Most Common Dental Insurance Claims: Call & Check Your Coverage

Dental insurance is designed to help offset the cost of preventive care and necessary treatment — but not all plans are created equal. At Mauka Family Dental in Mililani, HI, Dr. Ji Kim and Dr. James Wee encourage patients to check their coverage regularly, especially as the calendar year comes to a close.

Knowing what your plan includes can save you from surprise bills and help you take full advantage of the benefits you’re already paying for. Let’s walk through some of the most frequently used dental insurance claims and how they support your oral health.

Preventive Services: The Cornerstone of Dental Health

Preventive care is often the most cost-effective way to stay healthy — and fortunately, it’s also the most commonly covered by insurance. Most plans cover these services at 100%, encouraging patients to keep up with regular visits.

When you come in for a routine checkup, Dr. Kim or Dr. Wee will typically perform a periodic oral evaluation (D0120), assessing your teeth, gums, and overall oral health. This often includes a standard cleaning — coded as D1110 for adults or D1120 for children — which removes plaque and tartar buildup and helps prevent decay and gum disease. Dental sealants (D1351) are a quick, painless way to give your child’s molars an extra layer of defense — like putting a raincoat on their back teeth to keep out cavity-causing germs, especially in those deep grooves where a toothbrush doesn’t always reach.

We may also recommend a fluoride varnish treatment (D1206) to strengthen enamel, especially for patients more prone to cavities. To catch problems early, bitewing X-rays (D0274) are often taken once per year to detect decay between teeth where it’s hardest to see.

The Value of Dental Imaging

Dental X-rays play a critical role in preventive care and diagnosis. A periapical X-ray (D0220) allows us to evaluate a single tooth from root to crown, which is especially helpful when a specific tooth is causing discomfort.

For a broader view, a panoramic X-ray (D0330) provides a complete image of the jaw, sinuses, wisdom teeth, and surrounding structures. These images allow Dr. Kim or Dr. Wee to detect issues early and recommend treatment before more extensive procedures are needed.

Addressing Small Problems Before They Grow

When cavities or minor damage are caught early, composite fillings are often all that’s needed. A one-surface composite filling (D2391) is commonly used for small cavities, while larger areas may require multi-surface fillings.

Early treatment not only preserves more of your natural tooth structure, but also helps you avoid more complex and costly treatments like crowns or root canals later on.

When Gums Need Extra Attention

Gum health plays a major role in your overall oral health. If inflammation is present without bone loss, scaling in the presence of inflammation (D4346) may be recommended. This goes beyond a routine cleaning to address bacteria beneath the gumline.

For more advanced gum disease, scaling and root planing (D4341) is often necessary. This deep cleaning removes plaque and tartar from the root surfaces and helps slow or stop periodontal disease progression.

Other Commonly Used Codes: Restorative & Surgical Care

Some treatments fall under basic or major insurance benefits. Common examples include root canal therapy (D3310–D3330) to treat infected tooth pulp, dental crowns (D2740) to restore damaged teeth, and extractions (D7140–D7210) for teeth that cannot be saved — including wisdom teeth removal, which is especially common in teens and young adults.

Bone grafting (D7953) may be needed to rebuild jawbone, often in preparation for dental implants. Implant placement (D6010) is increasingly covered by insurance, especially when it supports long-term oral health.

Not All Insurance Plans Are the Same

Most dental plans divide coverage into preventive, basic, and major services — but coverage percentages, waiting periods, and frequency limits vary widely. Some plans restrict how often X-rays or fluoride treatments are covered, while others limit coverage for crowns or periodontal care.

That’s why verifying benefits ahead of time is so important — especially before the end of the year, when unused benefits typically expire.

Dental Insurance Guidance at Mauka Family Dental in Mililani, HI

At Mauka Family Dental, Dr. Ji Kim and Dr. James Wee believe dental insurance should work for you — not against you. Our team is happy to help review your benefits, explain coverage, and submit claims on your behalf.

If you’re due for a cleaning, have questions about your coverage, or want to make the most of your remaining benefits before they reset, give us a call. A quick coverage check today can help protect your smile — and your wallet — tomorrow.

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