What Are the Four Main Categories of Dental Coverage?
By Dr. Eastwood – Summerbrook Dental & Implants, Fort Worth, TX
Patients often ask me, “What are the four main categories of dental coverage?” Most dental insurance plans divide treatment into four groups so you know how much your plan will cover and what you may need to pay out of pocket. Understanding these categories makes planning your dental care much easier.
Here are the four main categories:
1. Preventive Care
Preventive care is the most important category because it focuses on stopping problems before they start. Most insurance plans cover 100% of preventive services, which include cleanings, exams, X-rays, fluoride, and sealants. Since these visits are fully covered, I always encourage patients to stay consistent—they protect your teeth and reduce your long-term dental costs.
2. Basic Services
Basic services fix small or early problems. This category usually includes fillings, simple extractions, and basic gum treatments. Most insurance plans cover 70–80% of these services, while the patient pays the remaining percentage. Treating problems at this stage keeps them from turning into major issues that require more expensive care.
3. Major Services
Major services are more complex treatments, such as crowns, bridges, dentures, and sometimes root canals. Insurance typically covers around 50% of major services. Some plans include limited implant benefits, but coverage varies. At my office, we always explain what is and isn’t included before beginning treatment so there are no surprises.
4. Orthodontic Coverage
Many plans offer a separate category for orthodontics, which includes braces or clear aligners. Orthodontic coverage usually pays a set amount or a percentage, often with age limits. Not all plans include orthodontics, so my team checks your benefits carefully if this type of care is needed.
At Summerbrook Dental & Implants, we know insurance can be confusing. My team helps you understand your coverage, gives clear estimates, and helps you get the most out of your plan. And remember—my office is always a no judgment zone, no matter your dental history.
So, the four main categories of dental coverage are preventive care, basic services, major services, and orthodontics. Knowing which category your treatment falls into can help you plan for cost and coverage with confidence.