Glossary of Terms
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- Abrasion
- Wearing away of enamel on teeth. This may be caused by normal grinding, friction or incorrect brushing of teeth.
- Abutments
- Attachments on the ends of a bridge, which are cemented to the natural teeth; a tooth used for support or anchorage of a fixed or removable prosthesis.
- Accelerated death benefit
- A rider that provides early access to life insurance benefits in case of a terminal illness. "Living benefits" are paid to the insured for medical expenses before death. Benefits paid decrease the benefit payable to beneficiaries after the insured's death.
- Accidental death benefit rider
- An additional cash benefit paid in addition to other benefits when a death is a result of an accident.
- Accumulation period
- Length of time an individual has to incur covered expenses to satisfy a required deductible and/or calendar year or plan year maximum.
- Actively at work provision
- Life insurance coverage is not available to employees who are not actively at work on the effective date of the employer's contract with Humana; employees are covered when they return to work.
- Age In
- When a retiree or eligible dependent becomes Medicare eligible - usually after turning 65 - and is eligible to enroll in the group sponsored Medicare Advantage plan.
- Alveolectomy
- Removal of excessive bone and soft tissues, usually done to enhance the fit or appearance of an artificial denture.
- Amalgam
- Metallic filling made by combining an alloy of silver, zinc, lead and tin with mercury. It is silver in color.
- Annual maximum
- The total amount you'll spend between your plan effective date and the end of your plan year.
- Annual maximum benefit
- Maximum dollar amount paid by the dental plan in a calendar year or plan year.
- Annual Notice of Change (ANOC)
- CMS mandated notification of yearly plan benefit changes that is sent to enrolled members.
- Anterior teeth
- The front teeth
- Apicoectomy
- Cutting off the root end of a tooth.
- Appeal
- A written request from the enrolled member or the enrolled member's authorized representative, a non-network provider, or court- appointed guardian to reconsider our initial adverse determination to deny coverage of service or payment of a claim, including delay in providing, arranging or approving the healthcare service.
- Arch
- Arrangement of the teeth in a bow shape or arc.
- Assignment of Benefits
- An arrangement by which a patient requests that their health benefit payments be made directly to a designated person or facility, such as a doctor or hospital.
- Baby teeth
- Primary or deciduous teeth of young children.
- Basic services
- Dental procedures to repair and restore individual teeth due to decay, trauma, impaired function, attrition, abrasion or erosion. Basic services may include endodontics (root canals), fillings and periodontics (tissue/bone treatment).
- Beneficiary
- The person who is eligible to receive or is receiving benefits under an insurance certificate. This person is named by the certificate owner, who is usually the person insured
- Benefit accumulations
- Amount that has been paid for a covered person during the calendar year or plan year.
- Benefit plan document
- Generic term for a legal document detailing a member's or group's coverage. This document usually is referred to as a Certificate of Coverage, Certificate of Insurance or Summary Plan Description.
- Benefits
- The medical – also dental and pharmacy – care for you and your dependents that's covered by your insurance either directly or through reimbursement.
- Benefits Summary
- A detailed summary of all the benefits available in your plan.
- Bicuspid
- Permanent teeth between the cuspids (canines) and first molars. They have two cusps (points) and are used for crushing and tearing food.
- Billing provider
- Any eligible person, physician, doctor's office, hospital, dentist or facility licensed to perform services for our members.
- Bitewing X-ray
- X-ray that reveals the crown and the adjacent tissue of the upper and lower jaws on the same film. It is used to detect decayed areas between teeth.
- Bleaching
- Technique used to restore a discolored tooth to its natural color.
- Braces
- Metallic bands and appliances used to move teeth for correction of the bite and tooth position.
- Bridge
- Appliance to replace a missing tooth or teeth, attached to and supported by abutment teeth.
- Bruxism
- Grinding of teeth during sleep. This occurs in children and adults, and causes abrasion of the tooth enamel.
- Buccal surface
- Surface of the back teeth next to the cheek.
- Canal
- Space within the root of the tooth that contains the pulp tissue.
