International Journal of Applied Dental Sciences 2024; 10(4): 269-272

ISSN Print: 2394-7489

ISSN Online: 2394-7497
IJADS 2024; 10(4): 269-272 Dental practitioners’ comprehension of dental
© 2024 IJADS
www.oraljournal.com
insurance policies: A cross-sectional study among
Received: 23-09-2024
Accepted: 28-10-2024
dentists in India
Dr. Selvarathi K
Thai Moogambigai Dental
Selvarathi K, A Vinita Mary, R Kesavan, Bhavya M Bhasakaran,
College and Hospital, Chennai, Catherine D, Vishwa M and S Vengateswara
Tamil Nadu, India
DOI: https://doi.org/10.22271/oral.2024.v10.i4d.2075
Dr. A Vinita Mary
Professor and Head, Department
of Public Health Dentistry, Thai Abstract
Moogambigai Dental College and Background: Dental insurance is vital for ensuring access to affordable dental care, yet the awareness
Hospital, Chennai, Tamil Nadu, and understanding of dental insurance among dental practitioners is inconsistent. This study aims to
India assess dental practitioners' awareness of dental insurance in Chennai, India.
Methods: A cross-sectional study was conducted from August to October 2024, involving 161 dental
Dr. R Kesavan practitioners selected via convenience sampling method. Data was collected through an online
Department of Public Health questionnaire and analyzed using SPSS.
Dentistry, Thai Moogambigai Results: The majority (75.2%) of participants were somewhat familiar with dental insurance, but only
Dental College and Hospital, 5% participated in any insurance scheme. While 89.4% acknowledged the importance of understanding
Chennai, Tamil Nadu, India dental insurance, 97.45% had not attended any related professional development courses. Many
misconceptions were observed, with 34.8% believing all plans offer the same coverage.
Bhavya M Bhasakaran
Thai Moogambigai Dental
Conclusions: Awareness of dental insurance among dental practitioners is moderate, but significant gaps
College and Hospital, Chennai, in knowledge, misconceptions, and lack of formal training exist. Collaboration between government,
Tamil Nadu, India insurance providers, and dental practitioners is essential for improving awareness and utilization.

Catherine D Keywords: Dental payments, dentists, co-payment, deductible, pre-authorization

Thai Moogambigai Dental
College and Hospital, Chennai, Introduction
Tamil Nadu, India Dental insurance is essential for ensuring that patients can access affordable dental care.
Vishwa M
However, the awareness and understanding of dental insurance among dental practitioners can
Thai Moogambigai Dental vary significantly. This knowledge gap can impact the quality of care provided to patients and
College and Hospital, Chennai, may hinder a practitioner’s ability to recommend or effectively guide patients through
Tamil Nadu, India available insurance options [1]. In India, dental insurance is typically included as part of
broader health insurance plans. These policies help individuals and families manage the costs
S Vengateswara
Thai Moogambigai Dental
of routine dental check-ups, cleanings, and other treatments, as well as cover unexpected
College and Hospital, Chennai, dental emergencies [2]. Dental insurance in India often covers procedures such as fillings,
Tamil Nadu, India extractions, root canals, and orthodontics, but may exclude cosmetic treatments, pre-existing
conditions, and injuries from high-risk activities. In developing countries like India, the "fee-
for-service" payment model is still the predominant payment mechanism, and many people
cannot afford regular dental care. Most individuals visit dentists only for curative treatments,
often neglecting preventive care due to its high cost, resulting in a low percentage of the
population seeking dental services [3]. This situation has led to a review of the various payment
mechanisms used in other countries. The "fee-for-service" model was the first method of
payment for dental services and continued to be the main form of payment for many years
before other payment systems emerged. Choosing the appropriate dental insurance plan is an
important decision, as it can help manage the costs of dental treatments. Factors to consider
Corresponding Author: include coverage, premiums, waiting periods, and the claims process [4]. While dental
Dr. Selvarathi K insurance helps cover treatment costs, maintaining good oral health through regular check-ups,
Thai Moogambigai Dental daily brushing, flossing, and a balanced diet remains essential.
College and Hospital, Chennai,
Tamil Nadu, India

