It is rightly said, “If your eyes are the window to your soul, then your mouth is a mirror of your health”. This is an important statement highlighting the positive effects of oral health on the general health. Oral health plays a pivotal role in the overall health, thereby forming a gateway of the body. Majority of the oral diseases require professional oral health care; however, due to limited availability to accessibility and awareness, the oral health is markedly poor among people with low income and without a health insurance.

Insurance is a form of protection from loss. It is a sort of risk management, primarily used to hedge against the risk of any contingent or uncertain loss. The various types of insurance generally include life, health, long-term disability and auto insurance. Out of this, health insurance plays an integral role for the society. The Insurance Regulatory and Development Authority of India define “health insurance” as the insurance contract, which provides for sickness benefits or medical, surgical, or hospital expense benefits. Health insurance generally covers medical expenses in case of any emergency. Generally, in our country, unlike the western world, medical insurance is considered as a holistic approach to insurance including dental insurance. Unfortunately, the dental insurance covered in health insurance is limited only to oral surgical procedures related to trauma. This brings so many questions into the minds thereby, highlighting the importance of dental insurance in India.

Dental insurance is a type of insurance that covers issues related to the oral health care i.e. prevention and treatment of the dental disorders. This includes broadly all the dental procedures except the cosmetic ones namely bleaching, smile designing, laminates & veneers, crowns etc. Majorly, various procedures, which require dental insurance, can be categorized as routine & non-routine dental procedures. Usually, dental insurance includes the preventive dental services. The preventive dental services generally include routine oral examination, scaling and root planning, application of fluorides and pit fissure sealants and radiographs, if required. In addition to this, restorations, extractions, emergency services etc. also form a part of insurance services. This may vary from one insurance scheme to the other.

Dental insurance plans generally cover Indemnity Dental Insurance Plan, Dental Health Maintenance Organization (DHMO) and Participating Provider Network (PPO) plans. As per the Indian perspective, dental insurance plans generally include exclusive dental health insurance plans and dental coverage under various policies of general, health, and life insurance companies. Moreover, employers from Indian Army and Public Sector Undertakings banks also aid in reimbursement for various dental procedures. A number of governmental and non-governmental schemes for health insurance covering dental insurance in its broader perspective have played a significant role to accommodate the insurance cover. This includes both advantages and limitations of the schemes associated with dental insurance. In addition to this, few insurance plans allow only an annual maximum benefit limit.

There have been few misconceptions in the minds of both patients and dental practitioners in relation to dental insurance. Due to this, the response to insurance claim for undertaking various dental procedures is bleak. A couple of reasons have led to the failure in promoting dental insurance in India. In general, lack of awareness about oral health and insurance availability, improper coordination with the policy makers and government, form a major part of the failure.

Participation with a dental insurance company may affect the relationship of dental surgeon with the patient. Dental surgeon should always be prepared to answer the question, “Why do I need this service if my dental insurance does not cover it?” Nonparticipation with a dental insurance company may result in a reduced number of new patients.

On a positive note, dental insurance has been found to be associated with higher rates of visiting for a check-up and regular dental visiting and was correlated with patient acceptance of prescribed dental treatment, thereby suggesting that the insured individuals can face few financial barriers to meticulous dental care. More of the dentist awareness programs through seminars, lectures or forums, educational articles, and debates are needed to increase dentist’s knowledge about dental health insurance. The insurance companies should focus more on factors like cheaper plans, cashless treatment facility, coverage of all illnesses, and coverage of all services, which the dentists perceive as most vital factors. Dental surgeons can definitely play a vital role in creating awareness and motivation in the minds of the patients in relation to the adoption of various dental insurance plans to improve their rapport with the patients and ultimately outreaching the whole community.

In the era of technological advancements, dental insurance plays a paramount role in the delivery of dental care. Insurance covering a broader horizon pertaining to the dental practice in India will definitely prove to be a boon in the times to come.