Dental Accident
A dental accident is a sudden, unexpected event that causes injury to the mouth, teeth, or jaw, resulting from an external force rather than from decay, chewing, or normal use. Examples include being struck in the face, falling and hitting your mouth, or suffering an impact during sports. Dental accident coverage helps pay for the repair or replacement of natural teeth damaged in such incidents.
This type of coverage is typically included under extended health benefits rather than standard dental coverage. It is designed to cover emergency treatment and restorative work that is medically necessary due to trauma. Eligible expenses may include examinations, X-rays, fillings, crowns, root canals, or tooth replacements caused by the accident. Most insurers require treatment to begin within a set timeframe, such as 90 or 180 days after the incident, though ongoing work may continue for up to a year or more if approved.
Example:
If you slip on ice and break a front tooth, your dental accident benefit may cover the cost of repairing or replacing the tooth, up to the plan’s per-incident or annual maximum.
What to Watch For:
Report the accident to your insurer as soon as possible, and keep detailed records from your dentist or oral surgeon. Routine dental issues such as broken fillings, biting injuries, or damage from eating hard food are not considered accidents. Check your plan’s definition of “accidental dental injury” and confirm how long you have to start treatment after the event.
