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Is wisdom teeth removal surgery covered by health insurance?

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The lowdown...
  • It’s important to contact your health insurance to see if you have any benefits for wisdom tooth extraction
  • Patients should talk to their dentist about local and general anesthetic
  • If wisdom teeth aren’t removed and need to be, it can cause serious health problems
  • Your dental insurance may pay for part of your procedure, but likely has an annual cap

Wisdom teeth are the third set of molars in the back of the human mouth. It’s the only round of tooth eruption that isn’t developed before a person is born.

For most people, wisdom teeth are more trouble than they’re worth. Most people’s third molars don’t begin to erupt until the late teens and early 20s.

Since the last tooth eruption happens much later than any of human’s other teeth, in the formative years of a person’s life, they’re called wisdom teeth. Unfortunately, these teeth aren’t full of wisdom.

Instead, they’re usually much more trouble than their worth and can actually be pretty painful too.

Adding to the headache of worrying about wisdom teeth eruption is trying to determine whether your health insurance will pay for all or any of the surgical removal.

To understand whether your health insurance may pay for part of all of this surgical removal, you need to know what these teeth are and why they need to be removed.

If you need your wisdom teeth removed and need better health insurance, enter your ZIP code above and compare at least three to four policies today!

Wisdom Teeth Aren’t Very Important

So many people ask why we have wisdom teeth if we don’t need them? We may not need them now, but we did once upon a time. Our primitive ancestors needed wisdom teeth to chew the raw meat, tree bark, roots, nuts, and leaves that were part of their everyday diet.

Advances in cooking and meal prep have made food much softer, which means the average person doesn’t need the third set of molars.

Today, the human brain is much larger than a caveman’s, which means there simply isn’t enough room in the human jaw for the third set of molars.

When there isn’t enough room for wisdom teeth to erupt through the gum, wisdom teeth can cause many health problems including impactions, infections, and overcrowding.

To prevent these problems from becoming overwhelming, many dentists will preemptively remove the third set of chompers. If left untreated, an impacted wisdom tooth can lead to serious health conditions including death.

Wisdom Tooth Removal Questions

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No matter how old you are, when you learn you’ll have to have your molar teeth removed, you probably have a ton of questions including:

  • Will I be awake?
  • How long will the removal take?
  • Is the recovery painful?
  • Does health insurance cover the procedure?

Anxiety about wisdom teeth removal and the length of time it will take you to recover is too much for some people to deal with. However, if you have a problem, the longer you wait, the worse the situation will get.

If you’re worried about pain, you can opt to have a general anesthetic – although some patients are comfortable with just a local anesthetic.

What’s the Difference between General and Local Anesthetic?

A local anesthetic is injected into gum tissue as a numbing agent. The area around the tooth will be completely done.

Usually, a dentist will prefer to use a local anesthetic if only one tooth is affected, whereas if a patient is having all of their wisdom teeth removed at the same time, a dentist will likely recommend general anesthetic.

Some patients may opt for this type of anesthetic even if they are having only one or two teeth removed. However, insurance companies do not often pay for elective general anesthetic.

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How long does wisdom tooth removal take?

In total, the procedure should take about an hour and thirty minutes. Recovery time is about two to three days to an entire week.

The length of time it will take you to recover is determined by how much swelling and discomfort you experience after the procedure.

Whether You Have Your Wisdom Teeth Removed May Boil Down to Money

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If it isn’t the fear of the procedure keeping you from having your wisdom teeth removed, it may be the cost that’s preventing you.

The average cost for a wisdom tooth removal with local anesthetic ranges from $75 to $200; if all four wisdom teeth are removed, the cost can increase to $300-$800.

However, if there are any complications, the cost can increase drastically.

An impacted wisdom tooth is a more involved procedure. For one tooth, the cost ranges from $225 to $600. If you opt for general anesthesia, the cost for removal will increase about $250 to $800.

It’s important to discuss with your dentist or oral surgeon whether your procedure is elective or medically necessary.

Wisdom tooth removal, which is considered medically necessary, may be covered by dental insurance. However, most dental plans have an annual cap of $1,000 to $1,500. But what is medically necessary?

When would health insurance pay for wisdom tooth removal?

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Under some situations, your health insurance may pay for wisdom tooth removal, even though it is considered a dental surgery. However, conditions in which a medical insurance company will pay for any dental issues are rare and usually include extreme situations.

For instance, if your wisdom teeth are partially or completely impacted in your gums, your health insurance may provide some payment.

The reason this type of removal is paid and others are not is because not treating the condition could lead to cysts, bone damage, infections, and even nerve damage.

While it’s very unlikely health insurance will pay for any tooth removal if your wisdom teeth are not impacted, it’s also important to call your health insurance to see if there are any benefits.

Looking for better health insurance in case you need to remove your wisdom teeth? Enter your ZIP code below and start comparison shopping today!

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