Good oral health plays a big role in overall health and well-being, but navigating dental benefits can sometimes feel like pulling teeth. As an employer, you want to help your team get the most out of their dental coverage — not just because it’s good for them, but because it’s good for business, too. When employees know how to use their benefits, they’re more likely to prevent costly dental problems, take fewer sick days, and feel more satisfied with their compensation.
This article explains how you can help your employees better understand — and better use — their dental benefits.
Breaking Down Benefits: What Employees Should Know
- Start With the Basics: What Dental Plans Usually Cover
Most dental plans group procedures into four categories:
- Preventive (e.g., oral exams, cleanings, fluoride treatments, x-rays)
- Basic (e.g., fillings, extractions, root canals)
- Major (e.g., crowns, bridges, dentures)
- Orthodontic (e.g., braces, retainers)
Many plans cover 80-100% of preventive services, which are key for avoiding bigger issues like gum disease or tooth loss. Let employees know how often they are eligible for checkups and cleanings.
- Demystify Dental Terms
Dental invoices are full of codes and clinical language that patients don’t always understand. Help employees by breaking down common terms:
- Scaling – cleaning below the gumline to remove plaque and tartar
- Polishing – smooths teeth after scaling
- Recall exam – routine dental checkup
- Amalgam filling – silver-colored filling
- Composite filling – tooth-colored filling
- Root canal – treatment to save an infected tooth
- Periodontics – treatment for gums and bone around teeth
- Prosthodontics – replacements like dentures, bridges, or crowns
A glossary in your benefits booklet or HR portal can be extremely helpful to employees.
- Explain Frequency Limits and Coverage Rules
Dental plans often limit how often a procedure is covered.
For example:
- Oral exams and x-rays: typically covered every 6 to 12 months
- Scaling: most plans have about 4 to 12 scaling units for every 12 months (each dental cleaning typically uses 3 scaling units)
- Polishing & Fluoride: typically covered every 6 to 12 months
- New patient comprehensive exams and panoramic x-rays: typically covered every 2 to 5 years
Let employees know that more isn’t always better — extra treatments might not be necessary and could lead to plan abuse, which increases premiums for everyone.
- Clarify the Fine Print: Maximums, Deductibles, and Coinsurance
Most dental plans include:
- Annual maximum – the most the plan will pay per year (e.g., $1,500)
- Deductible – what the employee pays out of pocket before coverage starts (e.g., $50)
- Coinsurance – the percentage the plan pays (e.g., 80% for basic services, 50% for major)
Give real examples. For instance:
“If you need a dental crown costing $1,000 and your plan covers 50%, you’ll pay $500 — unless you’ve hit your annual maximum, then your plan will pay out whatever amount is left for the year and you will pay the remaining balance.”
Also, explain fee guides — many insurers use provincial dental fee guides to determine what they’ll pay. Sometimes these fee guides can be several years behind. Most dentists charge the standard provincial fee, but if your insurance plan is using a fee guide that is not from the current year, you will have to pay the difference.
- Explain In-Network vs. Out-of-Network Dentists
Most dental plans work with a group of dentists called a “network.” These are dentists who have agreed to charge lower prices for patients with that insurance.
When employees go to an in-network dentist, they usually pay less out of pocket because the insurance covers more of the cost.
If they go to a dentist who’s not in the network, that dentist can charge higher prices. The dental plan will still pay some of the cost, but the dentist can bill the patient for the rest — this is called balance billing (extra money the patient must pay out of pocket).
Tip: Help employees learn how to find an in-network dentist by showing them how to use the insurance company’s website or app. That way, they can avoid surprise bills, save money, and maximize their benefits.
- Promote Preventive Care
Prevention saves smiles — and money. Studies show people who get regular cleanings and exams need fewer fillings, crowns, and root canals.
Encourage employees to:
- Schedule semi-annual cleanings
- Brush twice daily and floss
- Use fluoride toothpaste
- Ask their dentist about sealants, especially for kids
You can even use reminder emails or wellness challenges to boost preventive care participation.
- Teach Employees to Check Their Invoices
Dentists use procedure codes (five-digit codes starting with 01,02, etc.) to bill services.
Encourage employees to:
- Ask for a copy of their bill
- Match the services they received to the codes listed
- Ask their dentist to explain any unclear charges
This can reduce overcharging or accidental billing errors and make employees feel more in control.
- Encourage Use of Online Tools
Most insurers offer digital portals or mobile apps where employees can:
- Check coverage details
- See how much of their annual maximum is used
- Submit claims
- Get cost estimates
- Find local in-network dentists
Promote these tools during onboarding, benefit meetings, and renewal periods.
- Communicate Clearly and Often
Don’t wait until employees are in the chair to talk about dental coverage.
Communicate through:
- Simplified brochures with key benefits
- Lunch-and-learn lessons on how to read invoices or understand coinsurance
- Email reminders when the plan year resets
- Total rewards statements showing how much the dental plan is worth
When employees understand the value of their benefits, they’re more likely to use them wisely.
- Update Plans to Stay Competitive
Review your plan annually to make sure:
- Coverage amounts keep up with dental inflation
- Preventive services are excluded from annual maximums
- New treatments (like oral cancer screenings or teledentistry) are included
If your current plan feels outdated, your insurer or broker can help modernize it to better fit your workforce.
Final Word
Helping your employees understand their dental benefits is about more than just saving money — it’s about empowering them to take care of their health. When you provide clear information, helpful tools, and a supportive environment, your team is more likely to use their coverage effectively and avoid costly dental issues in the future.
After all, a healthy smile is always in style — and a well-informed employee is your best advocate for controlling benefit costs while maximizing value.
