Why is Arestin not covered by insurance


Arestin is a medication used to treat periodontal disease. It is a locally-managed antibiotic used to treat the deep pockets of infected gum tissue that are difficult to reach with standard cleaning methods. Still, unfortunately, it is not covered by insurance.

It is applied directly into the gums area by a dental professional, and it slowly frees antibiotics over time to eliminate the bacteria that cause periodontal infection. Arestin effectively reduces the pocket depth and improves overall gum health in patients with periodontal disease.

In this article, we will explore why Arestin is not covered by insurance and the impact this has on patients and dental professionals.

Why is Arestin not covered by insurance ?

1. The High cost

Arestin is a relatively expensive cure, and insurance providers may not want to cover it if cheaper alternative treatments are available. Further, insurance companies may view Arestin as a cosmetic treatment rather than a medically necessary one, limiting its coverage.

2. Lack of consensus among dental professionals

Some dentists believe that Arestin treatment is a valuable option, while others are skeptical about its effectiveness. Insurance companies may be doubtful to cover a treatment that does not have a clear agreement among dental professionals.

3. The Coverage policies

Insurance providers may have clear policies that exclude coverage for certain treatments, including the Arestin. These policies may be based on factors such as the high cost of the treatment, the availability of alternative treatments, and the sensed medical necessity of the treatment.

4. Lack of available long-term data

Insurance companies typically require extensive clinical evidence before covering a new medicine. While Arestin effectively reduces pocket depth & improves overall gum health, long-term data on its effectiveness still needs to be provided. They may only cover treatment with sufficient evidence of its long-term benefits.

Does it deserve to be covered by insurance ?

The effect of Arestin not being covered by insurance is significant. Patients who need Arestin treatment but cannot afford it may be pushed to forgo treatment entirely, which can have dangerous long-term consequences for their oral health.

Without the appropriate treatment, periodontal disease can progress and lead to tooth loss, which can affect a patient’s quality of life. Dental specialists who want to provide the best care for patients can also be restricted by insurance coverage, as they may be unable to suggest Arestin to their patients due to its cost.

Alternative treatments for periodontal covered by insurance

  • Insurance covers alternative medicines for periodontal diseases, such as scaling, root planning and traditional antibiotics. However, these treatments may not be as effective as Arestin in treating the deep pockets of infected gum tissue.
  • Patients & dental professionals may have to weigh the pros & cons of these alternative therapies compared to Arestin and decide what is best for their needs.

In conclusion, Arestin is a valuable treatment choice for patients with periodontal disease, but unfortunately, it is not covered by insurance. All the overhead factors contributed to its lack of coverage.

The effect of Arestin not being covered by insurance is significant, as patients may need suitable treatment for their oral health needs. It is necessary for patients and dental professionals to advocate for better insurance coverage for periodontal disease treatments, including Arestin, to ensure that everyone has access to the best possible care.


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