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

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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 You

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.

Are you missing a tooth?

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

It’s important to note that, if your employer requires a waiting period on major services (which includes crowns and replacement of missing teeth), you will need to wait that specified amount of time before having a tooth replacement procedure. If you are unsure if your dental plan has a waiting period, please check your policy documents.

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