When it comes to understanding your dental insurance, one of the most common questions we hear is: “What’s the difference between preventive, basic, and major services?”
Knowing how each category works, and what your plan covers, can help you make the most of your benefits, plan ahead for costs, and keep your smile healthy year-round.
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Preventive care is the foundation of good oral health. Regular checkups help your dentist catch small issues early, like cavities or gum inflammation, before they become painful or expensive problems.
What it includes:
Routine exams and cleanings
X-rays
Fluoride treatments and sealants (for kids and sometimes adults)
How your benefit works:
Preventive care is typically covered at 100%, meaning there’s no out-of-pocket cost when you visit an in-network dentist. Even if your teeth feel fine, these visits are crucial for keeping your smile healthy and avoiding more complex (and costly) treatments later.
Tip: Schedule your cleanings before the end of the year to make sure you use your preventive benefits.
Basic services treat problems that can’t be prevented with regular brushing or cleanings. Catching issues early, like small cavities, keeps them from turning into more serious conditions that require major work.
What it includes:
Fillings
Simple extractions
Periodontal (gum) cleanings or scaling
Root canals (sometimes)
How your benefit works:
Basic services are often covered at 70–80% after your deductible is met. That means you may be responsible for a small portion of the cost, but your insurance helps cover most of the bill.
Tip: If your dentist spots a cavity, scheduling treatment sooner rather than later can save you time, discomfort, and money.
Major services restore function and appearance when significant dental damage occurs. Regardless of whether the dental damage is from decay, injury, or wear over time, these procedures help protect the long-term health of your teeth and jaw.
What it includes:
Crowns, bridges, and dentures
Dental implants (coverage may vary by plan)
Complex extractions or oral surgery
How your benefit works:
Major services are usually covered at 50%, meaning your insurance pays half and you cover the rest after your deductible. Since these procedures can be more expensive, it’s a good idea to review your annual maximum and discuss treatment timing with your dentist. Sometimes you can plan procedures across two benefit years to maximize coverage.
Tip: Ask your dentist for a pre-treatment estimate before moving forward with major services, so you know exactly what your plan will pay.
Here are a few quick ways to get the most value from your dental benefits:
Stay on schedule with preventive care. You’ve already paid for it through your premiums, don’t let it go to waste.
Understand your coverage levels. Know which services fall under each category and what percentage your plan covers. Log into the Member Portal to take a closer look at your coverage.
Use your annual maximum wisely. If you need multiple treatments, your dentist can help you prioritize which ones to complete before year-end.
Check your network. Visiting an in-network Delta Dental dentist helps you save money through lower negotiated rates.
Dental benefits are designed to encourage preventive care, because prevention saves smiles (and money). Understanding how preventive, basic, and major services fit into your plan helps you take control of your oral health and budget more confidently.
If you’re not sure how your plan covers each category, log in to your Delta Dental of Tennessee member portal.