Missing Tooth Clause & Missing Tooth Exclusions | Delta Dental of New Jersey

Does Delta Dental have a missing tooth exclusion?

No, Delta Dental does not have a missing tooth exclusion. Delta Dental covers the tooth replacement procedures for members who had a tooth fall out or extracted prior to having dental coverage with Delta Dental.

Are you missing a tooth?

When someone loses a tooth because of severe tooth decay, a mouth injury, or some other oral health issue, a dentist can replace it with an implant, bridge, crown, or dentures. These dental procedures are more costly than something like a filling and are considered a “major service.”

What is a missing tooth clause?

Members covered by a dental plan with a missing tooth clause means the dental insurance company will not cover the costs of replacing the tooth if the tooth fell out or was extracted before the current dental coverage started. Members who have a dental plan with a missing tooth exclusion would be responsible for paying all the costs for the tooth replacement procedure.

We do recommend that members request a pre-treatment estimate from their dentist and submit it to us. By doing this, a member will have an idea of what Delta Dental will cover and the potential out-of-pocket costs for the member.

It’s important to note that if employers require a waiting period, the member will need to wait that specified amount of time before having a tooth replacement procedure. If a member is unsure if their dental plan has a waiting period, please ask them to check their policy documents.