- Canine
- Pointed tooth used to tear food
- Capitation
- Method of payment for health services in which a dentist or specialist is paid a fixed amount for each person served regardless of the number or nature of services provided to each person, usually associated with a prepaid/HMO.
- Caries
- Decaying of teeth. Also known as cavities.
- Cavities
- Decaying of teeth. Also known as caries.
- Centers for Medicare & Medicaid Services (CMS)
- The primary governing entity for the Medicare Advantage Program, formerly known as the Healthcare Financing Administration (HCFA). All materials, forms, letters, attachments, etc., that are distributed to retirees by the Medicare Advantage plan must be submitted to CMS.
- Certificate of Coverage
- Legal document detailing a member or group's coverage. Description.
- Certificate of Insurance
- Legal document detailing a member or group's coverage. This certificate serves as proof of insurance and outlines benefits and provisions.
- Cleft lip
- Congenital facial deformity characterized by non-fusion or malfusion of the development processes that form the lips.
- COBRA
- Consolidated Omnibus Budget Reconciliation Act; federal legislation regarding the continuation of health benefits for all types of employee benefit plans provided by the employer.
- Coinsurance
- The percentage of the total cost of covered services you must pay after you meet the deductible. Your plan pays the higher percentage (e.g. 80%) and you pay the lower percentage (e.g. 20%)
- Completed
- Indicates HumanaDental has received an estimate or claim, and released an explanation of benefits or explanation of remittance.
- Composite
- White plastic filling material of resin and quartz crystals.
- Condyle
- Joint of the jaw.
- Continuation
- State or federal (COBRA) option for a member who no longer qualifies as an active employee but can extend his or her insurance coverage for a specific amount of time. The member is responsible for any premium. This generally applies to medical coverage only, but can include dental depending on legislation and group size. Coverage and premium are the same as the group's.
- Contract types
- Type of contract or plan(s) such as Traditional, PPO or Prepaid/DHMOselected.
- Contributory
- An employer benefit plan in which employees pay at least part of the premium.
- Conversion privilege
- A certificate privilege that allows the insured to choose to convert from a group life policy to an individual policy before leaving the group to continue insurance coverage.
- Coordination of benefits
- Provision in a contract that applies when a person is covered by more than one group dental program. It requires that all programs coordinate payment of benefits to eliminate overinsurance or duplication of benefits.
- Copay
- C ost-sharing arrangement in which a member pays a specified charge at the time for service; for example, $15 for an office visit.
- Copayment
- The amount that you, as the member, have to pay out-of-pocket for certain services – such as a doctor's visit – at the time services are received.
- Crown
- Part of the tooth above the gum line. A crown also refers to a metal, plastic or porcelain cap that covers the tooth above the gum line.
- Cuspid
- Pointed tooth used to tear food
- Death benefit
- The amount payable after the death of the person whose life is insured.
- Decay
- Decomposed tooth structure (cavity formation).
- Deductible
- The amount that you – either by yourself or in combination with other covered family members – pay for covered in-network services each year before the plan pays for specified services. There's also a separate out-of-network deductible.
- Dentin
- Tissue that forms the main body of the tooth.
- Dentures
- Any dental appliance to replace missing natural teeth and the surrounding tissues.
- Dependent coverage
- Insurance coverage that extends to the insured's dependents, including spouse and dependent children.
- Diastema
- Space between two adjacent teeth in the same jaw.
- Disability benefit
- Benefit payable under a disability income policy.
- Distal
- Surface of a tooth farthest from the center line of the face.
- DOB
- Date of birth.
- Document number
- Nine-digit number assigned by our computer system to each document received.
- Effective date
- Date on which the member's coverage begins.
- Electronic Data Interchange (EDI)
- A method of enrollment where the enrollment information for the retiree is provided by the group benefits administrator to Humana in an electronic file. Necessary information includes HCFA number, geographic data, date of birth, etc. of the enrollee.
- Eligibility
- Requirements that must be satisfied by people who wish to be insured to establish eligibility.
