, many consumers overlook the importance of custom mouth guards and purchase one off the shelf because they see this as a quick, easy and inexpensive option for protection. However, all parents want the best for their children, and the custom mouth pieces can mean a huge difference between chipped, broken, loosened or even lost teeth. If you have any questions, please call us.


Whitening Options

We have several options to ensure your smile can be as bright as it can be:

1. Teeth whitening treatments

2. Crowns ("caps")

3. Esthetic bonding and veneers

Other things to prevent teeth staining:

1. Stop smoking

2. Limit coffees and strong teas

3. Swish with water after red wine consumption

4. Brush your teeth 2-3 times daily and floss!

5. Limit carbonated colas (sugary and diet)

We are so proud of our teeth whitening system! We have used it over 30 years with no tooth sensitivity (unlike Crest Whitening Strips and other methods). Come in for a free 15 minute consultation on our recommendations to whiten your teeth! We have patients who have used our system happy to talk to you about their experiences.



1. Dental Sealants

Sealants have been shown to be an effective way to prevent cavities in children. In our office, we use composite flowable resin (not plastic) sealer. This prevents our sealants from chipping or coming lose under normal use. In fact, we guarantee them for five years as long as the child is seen every six months (plus or minus one month) for re-care appointments. This is a great benefit our office offers to all our patients!

2. Crowns ("caps") or Fixed Bridges ("multiple "caps")

For a period of five years from the date of service, we will redo a crown or bridge for our patients due to breakage at no cost to the patient! This guarantee is null and void if the patient does not maintain their six month (plus or minus one month) re-care cleaning appointments. Please note: Gold, porcelain and the newer technology materials (Bruxir) are similar in properties, but porcelain can chip (just like a tooth can!). This will never happen with gold or Bruxir crowns but you sacrifice the beauty and color porcelain gives a tooth. However, heavy grinders and ice chewers should choose gold or Bruxir for function over beauty.

3. Root Canals ("Endodontics")

For a period of three years we will retreat a previously performed root canal at our office, again provided that the patient maintains a six month (plus or minus one month) re-care schedule. Please note: This guarantee is void if the patient failed to protect the treated brittle tooth with a crown or cap and it fractured or broke, causing reinfection. Failure to cap an endodontically treated tooth can sometimes lead to extraction.

4. All Fillings are Guaranteed

However, patients are warned that sometimes extra large fillings (bigger than 60% of the tooth) are prone to more damage. If within one year a person breaks off additional tooth from near the filling, necessitating a cap or crown on the tooth, we will credit half of the filling cost toward the crown. This shows we really try not to charge extra for our services-whether it's your fault or not!


Tobacco and Oral Health

Most people are aware that tobacco can cause cancer, strokes and heart diseases. Tobacco has also been linked to lung disease, birth defects, pregnancy problems, mouth and throat cancers. But did you also know that it can cause harm to your mouth like gum and bone diseases (besides bad breath?)

It doesn't matter how you use tobacco-whether you smoke, dip or chew. Tobacco is just not good for you!

Resources to Quit Tobacco:


-National Network of Tobacco Cessation Quitlines 1-800 QUITNOW