Does Medicare Cover Abscessed Tooth Treatment?

Christian Worstell
In this article...
  • Some Medicare Advantage (Part C) plans may cover abscessed tooth treatment. Original Medicare (Parts A and B) doesn’t typically cover routine dental care, including treatment of a tooth abscess.
Woman smiles at her dentist with dental assistant in background

While Original Medicare (Medicare Part A or Part B) doesn’t typically cover routine dental care such as treatment for a tooth abscess, some Medicare Advantage (Medicare Part C) plans may cover abscessed tooth treatment and other dental benefits.

Below is an overview of Medicare dental coverage and what you should know about how each different part of Medicare covers dental procedures, tooth extractions, cleanings, fillings and more. 

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Does Medicare Cover Oral Surgery?

Your inpatient hospital costs may be covered by Medicare Part A if you get oral surgery as part of preparation for other medically necessary surgery (such as jaw surgery to treat oral cancer) or to repair dental damage from a serious injury. A routine tooth abscess removal is not typically covered by Original Medicare, however. 

Medicare Part B may help cover your surgery costs if your oral surgery is performed in an outpatient setting, but only if your doctor determines that the surgery is medically necessary. In order for your oral surgery to be considered medically necessary, it must be required in order to treat a specific injury, illness, disease or condition.

Original Medicare does not typically cover routine dental care. This includes dental services such as cleanings, fillings, tooth extractions and abscessed teeth. 

Does Medicare Advantage Cover Tooth Infection and Other Dental Care?

Medicare Advantage (Medicare Part C) plans are sold by private insurance companies. These plans are required by law to provide all of the same basic coverage found in Medicare Part A and Part B. Beyond that minimum requirement, many Medicare Advantage plans may then offer additional coverage for certain things covered by Original Medicare. 

Dental coverage is often an extra benefit offered by Medicare Advantage plans. In most cases, Medicare Advantage plan dental benefits will include coverage for the treatment of an abscessed tooth.

Other common Medicare Advantage plan benefits include vision hearing care and prescription drug coverage.  

Medicare Advantage plans may require a monthly premium, although many plans come with $0 premiums. Deductibles, coinsurance and copayment requirements will vary by plan.

The selection of Medicare Advantage plans varies by location. You can compare the plans available where you live online for free, with no obligation to enroll.

Do Medicare Part D Plans Offer Dental Coverage?

Medicare Part D plans cover prescription medications, so a Part D plan will not provide any dental benefits. However, an individual who has an abscessed tooth repaired may be prescribed antibiotics following the procedure, and the antibiotics will typically be covered by a Part D plan. 

Most Medicare Advantage plans also provide coverage for prescription drugs. 

Standalone Dental Plans

Another option for Medicare beneficiaries seeking dental coverage is to purchase a standalone dental insurance plan through a private health insurance carrier or the Health Insurance Marketplace. Many employer-based plans include an option for dental coverage. 

Most standalone dental plans will cover abscessed tooth treatment. 

How Do You Treat an Abscessed Tooth?

A tooth abscess is a pocket of pus that has accumulated under or near a tooth as a result of a bacterial infection. A tooth abscess can cause pain, sensitivity to hot or cold temperatures and chewing, fever, swelling, odor and difficulty breathing or swallowing. 

If left untreated, the infection may spread to other parts of your body and can even lead to the life-threatening infection called sepsis. 

The most common treatments for an abscessed tooth include:

  • Draining the buildup of liquid
    This is only done for a very minor abscess near the surface of the gums. While this treatment does provide pain relief, it does not address the abscess itself.

  • Root canal
    The most common treatment for a tooth abscess is a root canal. During a root canal, the infected tissue is accessed and removed by drilling through the center of the tooth. The resulting hole is then filled with a synthetic material.

  • Extraction
    A tooth abscess that is large or badly infected may require the dentist to extract the tooth entirely.

  • Antibiotics
    Antibiotics are often used in conjunction with the above treatments to help the body fight off bacteria caused by an abscess and prevents the infection from spreading. 

You can help prevent a tooth abscess by practicing good oral hygiene such as brushing twice a day, drinking fluoridated water, limiting sugary foods and drinks and visiting your dentist for a checkup every six months. 

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.

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