- Eligible Person
- Former employee or their eligible dependent of a group and its participating affiliates who are eligible to participate in a Medicare Advantage plan.
- Enamel
- Hard surface covering the dentin portion of the crown of the tooth.
- End date
- Date on which the member's coverage ends.
- Endodontics (root canals)
- Dental specialty concerned with the treatment of diseases of the dental pulp (nerves, blood vessels, etc., within the tooth).
- EndStage Renal Disease (ESRD)
- Permanent kidney failure requiring dialysis or a kidney transplant.
- Enrolled Member
- An eligible person who has elected to enroll in a Humana Group Medicare plan.
- EOB
- An Explanation of Benefits that explains how your plan will pay your claim.
- Erosion
- Defect in the surface of a tooth, which cannot be accounted for by abrasion, in which the enamel is worn and smooth. This usually results from chemical action in the mouth.
- Erupt, Eruption
- When a new tooth comes in, it erupts when it breaks the surface of the gums, and you can see it.
- Estimate
- Details on how benefits would be covered by a member's plan when a dentist submits an estimate of services.
- Evidence of Coverage (EOC)
- A CMS approved document that details plan benefits and services. The EOC includes CMS mandated amendments that may occur during the year. All Humana Group Medicare enrolled members, will receive a copy of the EOC as well as any amendments that are mandated during the plan year.
- Evidence of insurability
- Medical information that shows an individual is medically eligible for insurance coverage. Insured may or may not need to provide this information depending on the employer's contract with Humana.
- Explanation of benefits (EOB)
- The EOB is not a bill. It details how the claim was processed and indicates the portion of the claim paid to the dentist and the portion of the claim you need to pay (if applicable).
- Extraction
- Separation and surgical removal of a tooth from its surrounding tissues.
- Eyeteeth
- Pointed tooth used to tear food
- Family deductible
- Deductible that may be satisfied by the combined expenses of all covered family members.
- Filling
- Material used to fill a cavity in a tooth. The substance may be gold, silver amalgam, copper amalgam, acrylic resins, porcelain or cement.
- Fluoride
- Chemical solution or gel hat you place on your teeth to help prevent decay.
- Frenectomy
- Surgical cutting of the frenum
- Frenum
- Piece of pink-colored skin that attaches your lips, cheeks and tongue to your mouth.
- General anesthetic
- Drug that causes loss of feeling generally or renders the patient unconscious.
- Generic prescription drugs
- Generic drugs use the chemical name of the drug and are less expensive than brand-name drugs. They're chemically identical to their name-brand counterparts and meet Food and Drug Administration (FDA) standards for safety, purity, and effectiveness.
- Gingiva
- Gum tissue surrounding the teeth and covering the bone of the upper and lower jaws.
- Gingivectomy
- Cutting away of loose infected and diseased gum tissue.
- Gingivitis
- Inflammation of the gum tissue.
- Grievance
- Any written complaint expressing dissatisfaction with any aspect of the plan, including the quality of the care received or how the plan is administered. A grievance isn't appropriate for concerns regarding denied claims or coverage.
- Group
- Used interchangeably with employer, group benefits administrator, and contract holder.
- Group certificate
- This document shows the benefits provided under the group contract.
- Group ID
- Number assigned to each case or group when we receive the application. It identifies the group in our computer system and remains with the account permanently.
- Guaranteed insurability
- An option that enables the insured to buy additional life insurance without being required to provide evidence of insurability.
- Guaranteed issue amount
- This provision allows a certain amount of insurance to be issued without evidence of insurability.
- Hard palate
- The approximate two-thirds of the front section of the palate, composed of relatively hard and unyielding tissue.
- Health Maintenance Organization
- With an HMO, you select a primary care physician (PCP) who's in the plan's network. Your personal doctor tends to most of your health needs and refers you to a specialist in the network when necessary.
- Hemisection
- Surgical division of a tooth to allow salvage of one part of the tooth, which is relatively free of disease.
