Does pet insurance cover dental claims?

Dental injury vs dental illness

Policy wordings usually split dental problems into two groups, and many cover only the first.

• Dental injury -- damage caused by an accident, such as a tooth broken in a fall, a road accident or a knock while playing. This is the type most commonly covered, including on some accident-only policies.
• Dental illness -- disease that develops over time, such as gum disease (periodontal disease), tooth resorption, abscesses linked to decay, or extractions for rotten teeth. Many policies exclude this entirely, and others cover it only with conditions or a lower limit.

Look in the booklet for a "dental" section, a definition of "dental illness" or "dental injury", and any separate sub-limit for dental treatment that sits below the main vet fee limit.

Why dental claims get declined

• Routine or preventive care. Scale and polish, routine cleaning and check-ups are usually treated as routine care and excluded, even when the vet recommends them.
• Pre-existing dental disease. Tartar, gingivitis or a "dental" note in the clinical history before cover started can make later dental claims pre-existing. See excess and pre-existing conditions.
• Missed dental checks. Where dental illness is covered, the wording often requires a dental examination at set intervals and that any recommended treatment was carried out.
• Cosmetic or breed-related work. Orthodontic, cosmetic and some retained baby tooth treatment is often excluded.
• Injury that was really disease. If the clinical notes show the tooth was already diseased before it broke, the insurer may treat the claim as dental illness rather than injury.

The dental check condition

Policies that do cover dental illness commonly attach a condition such as an annual dental examination by a vet, with any treatment recommended at that check completed within a set time. If the check was missed or the advice was not followed, a later claim can be refused under that clause.

The fix is boring but effective. Ask your vet to record a dental check at each annual booster or health check, and keep the record. If the vet recommends treatment, either get it done or get a note explaining why it was safe to wait.

Before you book treatment

1. Ask the vet for an estimate and a written note of the diagnosis, saying whether it is injury or disease and when it started.
2. Read your policy's dental section and any dental sub-limit.
3. Ask the insurer for a pre-authorisation or written view before non-urgent dental work. Many insurers will give one.
4. Check how the excess applies. A dental claim with a high fixed excess can leave little to claim back.

If a dental claim is declined

Ask the insurer which clause it relied on, and compare it with the clinical notes. Common fixable problems are a vet note that describes an accident vaguely, or an old "mild tartar" entry being read as pre-existing disease. Your vet can add a clarifying note. If the insurer still says no, follow our claim rejected guide for the complaint and Financial Ombudsman route.

Quick checklist

1. Find out whether your policy covers dental injury only, or dental illness too.
2. Note any dental sub-limit and the excess.
3. Keep a record of dental checks and any treatment the vet recommended.
4. Get a written diagnosis and estimate before planned dental work.
5. Send invoices and clinical notes with the claim -- see the claim evidence checklist.

Related: policy small print | how to claim | vet fee limits | switching.