Why Does Dental Insurance Usually Cover Only Two Cleanings a Year (And Can You Get More)?

Quick answer: Many dental plans are designed around a “standard preventive schedule” of two cleanings per year. That doesn’t mean you can’t get more. If you have gum inflammation, a history of cavities, dry mouth, orthodontic appliances, or other risk factors, your Greenville NC dentist may recommend more frequent visits to protect your oral health.

If you’ve ever wondered, “Why will my insurance pay for two cleanings but not three?” you’re not alone. Insurance benefits don’t always match what’s best for your specific needs—and the good news is that you still have options.

Why “two cleanings per year” became the standard

Most dental insurance plans follow a traditional preventive model: an exam and cleaning every six months. This schedule works well for many low-risk patients, so insurers often build benefits around it.

But insurance is a benefit plan, not a personalized health plan. Your mouth, your habits, and your medical history may justify a different schedule.

When you may need more than two cleanings per year

Some patients stay healthy with two cleanings a year. Others benefit from 3–4 visits (or even more) to keep inflammation under control and prevent problems from escalating.

Common reasons your dentist may recommend additional cleanings

• Bleeding gums or gingivitis (early gum inflammation)
• Periodontal (gum) disease or a history of deep cleanings
• Frequent cavities or high cavity risk
• Dry mouth (often caused by medications or mouth breathing)
• Braces or clear aligners (plaque traps more easily around appliances)
• Medical risk factors that increase inflammation or reduce saliva

If your gums bleed when brushing or flossing, it’s worth getting evaluated. Bleeding is often a sign of inflammation, and inflammation tends to worsen when plaque and tartar aren’t removed consistently.

Want a deeper explanation of why preventive care matters? Read:
Why regular dental exams and cleanings are important.

What cleanings actually do (that home care can’t)

Even if you brush and floss daily, plaque can harden into tartar (calculus) in hard-to-reach areas. Once tartar forms, it can’t be removed with a toothbrush—professional instruments are needed.

Professional cleanings help by:

• Removing tartar buildup above and near the gumline
• Reducing gum inflammation and bleeding
• Lowering bacterial load that can contribute to cavities and bad breath
• Helping your dentist catch small issues early

Can you get more than two cleanings if insurance won’t cover it?

Yes. You can always choose additional preventive care—insurance coverage just determines how much of the cost the plan will pay.

Options to consider

• Ask if your plan covers periodontal maintenance: Some plans cover more frequent visits after periodontal treatment.
• Use HSA/FSA funds: Many patients use pre-tax health accounts to cover extra cleanings.
• Ask about membership or preventive plans (if available): Some offices offer alternatives for patients without full coverage.
• Pay out-of-pocket when it makes sense: An extra cleaning can be far less expensive than treating cavities or gum disease later.

How we decide the right cleaning frequency for you

At Pruitt & Earp Dentistry, we recommend cleanings based on your actual risk level—not a one-size-fits-all schedule. During your visit, we evaluate:

• Gum health and bleeding
• Tartar buildup patterns
• Cavity risk factors (diet timing, dry mouth, past decay)
• Medical factors and medications that affect oral health

FAQs

Why do I keep getting cavities even though I get two cleanings?

Some people are higher risk due to dry mouth, diet timing, genetics, or between-teeth plaque retention. You may need a more personalized prevention strategy, not just the standard schedule.

Is it “bad” to get cleanings more often?

Not when it’s clinically appropriate. More frequent preventive care can help reduce inflammation and catch issues earlier—especially for higher-risk patients.

Will insurance ever approve extra cleanings?

Sometimes. Coverage depends on your specific plan and whether additional visits fall under preventive benefits or periodontal maintenance. Our team can help you review your benefits.

Schedule a preventive visit in Greenville, NC

If you’re concerned about gum bleeding, frequent cavities, or whether you need more than two cleanings per year, schedule with a dentist Greenville NC patients trust at Pruitt & Earp Dentistry.

Next step: Book an appointment here:
Contact us.

New patient? You can access paperwork here:
Patient forms.

Medical disclaimer: This article is educational and not a diagnosis. Your ideal cleaning frequency should be based on a dental evaluation and personalized risk factors.