Oral Surgery
Oral surgery refers to surgical procedures performed in or around the mouth and jaw by a licensed dentist, oral surgeon, or maxillofacial specialist. It includes both minor procedures, such as tooth extractions, and more complex surgeries involving the jawbone, soft tissue, or dental implants.
Health and dental insurance plans categorize oral surgery differently depending on where it is performed and the reason for treatment. Routine extractions and minor surgical procedures are usually covered under dental benefits, while more extensive operations related to injury, disease, or medical necessity may be covered under extended health benefits.
Oral surgery benefits typically include reimbursement for services such as wisdom tooth removal, treatment of oral cysts, repair of jaw fractures, and certain gum or bone surgeries. Some procedures may require pre-authorization, especially if they are performed in a hospital or under general anesthesia.
Example:
If your dental plan covers 80 percent of basic and surgical extractions, and the removal of impacted wisdom teeth costs $600, your plan pays $480 and you pay $120.
What to Watch For:
Check whether your plan classifies oral surgery as a dental or medical expense, since this affects which benefit pays first. Hospital-based oral surgery may require a referral and pre-approval. Always confirm whether anesthesia, facility fees, and follow-up care are included under your benefit.
