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The Difference Between Preventative and Restorative Dental Insurance

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By now you probably know why it's important to carry private health and dental insurance. Though Canadians enjoy the privilege of health care provided by their province or territory of residence, dental care is generally not included in these plans. As oral health care is recognized as an important component of our overall health care, choosing to go without appropriate insurance coverage is a risky proposition.

When deciding on dental insurance for yourself or your family, it’s hard to know if you need premium coverage, or if a more basic plan will suit your needs. To help you understand and make an informed choice, we will explain the difference between preventative coverage and restorative coverage.

Preventative Coverage

Coverage for preventative dental care means most of the services that take place in your routine trip to the dentist once or twice a year. It’s the routine maintenance like the standard checkup and cleaning, fillings and x-rays. It also may include periodontal basics like scaling to remove tartar from your teeth, though this may be an upgraded level of coverage from the most basic offering. Additional services for children may also be covered in some plans, like space maintainers for future orthodontic work, or sealants to help prevent tooth decay.

Restorative Coverage

Restorative dental coverage goes over and above routine maintenance services, and may also be referred to as major services. These services include, but are not limited to:

  • Tooth replacements like dentures, crowns or onlays
  • Oral surgical services and anaesthesia when surgery is required
  • Corrective procedures such as root canals
  • Laboratory tests and procedures

The need for restorative services is often diminished in those who have kept up to date with regular, preventative trips to the dentist. However, sometimes it’s simply a matter of bad luck that brings on the need for major dental treatments.

The Not-So Simple Difference

Simply put, preventative coverage takes care of the routine visit to the dentist, and restorative coverage is for the follow-up visits to treat the more complex conditions that are discovered during that routine visit. This isn’t universally the case as some follow up visits (e.g., fillings and minor extractions) fall under preventative care, but it’s a good rule of thumb.

The upfront cost of more comprehensive dental insurance coverage may seem high, but when you consider the cost of something relatively simple like a root canal can easily be in excess of $1,000, it quickly becomes clear that dental insurance is a sound financial plan.

Each insurer has its own definition of which services are classified as preventative, and which ones fall into the category of restorative. It can be hard to make an “apples to apples” comparison when evaluating the insurance quotes you obtain on your own. That’s why it’s important to work with an insurance broker.

When evaluating your needs for dental insurance coverage, your insurance broker can help explain the different levels of coverage. Knowing all of the facts is the key to making the right choice based on your family’s needs and your budget.

One Response

  1. Thank you for pointing out that restorative dental work includes dentures. My grandmother is in dire need of dentures and we want to find the best dentist to do this for her. I’ll have to do some research and find the best restorative dentist in the area.

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