- High-Deductible Health Plan
- This specially designed plan has one deductible that combines medical and prescription drug expenses. An HDHP is usually a Preferred Provider Organization (PPO) plan, but it also could be an HMO or Point of Service plan.
- HMO
- HMO is short for a Health Maintenance Organization. It's a type of plan that allows you to choose a primary care physician (PCP) in the plan's provider network to coordinate your care.
- Human Life Value
- A method to determine life insurance needs based on income, expenses, potential earnings and the projected depreciation of the dollar.
- Hygienist
- A trained, licensed person who performs dental prophylaxis under the direction of a licensed dentist.
- Immediate denture
- Denture constructed for insertion immediately after removal of natural teeth.
- Impacted tooth
- Tooth that has not erupted and is embedded in the jaw.
- Implant
- Device of metal or other foreign material that is surgically placed into or on the upper or lower bone, to support a crown, bridge, or partial or full denture.
- Incisal
- The cutting edge of the front teeth.
- Incisor
- A cutting tooth in the front of the mouth
- Incomplete application
- An application in which one or more of the required elements established by CMS are not complete. For example: the form isn't signed by the beneficiary or the legal representative, supporting documentation for a representative's signature isn't included, necessary elements on the form are not completed or inability to establish entitlement to Part A and enrollment in Part B.
- Individual deductible
- Amount of eligible expense a covered person must pay each year before the dental plan will pay for eligible benefits.
- Inlay
- A porcelain or metal restoration to be inserted into a previously prepared cavity in a tooth and retained with cement.
- Interproximal surface
- Surface of a tooth that faces its adjoining tooth as they stand in the line in the dental arch.
- Jacket
- A full crown constructed of porcelain or plastic.
- Jaw
- The term to indicate either the maxilla (upper) or mandible (lower).
- Late applicant
- Member and/or member's eligible dependent who enrolls or is enrolled for coverage more than 31 days after his/her eligibility date. Late applicants may be subject to a waiting period.
- Lifetime maximum
- The maximum amount your plan will pay toward eligible expenses while you're covered under the plan.
- Lifetime orthodontic services
- Maximum amount payable (for each covered person) for eligible charges related to treatment. No further benefits are payable after the maximum is reached.
- Limitation and exclusions
- Conditions listed in a policy for which benefits are not paid.
- Limiting Charge
- The highest amount of money you can be charged for a covered service by doctors and other healthcare suppliers who do not accept Medicare assignment. The limiting charge only applies to certain medical services, not to medical supplies or equipment.
- Lingual surface
- Surface of the tooth toward the tongue.
- Lump sum
- Proceeds paid to beneficiaries all at once instead of in installments
- Major services
- Dental procedures concerned with the restoration of teeth by cast restorations such as inlays, onlays, crowns or veneers. Major services may include endodontics (root canals) or periodontics (tissue/bone treatment).
- Malocclusion
- Abnormal position of the teeth or jaws.
- Mandible
- Horseshoe-shaped bone that forms the lower jaw.
- MAPD
- A Medicare Advantage plan (HMO, PPO, or PFFS) combined with a Prescription Drug Plan (PDP) for one total monthly premium administered by a Medicare Advantage Organization (MAO).
- Max
- Maximum.
- Maxilla
- Bones that form the upper jaw.
- Mbr Resp Amt
- Member responsible amount
- Medicare Advantage Organization (MAO)
- The state licensed business entity, certified by CMS as meeting the Medicare Advantage requirements, which offers a plan or plans and is legally responsible for any liability associated with the delivery or non-delivery of services offered through the plans.
- Medicare Advantage Plan (MA)
- A Medicare plan offered by a private insurer, which includes all of the benefits of Original Medicare (also called traditional Medicare) and may also include Medicare Part D prescription drug coverage, as well as extra benefits. When you have a Medicare Advantage plan, you still have Medicare and must continue paying Medicare premiums.
- Member ID
- Unique identifying number for a member under the dental plan.
- Mesial
- Surface of the tooth toward the center of the mouth.
- Molars
- The last three teeth in the upper and lower left and right sides of the mouth in an adult. These 12 teeth are for grinding food. The baby set of teeth has eight molars.
