The most common dental problems covered by health insurance

A visit to the dentist may not be at the top of your to-do list but it’s definitely necessary to keep your teeth and gums healthy. In fact, early treatment of toothache or other dental problems can help save you time, money and further discomfort in the long run. Bloom, in conjunction with Momentum Health4Me, offers basic dentistry benefits for our Health4Me Silver and Gold plan members.

Find out what’s covered on these dental plans.  

When should you visit the dentist?

Experts recommend visiting the dentist twice a year for a check-up and teeth clean. However, if you experience any of the following symptoms, we strongly advise that you make a dental appointment as soon as possible:  

  • Severe toothache  
  • Persistent jaw pain 
  • Bleeding gums 
  • A loose or chipped tooth 
  • A swollen gum area  

What happens during a dental visit?

The first time you visit a dentist, they will take a full medical history. The dentist will conduct a thorough examination of your teeth, mouth and gums to check for cavities and other dental problems. This could include using dental instruments to scrape the gum line and remove plaque build-up. Depending on what the dentist may find, he or she may then conduct a teeth cleaning procedure or administer dental treatment to correct a problem. 

What dental procedures are covered by health insurance?

There are a number of common dental procedures covered by health insurance. These include: fillings, tooth extractions, infection control and cleaning. Let’s discuss some of these in more detail. 

1. Fillings

Dental fillings and repairs use restorative materials, like porcelain, composite resin or an amalgam to repair teeth that have been damaged due to cavities. The reason this is done is to prevent further decay of the tooth and allow it to return to a normal function. Failure to do so will result in a rotten tooth that will have to be fully extracted or could even result in more complicated and costly procedures, like root canal, which is not covered by basic dentistry benefits’ cover.  

Once your dentist has detected the cavity, using a small mirror, he or she will clean out the affected area to remove the decay and will then fill the area with the chosen restorative material.  

2. Extractions

A severely rotten, damaged or compromised tooth may need to be extracted. This could be a result of tooth decay, a tooth infection or crowding of the mouth. A simple extraction process involves the patient receiving a local anaesthetic, which will numb the area around the tooth. The dentist will then use an elevator to loosen the tooth and a pair of forceps to remove the tooth.  

You may experience some discomfort or bleeding following the procedure. If so, you’re advised to get some rest and take some prescribed painkillers if necessary.

3. Teeth cleaning

Teeth cleaning involves the practice of removing plaque and tartar. Plaque is a substance created by the combination of food particles and saliva, which sticks to your teeth and hardens. Over time the hardened plaque will form tartar. Tartar attacks tooth enamel, damaging both teeth and gums permanently. 

The dentist will first use an instrument called a scaler to scrape the plaque and tartar off your teeth and gum line. Once they’ve removed most of the plaque and tartar, they’ll use a high-powered electric brush to remove any remaining plaque. Thereafter, you’ll be asked to rinse your mouth out with fluoride-containing mouthwash and the dentist will apply a fluoride treatment. This will protect your teeth and gums for the next six months.  

5 Ways to keep your teeth healthy

Avoid unnecessary visits (and costs) to the dentist by keeping your teeth healthy. You should always take steps to keep your teeth in tip-top condition even if you have strong, beautiful teeth. They may not last forever if you don’t take care of them. Many dental problems can be prevented by following these easy tips: 

1. Brush your teeth twice a day

Remember that everyone’s mouth is full of bacteria, most of which is natural and healthy. Unfortunately, the problems occur when plaque forms from the bacteria caused by carbohydrates or sugars left in your mouth from food. This will erode your tooth enamel and cause tooth rot (or cavities), which is why it’s so important to brush your teeth after meals.  

2. Use a fluoride toothpaste for best results

There are certain elements that a good toothpaste needs to have in order to be effective; the key ingredient is fluoride. Fluoride is the leading defence against tooth decay as it provides a protective barrier against plaque. Use gentle, circular movements to brush your teeth properly and don’t forget about your tongue!  

3. Flossing and mouthwash are a must

Flossing isn’t just about getting rid of unwanted pieces of food stuck between your teeth. Regular flossing (at least once per day), will help stimulate your gums, prevent plaque build-up and help lower inflammation. Likewise, a good quality mouthwash that contains fluoride will also assist in cleaning your teeth by reducing the acid content in your mouth.  

4. Watch your diet

Limit your consumption of sugary and acidic foods. Not only is sugar bad news for your waistline, but it also has an adverse effect on the quality of your teeth. Sugar converts to acid in your mouth, which erodes tooth enamel. Keep it clean and opt for crunchy vegetables and foods that are high in fibre.  

5. Keep safe and visit your dentist regularly

Make sure your teeth are in good health by visiting your dentist for a check-up at least once per year.  

What type of dental procedures are not covered by health insurance?

Any sort of specialised services, like bridges crowns, surgical tooth extractions, implants, root canal treatments, gold fillings, dentures or braces are not covered by Health4Me health insurance plans. Likewise, cosmetic dental procedures like teeth whitening are also not covered by health insurance.  

How to find a Health4Me dentist?

You can use any dentist on the Momentum CareCross Dental Network. If you would like some help locating a dentist, simply contact us on 0860 1029 03. 

How much does health insurance with dentistry cost?

Get affordable dental health insurance with our Silver option, which starts at just R483 per month or our comprehensive health insurance, Gold option at R524 per month.  


Bloom advocates healthy living at an affordable price. This is why we offer flexible medical insurance plans for our members. 

Contact one of our trained consultants to get health insurance online.

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You understand and acknowledge that all users of the Bloom website are responsible for their own medical care, treatment, and oversight. All content provided on the website, is for informational purposes only and does not constitute medical advice. Neither is it intended to be a substitute for an independent professional medical opinion, judgement, diagnosis or treatment.

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Momentum Health4Me is not a medical scheme product, and is not a substitute for medical scheme membership. The information provided on this website does not constitute advice in terms of the Financial Advisory and Intermediary Services Act. Momentum is a division of Momentum Metropolitan Life Limited, an authorised financial services provider (FSP 6406) and a wholly owned subsidiary of Momentum Metropolitan Holdings Limited.

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