What to do if an employee has a dental emergency

Dental emergencies are stressful, no matter when they happen. As an employer, one of the most supportive things you can do is help your employees understand what steps to take and what their dental benefits cover in urgent situations. Here are the most common questions we hear about dental emergencies and coverage.

What counts as a dental emergency?

A dental emergency typically involves sudden pain, injury, or infection that needs immediate attention. Some examples include:

• A knocked-out or broken tooth

• Severe toothache or swelling

• Lost fillings or crowns causing pain

• Signs of infection, such as abscesses

If your employee isn’t sure whether their situation is an emergency, the safest approach is to call their dentist right away.

Is emergency dental care covered by most plans?

Yes. In most cases, emergency dental visits are covered the same way as standard care, which means the usual copays, deductibles, and annual maximums apply.

Many dentists also have after-hours numbers or on-call arrangements for emergencies. Encourage employees to ask their dentist at their next visit what the process is if something urgent comes up outside of normal office hours.

What if the employee sees an out-of-network dentist?

It depends on the type of plan. For example:

PPO plans often provide partial coverage for out-of-network care, though employees may pay more out of pocket.

DHMO plans may not cover out-of-network emergency visits.

That’s why it’s important for employees to know the details of their specific plan and, when possible, choose in-network dentists to keep costs down.

How does coverage work if an emergency happens while traveling?

Within the U.S.: With Delta Dental’s nationwide network, employees can usually find an in-network dentist in almost any city. They can use the Delta Dental mobile app or the Find a Dentist tool to locate one quickly.

Outside the U.S.: Coverage varies by plan. Some include emergency care abroad, while others do not. It’s a good idea for employees to check their coverage before traveling internationally.

Are emergency room or urgent care visits covered?

Dental benefits typically don’t cover ER or urgent care visits for dental problems. Those fall under medical insurance instead.

Similarly, if a prescription is needed for dental pain or infection, that’s also covered by the employee’s medical or pharmacy benefits, not dental.

How can employers support employees in these situations?

Dental emergencies can be overwhelming. You can help by:

• Encouraging employees to keep their dentist’s after-hours number handy.

• Sharing information about how their plan handles emergencies, both at home and while traveling.

• Reminding employees to check whether their plan includes coverage abroad if they travel internationally.

A little preparation can go a long way in easing stress when the unexpected happens.

Dental emergencies can’t always be avoided, but knowing what to do, and what’s covered, makes them easier to manage. By helping employees understand their options, you can give them peace of mind and support their health when they need it most.

For more details about how your company’s dental plan covers emergencies, reach out to your broker or your local Delta Dental of Tennessee representative.