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As demand for affordable dental care grows, understanding practitioners believed the government should collaborate with
dental practitioners' awareness and attitudes toward dental insurance companies (44.4%), offer incentives (25.5%),
insurance becomes increasingly important [5]. This study aims provide regulatory support (23%), and monitor and evaluate
to assess the level of awareness and knowledge of dental (20.5%) dental insurance. Accessibility of dental insurance
insurance among dental practitioners. was considered good by 46% of the practitioners, who felt
that insurance companies made it more accessible and
Materials and Methods understandable for both dentists and patients. However,
This cross-sectional study aimed to assess the awareness of misconceptions about dental insurance were prevalent, with
dental insurance among dental practitioners. Conducted from 34.8% believing all plans offer the same coverage, 28.6%
August to October 2024, the research included stages of data equating dental and medical insurance, and 22.4% expecting
collection, analysis, and reporting. The study focused on all treatments to be covered. Regarding the future of dental
dental practitioners in Chennai and received ethical clearance insurance in India, 39.8% recommended expanding coverage,
from the Institutional Review Board (No. 16.1% suggested continuing professional development, and
511/2024/IEC/TMDCH). The convenience sampling method 23% favored community-based plans. In terms of
was used to collect a sample of 161 participants, and their understanding procedures covered by dental insurance, 63.4%
demographic information was recorded. An online were aware of routine checkups and cleanings, while 20.4%
questionnaire containing 20 questions related to dental knew about coverage for pre-existing conditions. Information
insurance awareness was administered, with informed consent about insurance coverage was mostly sourced from insurance
obtained to ensure confidentiality and privacy. Data collected company websites (51.6%) and dental association websites
through Google Forms was transferred to Excel, and analysis (40.4%). The biggest challenges faced by practitioners
was carried out using IBM SPSS Statistics for Windows, included a lack of clarity on what patients are covered for
Version 26.0. Descriptive statistics, including frequencies and (46.6%) and complex claim processes (28.6%). The
percentages, were used to analyze the responses. practitioners' knowledge of dental insurance plans in India
was generally poor, with 67.1% rating it as poor, and only
Results 28.6% as fair. Regarding key concepts, 59.6% partially
A total of 161 dental practitioners participated in the study, understood co-payments, 58.4% understood deductibles, and
with a mean age of 30.84(+6.99) years, ranging from 22 to 52 70.2% were unaware of authorization requirements and the
years. Demographically, 55.3% were female and 44.7% were utilization review process. When assisting patients with
male. Regarding educational qualifications, 47.8% held an insurance, 52.8% referred them to insurance representatives.
MDS, while 52.2% had a BDS degree. The years of practice A majority (51.6%) strongly agreed that increased patient
ranged from 1 month to 23 years, with 46.6% practicing solo, awareness of dental insurance would positively impact oral
9.3% in group practices, and 57.8% in hospitals. When it health care. Furthermore, 97.45% had not attended any
came to awareness of dental insurance, 75.2% were somewhat professional development courses or seminars on dental
familiar with various dental insurance plans, though only 5% insurance in the past year. Lastly, most practitioners (99%)
participated in any dental insurance scheme. A majority, 82%, felt that dental insurance does not cover sufficient procedures,
discussed insurance options with patients, and 89.4% and 97% believed dental insurance should be integrated with
recognized the importance of understanding dental insurance general health insurance policies.
for practitioners. On the role of government policy, dental

Table 1: Distribution of awareness of dental practitioners regarding dental insurance

