I’m wondering if my wisdom teeth qualify as a dental emergency or if it’s ok for me to wait for treatment a while. I’m 23 and they’ve bothered me off and on since I was 16, but my parents never took me in to have them taken out. I just kind of lived with it and took Tylenol when they’d bother me. They’d usually calm back down after a week or so. This time, however, I’m going on a month or more of pain. It’s not a screaming pain, but it is enough that I usually wake up in the middle of the night and have to take more Tylenol, then wait for it to kick in, before I can get back to sleep.
I get that they need to be checked out, but I just started my first post-college job and won’t qualify for insurance for another month. On top of that, I’m told there’s some kind of clause in the plan that requires me to have all “major services” preauthorized, and extractions are a “major service.” My boss says it took her more than a month to get approved for a crown. The caveat, though, I guess, is that if it’s a dental emergency, I can have treatment on the spot. Will this qualify or should I wait for an approval to come back? I don’t want to, but I’m also afraid I’m going to get stuck with a huge bill that I can’t afford. If it comes down to that, I’m going to try to wait it out.
Thanks,
Rochelle
Dear Rochelle,
The general rule of thumb is that if it hurts, you should go in and have treatment. Ideally, you should get treatment before it hurts, but barring that, pain is a big warning sign that shouldn’t be ignored.
When we’re talking wisdom teeth, there are three common types of pain. You can have discomfort from the tooth, itself, pushing upward, you can have pain from the tooth pushing other teeth out of alignment, or you can have a cavity/ infection. Obviously, if it’s one of the first two, waiting a few weeks isn’t going to change much. This is likely what you’ve dealt with in the past, which is why it stopped. You may have experienced shifts in your other teeth, which could eventually necessitate orthodontics, but treating that falls into the “as soon as you can” category, and it isn’t urgent. On the flip side, an incessant nagging pain, one which you describe as being different from prior occurrences, is a red flag that you may have some kind of infection or cavity brewing. That’s something you’ll want to get diagnosed right away. If it’s not serious, the dentist looks at it and says it’s just pressure/ shifting pain, and then you can go back to waiting if you want. But, if you delay, you could become quite ill, the pain will likely get even worse, and there could be potentially life-threatening consequences of ignoring an infection. It really should be checked before your insurance kicks in.
As far as preauthorization and insurances go, pain is the distinguishing factor here. While the insurance company is always going to do whatever it will do based on its internal criteria, the pain is what makes this a dental emergency, and you shouldn’t be expected to wait. Generally speaking, all the doctor will have to do is note in your chart that you were in pain, and his billing specialists will tell the insurance company that’s why you went forward. They should cover it without an issue. If you have concerns, though, give the insurance company a call and let them know what’s up, so they can advise you on your specific plan.
This blog is sponsored by Elgin dentist, Dr. Steve Sirin. Dr. Sirin offers same-day dental emergency appointments in Elgin, Illinois.