- Myofacial pain dysfunction (MPD)
- Hyperactivity of the jaw, usually affecting the facial muscles and chewing muscles.
- Network (and in-network provider)
- Humana has negotiated lower rates from specific doctors, hospitals, and other providers, so these providers are part of Humana's networks and are referred to as "in-network" providers. Also called "participating providers."
- Network deal
- Financial agreement applied to a specific dentist or dental network.
- Nonparticipating provider
- Dentist who has not contracted with the carrier to be a participating dentist for a plan.
- Nonprecious metals
- Materials developed for all types of restorative procedures that are less costly than gold and other precious metals
- Occlusal
- Biting or grinding surfaces of molars and bicuspids.
- Occlusal guard (night guard)
- Removable appliance, usually constructed of plastic, that covers one or both dental arches; designed to minimize the damaging effects of teeth grinding.
- Onlay
- Restoration that is extended to cover the entire incisal or occlusal surface of the tooth; often used to restore lost tooth structure and increase the height of the tooth.
- Oral surgery
- Dental specialty concerned with the surgical procedures in and about the mouth and jaw.
- Orthodontic services
- Dental specialty concerned with the correction of improper alignment of the upper and lower teeth.
- Osseous
- Pertaining to bone.
- Out-of-network
- Dental services from a dentist who is not affiliated with or contracted with the dental network.
- Out-of-network provider
- Also called "non-participating provider," this term refers to providers who are not part of the Humana network and, therefore, will cost you more.
- Out-of-pocket maximum
- The annual limit on your costs. After you meet the maximum out-of-pocket amount, your plan pays 100 percent for covered services. You may still pay copayments. Refer to the plan's Benefits Summary for more details.
- Overbite
- Misalignment of the upper and lower teeth or jaws in which the upper teeth overlap the lower teeth when the mouth is closed.
- Overdenture
- A complete denture that fits over one or more natural teeth
- Palate
- The roof of the mouth.
- Panorex
- Out-of-mouth film that provides a continuous view of the teeth and associated structures. It is used for orthodontics and the detection of fractures, TMJ cysts and tumors.
- Partial denture
- Prosthesis replacing one or more, but less than all, of the natural teeth; may be removable or fixed.
- PCP name
- Primary care physician name. In dental insurance for a DHMO, we use PCD, for primary care dentist.
- PDP
- A Prescription Drug Plan that provides seniors and people with disabilities with the first comprehensive prescription drug benefit ever offered under the Medicare program for a monthly premium.
- Pedodontics
- Dental specialty concerned with the prevention and treatment of dental disorders in children.
- Pended
- Indicates an estimate or a claim that has been received but processing is not complete.
- Periodontal pocket
- The deep crevice produced by detachment of a part of the soft tissue from the root of the tooth.
- Periodontics
- Dental specialty concerned with diseases of the gums and other supportive structures of the teeth.
- Permanent and total disability
- Disability that prevents the insured from working again because of injury or illness.
- Permanent teeth
- The "second" or adult teeth
- PFFS
- A Private-Fee-for-Service (PFFS) plan is a Medicare Advantage plan that allows its members to use any doctor, specialist, or hospital that participates with Medicare, accepts Medicare payment, and accepts the terms, conditions, and payment rate of Humana, which is based upon Original Medicare payment calculations.
- Physician Finder Plus
- Here's where you can find out if your doctor is in-network. Physician Finder Plus – on Humana.com/members – lets you search for in-network doctors, hospitals, urgent care centers, and other providers of healthcare.
- Pit
- Small depression in the enamel of the tooth.
- Plan certificate
- The document that details your dental benefits.
- Plan year
- The year starting with your plan effective date.
- Planing (root)
- Scaling of the root surface to smooth the surface.
- Plaque
- Sticky substance composed of secretions containing bacteria, dead tissue cells and debris. When this toxic substance accumulates on teeth, it is considered to be an initiating factor in gingival inflammation.
