Dental insurance for kids

Key takeaways

• Regular dental care should begin by a child’s first birthday, since children are vulnerable to tooth decay, dental injuries, orthodontic issues, and gum disease throughout childhood and adolescence.

• Poor oral health can negatively affect a child’s school attendance, confidence, and long-term well-being, making preventive dental care especially important.

• Dental insurance helps make routine cleanings, X-rays, fillings, crowns, and even orthodontic care more affordable, increasing the likelihood that children receive needed treatment.

• Families with dental insurance are much more likely to take their children to the dentist regularly, while uninsured families often delay care because of rising dental costs.

• There are two main kinds of plans: a PPO will have more dentist options; an HMO offers lower costs.

• Parents can usually get the most affordable coverage through an employer plan, but family coverage can be purchased directly from Guardian and other providers.

Oral health is critical to a child's overall health and well-being. More than 40% of children have tooth decay by the time they reach kindergarten, according to research by the American Dental Association. And this can lead to missing school, because children who suffer from poor oral health are three times more likely to be absent due to toothaches. In fact, the CDC notes that unplanned dental care accounts for about 34 million missed school days per school year.^1,2 The fact is, children with poor oral health often miss more school and may receive lower grades. This missed school time can also impact parents and caregivers, who may need to take time off work to address their child's dental needs.

Kids who are unhappy with their smile, have chronic bad breath, or experience discomfort due to cavities or gum disease may experience anxiety and lower self-confidence.³ And while cost is often a barrier to getting children the dental care they need, dental insurance can help make quality care more accessible. Addressing oral health issues may not only helps children stay in school and participate in social activities, but also alleviates the stress and anxiety for both children and their parents. Dental disease prevention through regular dental visits, good oral hygiene, and healthy habits is a way to help children thrive and achieve an even brighter future.

A few things every parent should know:

• Reasons why babies, young children, and teens need regular dental care

• The benefits of dental insurance

• How to get coverage for you and your family

Why do babies, children, and teens need regular dental care?

The American Dental Association (ADA) recommends that children have their first dental exam by their first tooth or first birthday, and the American Academy of Pediatric Dentistry (AAPD) suggests that they have checkups every six months as they grow up.^4,5 All for a good reason: From the time their first baby teeth come in at age six months to a year, to the time their wisdom teeth emerge in the late teens, kids are at risk of dental issues, both routine and serious. Typical issues to look for (or expect) by age include:

Babies (0-2 years old)

1. Teething: Teething can be uncomfortable for babies as their first teeth start to emerge, typically around 6 months of age.

2. Baby bottle tooth decay: This can occur if a baby falls asleep with a bottle containing sugary liquids, such as milk or juice, in their mouth.

3. Thumb-sucking and pacifier use: Prolonged thumb-sucking or pacifier use can affect tooth alignment and the development of the jaw.

Toddlers (2-5 years old)

1. Tooth decay: As toddlers start eating more solid foods, they may be at risk for cavities if they consume sugary snacks and drinks frequently.

2. Injury: Toddlers are active and may be prone to accidents that could result in dental injuries.

Children (6-12 years old)

1. Tooth decay: Lack of regular brushing and flossing is common in this age group, and neglect of oral hygiene can lead to cavities. But dental sealants, which can prevent up to 80% of cavities, can be applied as children develop permanent teeth.

2. Orthodontics: Your child’s teeth may require orthodontic treatment to address issues like misaligned teeth or bite problems and help ensure a healthy smile. Monitoring the development of permanent teeth is important during this stage, as early intervention can prevent future complications.

Teens (13-19 years old):

1. Tooth decay: Teens may face increased risks of cavities due to dietary choices and neglect of oral hygiene.

2. Gum disease: Gingivitis and more advanced gum disease can become a concern during the teenage years if proper oral care is neglected.

3. Wisdom teeth: Wisdom teeth typically start to come in during the late teens, and they can sometimes cause issues like impaction (inability to break through the gum) or crowding.

Bottom line? Parents and caregivers should promote good oral health habits like flossing and brushing at every stage of a child's development. Importantly, children should have regular access to dental checkups, cleanings, and interventions to help prevent, detect, and mitigate problems before they become serious. Regular dental visits can also help dentists spot signs of mental health issues, such as anxiety and eating disorders, which can impact mental and overall health.

Why should you consider dental insurance?

Just as health insurance makes visits to the pediatrician more affordable, dental insurance for kids helps make dental care more affordable. Dental insurance plans help families save money by covering preventative care, such as exams, cleanings, and X-rays. When cost isn’t a big issue, kids are often more likely to go to the dentist and receive services: Over 52% of children with dental insurance visit the dentist at least once per year, compared to only 20% without.⁶

Important facts to know about dental insurance

Dental costs without insurance continue to increase. The cost of a cleaning typically may be up to $200; normal cavity fillings range in cost from $200-$335; root canals cost about $1,200; and the average cost of a dental crown ranges from $800-$3,000.^7,8,9,10

Dental insurance can cover a range of costly care. An insurance plan can help make oral care more affordable by covering preventive cleanings and x-rays, restorative services like fillings and crowns, and even more serious oral surgery. Some plans even may cover orthodontia — among the most expensive treatments. And when you see a provider in your network, you’ll benefit from discounted rates.

Dental insurance networks can help you find a quality dentist for your child. A comprehensive insurance plan can provide access to a large network of dentists nationwide, including pediatric dentists who are specially trained to work with children. The bigger the network, the more likely you are to find a provider you like close to home. How big a network do you need? For comparison, Guardian network has more than 130,000 providers nationally.¹¹

There are two basic types of plans. A Dental PPO will give you a greater choice of dentists without referrals; a Dental HMO will likely lower your overall cost of care — but you may have to go further to find a provider in your network.

It’s easy to get dental coverage at work, or on your own

Why so many parents choose Guardian dental plans

With more than 130,000 providers nationwide, Guardian offers one of the largest networks around, helping make it easier for caregivers to find a nearby network dentist. Most dental insurance plans pay all or most of the charge for checkups and cleanings—so there's no reason not to take advantage of regular dental services that can be so important to both oral and overall health. With average network discounts of 43% the whole family can save on procedures and treatments.

Plus, plan innovations put quality care in even easier reach. For example, Guardian Early Smiles® provides 100% in-network coverage on preventive, basic, and major care for children ages 12 and under. And Guardian Diminishing Deductible® reduces your deductible for all covered family members each year until it reaches $0 after three years.