Credit: Adobe Stock
Employers are facing a new threat to workers' oral health, and overall oral health: workers' terror of routine cleanings leading to follow-up visits for "deep cleaning" services that may or may not be necessary.
Most workers with employer-sponsored dental plans expect to pay $100 or less for the cleanings, according to Jordon Comstock, the founder and chief executive officer of BoomCloud, a dental practice software firm.
When dentists recommend deep cleanings, those extra cleanings can cost $1,000 or more, and the patient's share of the bill could be $150 to $300.
Patients who face calls for deep cleanings may think the dentist is trying to sell them overly aggressive services. An affected patient may skip the deep cleaning, stop seeing the dentist or even stop getting routine dental care.
Comstock said the extra deep cleanings recommended are often necessary.
"Do not skip preventive care because of uncertainty," he said.
Dr. Peter Fuentes, chief dental officer at MetLife, said patients' skepticism about dentists' recommendations for care may be the result of a gap in communication or about patients' understanding about treatment needs.
"That's why transparency education and a strong emphasis on prevention are critical," Fuentes said.
What it means: Employers and benefits advisors may be able to protect workers' dental health, and, indirectly, their overall health, by thinking about deep cleaning needs when designing dental plans, encouraging workers to brush and floss their teeth, and educating workers about when deep cleanings might be necessary.
The backdrop: Employers have entered a world where some of the drama in the major medical plan market is starting to spill over into the dental plan market.
Dentists are trying to push back against dental plan cost-mangement strategies, and employers have faced big swings in dental insurance prices in recent years, and
More dentists are moving to cash-only or cash-preferred business models.
Comstock's own company, BloomCloud, sells software to dental practices that charge membership fees in addition to, or instead of, serving patients that come in with commercial dental insurance.
How to move forward: Fuentes said in an email that concerns about "aggressive treatment plans" involve recommendations for relatively high-cost procedures that have more conservative alternatives, such as recommending a crown instead of simply replacing a filling.
"In some cases, we are seeing a shift toward more comprehensive — and sometimes more expensive — treatment plans," Fuentes said.
The drivers include advances in available treatments and a greater emphasis on long-term oral health outcomes, he said.
"However, when care is not clearly explained, patients may interpret these recommendations as unnecessary or overly aggressive," Fuentes said.
He sees educating dental plan participants as one priority.
But MetLife is also communicating more with some of the dentists, through a new SpotLite dental network that puts more emphasis on disease prevention, early interventions, and practice performance charts.
"In addition to identifying high-performing, prevention-focused providers, our program also highlights those with lower preventive care rates and higher utilization of more costly procedures," Fuentes said.
In one group of about 600 dentists, the peer benchmarking strategy reduced the number of fillings performed in the following quarter by 65%.
© Arc, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.