Question Options Frequency (N) Percentage (%)
Not at all 38 23.6%
How familiar are you with the various dental insurance plans available in
Somewhat 121 75.2%
your region?
Very familiar 2 1.2%
No 153 95%
Are you part of any dental insurance scheme?
Yes 8 5%
Yes, always 6 3.7%
Do you discuss dental insurance options with your patients? Yes, sometimes 132 82%
No, never 23 14.3%
Do you believe that understanding dental insurance is important for dental Yes 144 89.6%
practitioners? Not sure 17 10.6%
Regulatory support 37 23%
What role do you think government policies should play in promoting dental Incentives for dentist 41 25.5%
insurance coverage to dentist? (Choose the most preferred option) Partnership and collaboration 65 40.4%
Monitoring and evaluation 33 20.5%
Simplifying policy 74 46%
In your opinion, what could insurance companies do to make dental insurance
Providing educational resources 40 24.8%
more accessible and easier to understand for both the dentists and patients?
Enhancing customer support 27 16.8%
(Choose the most preferred option)
Standardizing billing practices 20 12.4%

Assuming all dental plans offer the same coverage 56 34.8%

What are some misconceptions or myths about dental insurance that you Believing it’s the same as medical insurance 46 28.6%
encounter? (Choose the most preferred option) Expecting coverage for all the dental treatments 36 22.4%
Assuming pre-existing conditions 23 14.3%
How do you foresee the future of dental insurance in India, and what changes Expansion coverage 64 39.8%
would you like to see in the coming years to improve awareness and Public-private partnerships 34 21.1%
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accessibility? (Choose the most preferred option) Community based programs 37 23%
Continuing professional development 26 16.1%
Routine checkups and cleanings 102 63.4%
Orthodontics (braces) 3 1.9%
In your understanding, what procedures are typically covered by dental Fillings and root canals 47 29.2%
insurance plans in India? (Choose all that apply) Cosmetic dentistry 2 1.2%
Pre-existing dental conditions 33 20.5%
Other 4 2.4%
Insurance company websites 83 51.6%
Dental association websites 65 40.4%
Where would you recommend dentists look for the latest information on
Continuing dental education (CDE) courses 19 11.8%
dental insurance coverage in India? (Choose all that apply)
Industry publications 13 8.1%
Other 1 0.6%
Lack of clarity on covered procedures 75 46.6%
Complex claim processes 46 28.6%
What are the biggest challenges you face when dealing with dental insurance
Difficulty in getting pre-authorizations 7 4.3%
for your patients? (Choose the most preferred option)
Low reimbursement rates 33 20.5%
Other 0 0.0%
Poor 108 67.1%
How would you rate your knowledge about different dental insurance plans Fair 46 28.6%
available in India? Good 7 4.3%
Excellent 0 0.0%
Yes 6 3.7%
Do you understand the concept of co-payments in dental insurance? No 59 36.6%
Partially 96 59.6%
Yes 5 3.1%
Do you understand the concept of deductibles in dental insurance? No 62 38.5%
Partially 94 58.4%
Are you aware of pre-authorization requirements and utilization review Yes 48 29.8%
processes of dental insurance plan? No 113 70.2%
Provide detailed explanations during consultations 14 8.7%
How do you assist patients in understanding their dental insurance coverage Refer them to insurance representatives 85 52.8%
and benefits? (Choose the most preferred option) Provide brochures or written material 62 38.5%
Other 0 0.0%
Strongly agree 83 51.6%
Agree 70 43.5%
Do you believe that increased patient awareness about dental insurance can
Neutral 7 4.3%
positively impact their oral health care?
Disagree 1 0.6%
Strongly disagree 0 0.0%
Have you attended any professional development courses or seminars on Yes 4 2.5%
dental insurance in the past year? No 157 97.5%
Yes 2 1.2%
Do you think dental insurance in India covers sufficient dental procedures?
No 159 98.8%
Do you believe that dental insurance should be integrated with general health Yes 156 96.6%
insurance policies? No 5 3.1%

