Oral SurgeryTRICARE covers the following oral surgery procedures/treatments. These may be performed by physicians or dentists, but they are considered medical care rather than dental care.
- Excision of tumors and cysts of the jaws, cheeks, lips, tongue, roof and floor of the mouth, when such conditions require a pathological (histological) examination.
- Surgical procedures required to correct accidental injuries of the jaws, cheeks, lips, tongue, roof and floor of the mouth.
- Treatment of oral and/or facial cancer.
- Treatment of fractures of facial bones.
- External (extraoral) incision and drainage of cellulitis.
- Surgery of accessory sinuses, salivary glands or ducts.
- Surgical treatment of the temporal bone and the lower bone of the jaw.
- Surgical treatment of the temporomandibular joint for the following:
- Congenital causes
- Surgical correction of prognathism and micrognathism and congenital craniofacial anomalies (i.e., Treacher-Collins syndrome, hemifacial microsomia, etc.)
- Oral surgical procedures for treatment of the following medical conditions:
- Removal of a foreign body which is hazardous to the patient's health, which is reaction-producing or complicates a primary medical condition.
- Intrinsic and traumatic diseases of the temporomandibular joint which require surgery such as rheumatoid arthritis and osteoarthritis.
- Mandibular bone grafts performed for other than orthodontia or dental support.
- Surgical treatment of the temporomandibular joint.
- The Therabite Jaw Motion System may be considered for cost-sharing as durable medical equipment.
TRICARE doesn't cover:
- Treatment of Temporomandibular Joint Syndrome, also known as Myofacial Pain Dysfunction Syndrome, occlusal equilibration and restorative occlusal rehabilitation
- Extraction of unerupted or partially erupted, malposed or impacted teeth, with or without the attached development tissues, aren't covered except when the care is indicated in preparation for, or as a result of, dental trauma caused by the medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. treatment of an injury or illness.
- Vestibuloplasty or surgical preparation of the mouth for dentures.
- Mandibular staple implants because their primary purpose is to prepare the mouth for dentures.
This list of covered services is not all inclusive. TRICARE covers services that are medically necessary and considered proven. There are special rules or limits on certain services, and some services are excluded.
Last Updated 3/20/2022