- POA
- A Power of Attorney (POA) - a document that's signed by a member to authorize another party to act on the member's behalf. The Executor of Estate takes the place of a Power of Attorney after a member is deceased and the Executor is appointed. Power of Attorney and Executor of Estate are legal documentation and must be provided before another party can act on the member's behalf.
- Pontic
- Portion of a fixed bridge between the abutments. This serves as an artificial substitute for a missing tooth.
- Porcelain
- Restorative material of various types of fused (molten) glasses. Used to make teeth, facings, jackets and dentures.
- Portability
- Humana Voluntary Life is portable subject to plan provisions. An active eligible employee who leaves the group can continue coverage by paying annual premiums to Humana if he or she is not yet age 70. Only coverage in force or a lesser amount can be ported at termination.
- Post and core
- Single cast unit that provides strength and restores lost structure. It is placed into the tooth, followed by the permanent exterior restoration, usually a crown.
- Posterior
- The back teeth
- PPO
- PPO is short for a Preferred Provider Organization, a type of health plan that gives you the freedom to choose your own doctors and hospitals. However, your out-of-pocket costs are usually lower if you choose healthcare providers who participate in the plan's network.
- Pre-existing condition
- A condition you had and were advised of before obtaining health insurance with Humana. In some cases, there's a waiting period before this condition will be covered by your insurance.
- Preferred Provider Organization (PPO)
- With this plan, you get coverage for doctors in and out of your plan's network. You pay less when you go to doctors, hospitals, and other providers in your plan's network.
- Premium
- The amount taken out of your regular paycheck to: Cover your share of a health plan's premium; your employer pays the rest of the premium, if any; Fund a spending account if you have one
- Premolars
- The bicuspid teeth immediately before the molars.
- Preparation (prep) date
- The date the tooth is prepared for an appliance, and an impression is taken of the tooth.
- Preventive services
- Dental procedures concerned with the prevention of dental diseases by protective and educational measures. May include examination, cleanings, X-rays and fluoride.
- Primary care doctors
- Most plans consider the following doctors to provide this basic level of healthcare: general practitioner, family medicine doctor, obstetrician, pediatrician and, sometimes, a nurse practitioner.
- Primary Care Physician (PCP)
- Doctor who is chosen by enrolled members of HMO plans to coordinate and manage all of their healthcare.
- Prophylaxis
- Teeth cleaning.
- Prorate
- To divide, distribute or assess based on proportion.
- Prosthodontic services
- Dental specialty concerned with the restoration of missing teeth by artificial means.
- Proximal
- Surface nearest the adjacent tooth.
- Pulp
- Soft inner structure of a tooth consisting of blood vessels and nerves.
- Pulpectomy
- Removal of either vital or inflamed pulp from the chamber and root canals
- Quadrant
- One-half of each dental arch; one fourth of the two dental arches
- Recession
- Gradual drawing away of tissue from its normal position; for example, the recession of the gum away from the tooth.
- Reference number
- Nine-digit number assigned by our computer system that serves as a confirmation number of receiving the document.
- Reline
- To resurface the tissue-borne areas of a denture with new material.
- Resin
- Organic materials, usually named according to chemical composition, physical structure or means of curing, frequently referred to as "plastic."
- Retainer
- Appliance to prevent collapse of the dental arch.
- Rider
- A provision attached to a policy that adds or restricts benefits
- Root canal therapy (endodontic therapy)
- Treatment of a tooth having damaged pulp, usually performed by removing the pulp chamber and root canals, and filling these spaces with inert sealing material.
- Root planing
- Smoothing of roughened root surfaces with scalers and dental instruments
- Scale
- To remove tartar and stains from teeth with special dental instruments.
- Sealant
- Material applied to the chewing surface of a tooth to prevent decay.
- Seat belt benefit
- If the insured dies from injuries sustained in an automobile accident while driving or riding in a private passenger car and wearing a seat belt, Humana Life will increase the amount of the insured's benefit by 10 percent, but not by less than $1,000 or more than $10,000.
- Seat date
- Date the appliance is cemented/put in place. For orthodontics, it is the date the bands are placed on the teeth.