Discussion quality care compared to private insurance patients and 69%

The study reveals important insights into the awareness, of the dentists indicated that they would reduce their
attitudes, and challenges faced by dental practitioners participation in the Medicaid program due to many significant
regarding dental insurance in India. While the findings reveal challenges and Nebeker et al. (2014) [7] in which 46% of
a baseline level of awareness, they also highlight significant Michigan dentists reported dissatisfaction with Medicaid
gaps in knowledge, misconceptions, and participation in reimbursement rates, 58% of dentists supported an alternative
professional development related to dental insurance. This public dental insurance system for children and 72%
disconnect between awareness and participation suggests that expressed concerns about the administrative burdens of
while practitioners recognize dental insurance as an important participating in the Medicaid program. These comparisons
tool for promoting oral healthcare, barriers such as limited highlight potential regional or demographic differences in
understanding of insurance policies, skepticism about their attitudes toward dental insurance and may point to areas for
benefits, or procedural challenges may hinder engagement. further investigation or intervention. This contrasts with Joshi
In comparing our study with findings from other research on et al. study, where 100% of private dental practitioners in
dental insurance awareness and attitudes among dental Jaipur considered dental health insurance essential for family
practitioners, several similarities and differences emerge. Our oral health protection, and 62% felt that cashless treatment
study found that while 75.2% of practitioners were somewhat facilities significantly influenced insurance uptake [8].
familiar with dental insurance plans, only 5% actively Similarly, Lee et al. reported that 92.2% of respondents
participated in dental insurance schemes, despite 89.4% agreed that a course on dental health insurance should be
acknowledging its importance. This finding is inconsistent offered at universities, and 80.6% were willing to participate
with the previous online surveys conducted by Shulman et al. in supplementary training on the subject, highlighting the
(2001) [6] in which 57% of Louisiana dentists were not need for more structured education-something our study
satisfied with Medicaid reimbursement rates, 38% of dentists revealed was lacking, with 97.45% of practitioners not having
felt that Medicaid patients were more likely to receive lower attended any professional development courses on dental
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insurance in the past year [9]. Gupta et al. found that 79.4% of DOI: 10.1111/j.1752-7325.2005.tb03017.x.
dental practitioners did not have professional indemnity 4. Mashioff LS. Management of dental insurance in the
insurance, and 35.6% felt it was not mandatory, reflecting the dental office. Dent Clin North Am. 1987;31:179-92.
general lack of understanding observed in our study, where 5. Das N. Knowledge and awareness about dental health
many practitioners had misconceptions, such as 34.8% insurance among dental practitioners in India: A situation
believing all insurance plans offer the same coverage and analysis. J Disease Glob Health. 2021;14:27-34.
28.6% equating dental insurance with medical insurance [10]. 6. Shulman JD, Ezemobi EO, Sutherland JN, Barsley R.
The awareness level in our study (75.2%) aligns closely with Louisiana dentists' attitudes toward the dental Medicaid
Prayan et al. [11], who found 77.31% awareness, suggesting a program. Pediatr Dent. 2001;23:395-400.
similar regional pattern. Furthermore, our study identified that 7. Nebeker CD, Briskie DM, Maturo RA, Piskorowski WA,
46% of practitioners believed insurance companies made Sohn W, Boynton JR, et al. Michigan dentists' attitudes
dental insurance more accessible, which is consistent with toward Medicaid and an alternative public dental
Joshi et al. finding that cashless treatment was a major insurance system for children. Pediatr Dent. 2014;36:34-
influencing factor for health insurance subscriptions in India. 8.
However, a notable discrepancy emerged when practitioners 8. Joshi P, Solanki J, Chaudhary P, Jadoun DS, Mishra P,
in our study, like those in Gupta et al. research, struggled with Sharma P. Knowledge and perceptions about dental
