Yes. Wisdom teeth removal is covered by Daman insurance when clinically necessary. The coverage amount and copay depend on whether the extraction is simple (erupted tooth) or surgical (impacted tooth requiring bone removal or sectioning). All Daman plan tiers including Basic cover medically necessary wisdom tooth extractions, though coverage rates vary.

Simple extraction (D7140): the wisdom tooth has erupted and can be removed with forceps in minutes. Covered on all plans at 80-90% (10-20% copay). Surgical extraction (D7240 or D7210): the tooth is impacted (partially or fully under the gum/bone), requiring a cut through gum tissue, possible bone removal, and tooth sectioning. Often billed under both dental and oral surgery codes. Covered on all plans but at different rates and almost always requires pre-authorization.

For simple extraction: pre-authorization is often not required. For surgical extraction of impacted wisdom teeth: pre-authorization is almost always required. Your oral surgeon or dentist will submit X-rays (OPG and sometimes CBCT) along with the clinical diagnosis and procedure plan. Emergency removal (acute infection, pericoronitis, abscess) may bypass the standard pre-authorization timeline with urgent authorization.

Daman can authorize multiple wisdom tooth extractions — including all four simultaneously — when clinically indicated. Removing all four under one anesthesia session is common practice as it minimizes recovery time. Each tooth is authorized separately by procedure code and position. Pre-authorization for multiple extractions should be submitted together, noting all quadrants involved.

CBCT (cone beam computed tomography) scans are used for complex impacted wisdom teeth to map the roots in relation to the inferior alveolar nerve. These are covered under Daman's diagnostic imaging benefit when clinically indicated. Pre-authorization may be required for CBCT specifically. Your oral surgeon can include the CBCT request in the overall wisdom tooth pre-authorization submission.

Simple erupted wisdom tooth (80% coverage): clinic fee AED 400–700, patient pays AED 80–140. Surgical impacted wisdom tooth (80% coverage on Basic/Silver): clinic fee AED 1,200–2,500, patient pays AED 240–500. General anaesthesia/IV sedation: billed separately, may be under medical (not dental) benefit — see sedation section. On Gold/Platinum at 80-90% coverage, patient costs are 10-20% lower.

Yes. The DHA Essential Benefit Plan (Daman Basic) covers wisdom tooth extractions — both simple and surgical — as medically necessary dental treatment. The copay is typically 20% for the extraction itself. Basic plan coverage for associated costs (CBCT, sedation) varies — check your specific benefit schedule.

This is one of the most complex aspects of wisdom tooth coverage. IV sedation is often billed as a medical procedure (not dental) because it involves a separate anesthesiologist or sedation-trained professional. Medical benefit coverage for sedation depends on whether your plan has a medical anesthesia benefit separate from dental. On many Gold and Platinum plans, the sedation fee is partially covered under medical benefits. On Basic, sedation may not be covered — you pay the dental extraction rate without sedation reimbursement. Confirm with Daman before scheduling sedated extraction.

Pericoronitis is an infection of the gum tissue partially covering an erupted wisdom tooth. It causes pain, swelling, and sometimes trismus (difficulty opening). It is a genuine dental emergency — Daman covers treatment (irrigation, antibiotics prescription, emergency management) as emergency dental care on all plans. If pericoronitis is recurrent, it becomes clinical justification for wisdom tooth extraction authorization.

Common denial reasons: (1) Missing or insufficient radiographic documentation (OPG required, CBCT for complex cases). (2) The tooth is not clinically indicated for extraction — Daman's reviewers may request clinical justification for removal of a fully erupted, symptom-free wisdom tooth. (3) The procedure was performed before authorization was obtained for a non-emergency case. (4) The clinic is not Daman-accredited. Appeal by providing additional clinical documentation from your oral surgeon.

Yes. Upper wisdom teeth (maxillary third molars) are covered at the same rates as lower wisdom teeth. Upper wisdom teeth are often easier to extract (less nerve proximity risk) and may more often qualify as simple extractions. Impacted upper wisdom teeth requiring surgical extraction are covered with the same pre-authorization requirements as lower impacted wisdom teeth.

Yes. Antibiotics, anti-inflammatories (ibuprofen, diclofenac), and pain relief medications prescribed after wisdom tooth surgery are covered under your pharmaceutical benefit (not dental benefit). Medications dispensed at a Daman-accredited pharmacy are covered at your standard drug copay rate, typically 10-20% for branded drugs.

Emergency cases (acute infection, pericoronitis, abscess): 2-4 hours. Urgent cases (significant pain, progression risk): 4-24 hours. Planned/elective surgical extraction: 2-7 business days. Your oral surgeon's clinic should submit the authorization well in advance for planned procedures. Avoid booking the surgical appointment before authorization is confirmed — if treatment begins without authorization, you may be responsible for the full cost.

Post-operative check-ups are covered under your dental examination benefit. Complications like dry socket (alveolar osteitis) — painful condition where the blood clot dislodges — are covered for treatment as a dental emergency on all plans. A dry socket irrigation and dressing appointment is billed at a low procedure cost and covered at your standard copay rate.

You must use a Daman-accredited facility for direct billing. Many oral and maxillofacial surgeons practice at accredited hospitals and dental clinics. If your wisdom tooth case requires general anaesthesia in a hospital operating theatre, confirm that both the hospital and surgeon are Daman-accredited — hospital coverage and dental coverage may be different benefit categories with different accreditation lists.

This is a clinical decision your dentist or oral surgeon should advise on. Asymptomatic wisdom teeth are not always a clinical emergency — Daman will cover their removal when there is clinical justification (impaction affecting adjacent teeth, cyst development, recurrent infection, crowding effect). Purely prophylactic removal of asymptomatic wisdom teeth with no identified risk may be harder to get approved. Your dentist's clinical documentation is key.