- Semiprecious metals
- Materials developed for dental restorations that have a lesser amount of precious metals.
- Service Area
- Refers to the specific county/ZIP code/state that a member actually resides in. The service area is where you must live for a plan to accept you as its member. If a member moves, he or she needs to contact Customer Care to see if the service area is affected.
- Short-term disability insurance
- A policy that pays benefits for a limited period of time (e.g., one year).
- Silicate
- Synthetic fillings other than silver, gold or ordinary cement to set crowns, bridges, etc.
- Sockets
- C one-shaped cavities in the upper and lower arch, in which the teeth are embedded.
- Spending account
- Spending accounts can be used to help fund employee healthcare expenses and include:
- Health Savings Account (HSA) – A tax-free, interest-bearing account to help you pay for healthcare expenses – now and in the future.
- Flexible Spending Account (FSA) – An employer-funded account to help you pay for healthcare expenses.
- Dependent Care Flexible Spending Account – An account you fund to help pay your dependent care costs with pre-tax dollars.
- Limited FSA – An account is limited to paying dental, vision, and preventive medical expenses.
- Personal Care Account (also called a Health Reimbursement Arrangement) – An employer-funded account employees can use to pay qualified medical expenses.
- Splint
- Appliance to prevent motion of teeth.
- Spouse coverage
- If your spouse is eligible for another employer's health plan – but chooses to be covered by your plan – you may pay a surcharge fee to cover some of your employer's costs for insuring your spouse.
- Status
- Informs the member if the policy is active, termed or COBRA.
- Stayplate (flipper)
- An acrylic partial, with or without wire clasps, that replaces one or more teeth; usually temporary.
- Stomatitis
- Inflammation of the tissues of the mouth.
- Study models
- Plaster models of the teeth made from an impression showing all the teeth in the upper and lower jaws, and the relationship between the teeth.
- Subscriber number
- Unique identifying number for a dental insurance plan member.
- Summary Plan Description
- A legal document detailing a member's or group's coverage.
- Surgical extraction
- Removal of a tooth by surgical methods
- Tartar
- Hard deposit that forms on teeth when plaque hardens.
- Temporomandibular joint (TMJ)
- Joint between the skull and the mandible.
- Term life Insurance
- Insurance that provides death benefit protection for a specified length of time and pays benefits only if the insured dies while the term insurance is in force.
- TMJ syndrome
- Symptoms associated with malfunction of the temporomandibular joint.
- Torus
- A projection or overgrowth of bone
- Underwriter
- A person who identifies and calculates the risk of loss from policyholders, establish premium rates, and write policies to cover the risks
- Unerupted
- Not having come through the gums.
- Unilateral
- Involves only one side.
- Urgent care center
- Urgent care – also called walk-in – centers provide a good medical and financial alternative when you can't see your regular doctor, and your illness or injury is relatively minor. Urgent care centers have shorter waits, don't require an appointment, are open evenings and weekends, and cost less than an emergency room
- Usual and customary
- Establishing a maximum amount to pay for a specific procedure
- Veneer crown
- A full crown, which has one or more surfaces, covered by tooth-colored plastic or porcelain.
- Vitality test
- Test using thermal, electrical or mechanical stimuli to determine the vitality of the dental pulp.
- Voluntary life insurance
- Insurance for which the employee pays the entire monthly premium based on the group's characteristics
- Voluntary plans
- A comprehensive dental insurance plan that employers can offer at no cost to their business. Employees like the simplicity and convenience of having their dental premiums deducted directly from their paychecks.
- Waiting period
- Period between employment or enrollment in a dental plan and the date when a covered person becomes eligible for benefits. Services subject to a waiting period could be crowns, bridges or orthodontics.
- Waiting period days remaining
- Time remaining before the waiting period expires
- Waiver of premium
- Provision that continues insurance coverage without further premium payments if the insured is totally disabled
- X-ray
- A form of radiation that produces a shadowy negative, which provides a means of diagnostic dental evaluation. The following terms are examples of dental X-rays taken