Does Diabetes or Leaky Heart Valves Change How I Should Handle Six Broken Teeth?

I have considered implants or dentures though I'm only 48 y/o because my teeth keep breaking. I've already had 3 pulled. I have very limited dental insurance and good medical insurance. is there any way the other issues can make any of the charges go under medical. Thanks for ANY help.

Doctor Answers 5

Diabetes, heart condition and medical insurance

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Medical insurance has a very little history of compensation for dental conditions. Certain cases of trauma, cancer reconstructions or malformations which require implant supported restorations, facial prosthesis, or orthognathic cases can be reimbursed by medical insurance. But this is very individual for every case. 

The patients with any medical condition require the release from current physician before any comprehensive treatment. For diabetic patient we obtain medical clearance, HbA1C results, that show the level of blood sugar for the last 3 months. Before treating the patient with any heart condition the dentist should get the medical release and recommendations from MD regarding anesthetics and antibiotics that are planned to use.


Medical reasons for getting benefits for dental treatment

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Medical insurance do not cover for teeth related procedures and I do not think this is possible. The only exception would be trauma or pathology. In this case, medical may cover for extraction and sometimes even implants for replacement.

H. Ryan Kazemi, DMD
Bethesda Oral & Maxillofacial Surgeon
5.0 out of 5 stars 7 reviews

Diabetes can affect dental treatment outcomes.

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Im hoping the heart condition is being treated by a cardiologist. That said there isnt much we can do with medical insurance and dental treatment..We've tried for years to bill medical and they deny every claim..

Michael J. Thomas, DDS
Los Angeles Dentist

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Dental insurance and Medical insurance exclude each other

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As a rule of thumb, while medical conditions are managed for dental procedures, the dental procedures are still dental (even with a medical necessity).

Medical issues can be related to your dental health.

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Unfortunately, medical insurance will not cover dental procedures nor will it be.  In some cases it will consider a sinus lift, however not if it is in conjunction of the placement of dental implants.  Again, medical conditions will not justify dental treatment as far as insurance, which is what I believe you are asking.  The fact that your teeth keep breaking is either due to the fact that you are missing teeth, thus too much stress is affecting the remaining teeth, or you have a heavy or uneven bite , which should be corrected.



Anca Bazile, DDS, MSD, Periodontist, New York City

Anca Bazile, DDS
New York Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.