Notice

We’re experiencing a high volume of calls and emails, causing delays in response times. We apologize for any inconvenience and appreciate your patience.


On November 19th, the Call Center will be open from 8:00 AM to 11:45 AM ET due to team training.

To view benefit information and claim status at any time, you can sign into your account or use our Interactive Voice Response System 24/7 at 800-452-9310.

Delta Dental of New Jersey’s Missing Tooth Inclusion.

When someone loses a tooth because of severe tooth decay, a mouth injury, or some other oral health issue, a dentist can replace it with an implant/crown, bridge, or dentures. These dental procedures are more costly than something like a filling and are considered a “major service.”

What This Means for Your Practice

What is the missing tooth clause? 

When members are covered by a dental plan with a missing tooth clause (also called a missing tooth exclusion), this means the dental insurance company will not cover the costs of replacing the tooth if the tooth was lost or extracted before the current dental coverage started. Members who have a dental plan with a missing tooth exclusion would be responsible for paying all the costs for the tooth replacement procedure.

Does Delta Dental of New Jersey have a missing tooth clause?* 

No, Delta Dental does not have a missing tooth clause. We understand that, while teeth may be gone, they’re never forgotten. That’s why Delta Dental offers plans that cover tooth replacement procedures for members aged 16 and over who lost a tooth or had a tooth extracted prior to the start of their Delta Dental coverage. We call this coverage the Missing Tooth Inclusion, and it’s automatically included in plans that cover restorative work.

What to know about coverage and waiting periods.

If a patient needs a tooth replacement procedure, we recommend that they request a pre-treatment estimate from you and submit it to us. This will give the patient an idea of what Delta Dental will cover and the potential out-of-pocket costs.

It’s important to note that while not common, some groups require a waiting period for major treatment (which includes crowns and replacement of missing teeth). Members must wait for the specified amount of time before having a tooth replacement procedure (or other major services) to be eligible for benefits. If a member is unsure if their dental plan has a waiting period, please ask them to check their policy documents.

*Coverage is subject to the terms, conditions, limitations, and exclusions of the group policy.