a lack of clarity regarding what insurance plans covered and health insurance among dental practitioners of Jaipur
how claims were processed [8, 9]. This points to a significant city. J Indian Assoc Public Health Dent. 2019;17(2):130-
gap in knowledge that could be addressed through 135. DOI: 10.4103/jiaphd.jiaphd_193_18.
government collaboration with insurance companies, as 9. Lee SH, Oh HW. Perceptions and behaviors of dental
suggested by 44.4% of our participants. Similarly, Jogu and practitioners with regard to the national health insurance.
J Korean Acad Oral Health. 2014;38:246-253.
Kalla’s literature review underscored that dental insurance
10. Gupta D, Thomas S, Dagli R, Solanki J, Bhateja GA,
could alleviate the financial burden of dental care,
Mahajan R. Professional indemnity insurance used
encouraging preventive measures-an opinion shared by our
among graduated and post-graduated dental surgeons in
study participants, 51.6% of whom believed that increasing
Mumbai city, India. J Health Res Rev. 2014;1:44-48.
patient awareness of dental insurance would positively impact
11. Priyan I, Sinduja P, Lakshmi TA. Survey on the
oral health care [12, 13]. Ultimately, the comparison reveals that
awareness of dental insurance. Nat Volatiles Essent Oils.
while there is some recognition of the value of dental
2021;8(5):8668-8679.
insurance, significant gaps remain in practitioners’ 12. Sri AK, Jogu K, Kalla K. Dental insurance in India: An
understanding, misconceptions about coverage, and a lack of effective solution to enhance oral health and mitigate the
professional training, all of which need to be addressed financial burden of dental treatments. Indian J Appl Res,
through more structured educational initiatives, clearer 2024, DOI: 10.36106/ijar/2500448.
communication from insurance providers, and greater 13. Srivastava R, Tangade P, Priyadarshi S, Malti V. Protect
government involvement [14, 15]. your smile and your wallet: A review on dental insurance
in India. Int J Appl Dent Sci. 2023;9(2):1738. DOI:
Conclusion 10.22271/oral.2023.v9.i2d.1738.
Overall, the study reveals that while there is a general 14. Ingole S, Adhav V, Gupta P, Ramanathan V, Mahajan S.
awareness of dental insurance among dental practitioners, The need of dental insurance plan in India: Survey. Int
significant gaps in knowledge, misconceptions, and a lack of Healthc Res J. 2022;5:35-21.
formal education on the subject persist. The role of DOI: 10.26440/ihrj/0512.03521.
government, better training for practitioners, clearer 15. Bhanushali V, Shivakumar KM, Patil S, Kadashetti VD.
communication from insurance providers, and increased Knowledge, attitude, and practice of professional
patient awareness are all critical factors in improving the indemnity insurance among dental practitioners in
integration of dental insurance into dental practice. Maharashtra State, India. J Int Clin Dent Res Organ.
Addressing these issues can lead to better utilization of dental 2018;10:27-17. DOI: 10.4103/JICDRO.JICDRO_27_17.
insurance, enhanced patient care, and ultimately, greater
access to affordable dental care for the population.
How to Cite This Article
Selvarathi K, Mary AV, Kesavan R, Bhasakaran BM, Catherine D,
Conflict of Interest: Not available
Vishwa M, Vengateswara S. Dental practitioners’ comprehension of
dental insurance policies: A cross-sectional study among dentists in
Financial Support: Not available India. International Journal of Applied Dental Sciences.
2024;10(4):269-272.
References
1. Garla BK, Satish G, Divya KT. Dental insurance: A Creative Commons (CC) License
systematic review. J Int Soc Prev Community Dent. 2014 This is an open-access journal, and articles are distributed under the
Dec;4(Suppl 2):S73-7. DOI: 10.4103/2231-0762.146200. terms of the Creative Commons Attribution-Non Commercial-Share
Alike 4.0 International (CC BY-NC-SA 4.0) License, which allows
PMID: 25558454; PMCID: PMC4278106.
others to remix, tweak, and build upon the work non-commercially, as
2. Noraini I, Maizaitulaidawati Md, Husin Md, Izzaamirah long as appropriate credit is given and the new creations are licensed
I, Normaisarah Binti Abdul Manaf. Insurance awareness: under the identical terms.
A literature review. Int J Asian Soc Sci. 2018;8(1):28-33.
DOI: 10.18488/journal.1.2018.81.28.33.
3. Stancil TR, Li CH, Hyman JJ, Reid BC, Reichman ME.
Dental insurance and clinical dental outcomes in
NHANES III. J Public Health Dent. 2005;65:189-95.
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