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Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for dental care at James P. Orticelli, DDS. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like routine checkups with Dr. James Orticelli, cleanings, X-rays, fluoride treatments, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

• If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that a dental insurance plan will pay toward dental care for an individual or family (if you have an applicable family plan)

• This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures a dental insurance policy does not cover

• Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under a dental insurance plan

Provider– Dr. James Orticelli or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Lindenhurst, IL office.

Dr. James Orticelli and our team at James P. Orticelli, DDS frequently get questions about cavity causes and prevention. You brush twice a day and floss regularly. You rinse with hydrogen peroxide, just like the dentist recommended. In fact, you can’t remember the last time you had a cavity, but you think it was when you were a little kid. In all seriousness, you thought only kids got cavities.

The Signs and Symptoms of a Cavity

It’s believed that roughly 90% of Americans will get at least one cavity in their lifetime. Those other ten percent, it seems, can eat as much pie, cake, and sugary cereals and sweets as they want. That’s not really true; just a stab at dental humor, and it was as bad as the pain your cavity is probably giving you.

When a cavity is in its initial stages, you will often be symptom-free and experience no discomfort at all. It’s not until the tooth decay has reached a certain level that you will begin to notice the signs and symptoms. While a toothache and sensitivity to hot and cold foods and liquids are surefire signs that you have a cavity, there are lesser-known symptoms as well. If you’re experiencing any of these warning signs, you may want to consider making an appointment with our office as soon as possible:

• Persistent bad breath or a bad taste in the mouth
• When you bite down, there is a sticky, tarry feeling
• Puss or discharge around a tooth
• A visible discoloring, usually black or brown
• Small pits or holes in the tooth

Routine dental care is important. While good oral hygiene, a healthy diet, and regular cleanings will deter the formation of cavities, they do not constitute a foolproof practice. A cavity can occur at any time, no matter what your age. Bacteria causes tooth decay, and no amount of brushing, flossing, and rinsing will eradicate all the bacteria from your mouth. If you think you may have a cavity, please contact our office immediately.

In honor of June being Dairy Month, Dr. James Orticelli and our team at James P. Orticelli, DDS would like to remind our patients about the importance of dairy to your overall health! Regular consumption of dairy products, such as milk, cheese, and yogurt, has been found to lower your chances of contracting gum disease (also known as periodontal disease).

Those who consume at least 55 grams of lactic acid a day are less at risk for gum disease. Eating dairy is not just healthy for building strong bones, but is essential for maintaining a strong, healthy mouth and a smile that will last a lifetime.

Questions about which foods you should steer clear of and which you should enjoy? Give us a call or ask us on Facebook!

Snoring may not be something you take seriously. You might even laugh or joke about it. But the fact is, anytime you or your partner snore to the point of waking, it could be a sign of serious health problems.

Sleep Apnea and Its Effects

Sleep apnea is a sleep disorder that is potentially dangerous, and the most common symptom is loud snoring. Breathing repeatedly starts and stops throughout the night, and you wake up feeling tired. Other serious effects from sleep apnea could be potentially dangerous to your health if left unaddressed.

Besides losing a good night's sleep, you may experience difficulty concentrating. Depression, risk of heart attack, irritability, high blood pressure, memory loss, sexual dysfunction, and chances of stroke all increase when sleep apnea is not treated.

Sleep apnea occurs when the muscles in the back of the throat relax to the point of inhibiting natural breathing. The muscles used to support the soft palate relax and the airway closes, causing breathing to stop for ten to 20 seconds. This lowers the oxygen level in the brain. As the brain senses the inhibited oxygen levels it rouses the sleeper awake so the airway can reopen. Normally, the reawakening is so brief the person won't remember it.

If you think you may have sleep apnea, visit our Lindenhurst, IL office and let Dr. James Orticelli determine what treatment is needed. Without it, you could risk losing more than a restful night's sleep.

Prevention and Treatment

Anyone can develop sleep apnea, but it is more common among middle-aged adults who are overweight. Dr. James Orticelli can help you determine the cause and suggest positive treatment.

A common treatment for apnea is the placement of oral devices that are designed to help keep the airway open. By bringing the jaw forward, the device opens the airway and thereby discourages snoring. We are experienced in sleep apnea appliances, and Dr. James Orticelli can prescribe a fitted device and monitor its success with follow-up therapy.

A continuous positive airway pressure mask, known as a CPAP, is among the other treatment options. A mask is fitted over the mouth and forces oxygen through the throat while you sleep. The pressure holds the soft tissue and throat muscles open.

Our professionals at James P. Orticelli, DDS can advise you of other ways to prevent sleep apnea, including weight loss, avoiding alcohol, or alternative sleeping positions. We can help you sleep return to easy sleep, knowing you are safer and healthier during your resting hours.