Frequently Asked Questions

We are not contracted providers with Medicare or Medicaid, meaning those programs will not cover services at our office. This is because Medicare and Medicaid are closed-network programs — if a provider isn't specifically enrolled with them, they simply do not pay, regardless of the procedure.

That said, Apex does participate with a wide range of dental PPO plans, and we welcome patients who have out-of-network benefits through other medical or dental insurers. You can search our full carrier list using our Insurance Participation page.

This is one of the most common questions we receive — and the honest answer is: sometimes, but not usually as a primary payer.

Most medical health plans contain what's called a dental exclusion clause, which means they categorize procedures performed inside the mouth as "dental" — and decline to cover them — regardless of how surgical or complex the procedure is. This surprises a lot of patients who assume that because they're having surgery, their health insurance kicks in automatically.

There are genuine exceptions where medical insurance is more likely to apply:

• Facial trauma — injuries from accidents, falls, or impacts
• Oral pathology — cysts, tumors, biopsies of suspicious lesions
• Medically necessary sedation — when a diagnosed condition prevents treatment under local anesthesia alone
• Functional reconstruction — rebuilding bone destroyed by disease

Not at all — for most patients, being out-of-network still means substantial coverage. Most PPO dental and medical plans include out-of-network benefits, meaning your plan will still pay its share of the cost even when a provider hasn't signed a direct contract with them.

The coverage percentages are typically the same in-network or out-of-network (for example, 80% for major services). The main difference is the fee schedule the plan uses to calculate that percentage — out-of-network plans apply their own "usual and customary" rate, which may differ slightly from a contracted rate. In practice, your actual out-of-pocket cost is often very similar.

Unsure where your plan stands? Use our insurance participation lookup, or call us and we'll verify your benefits personally.

Insurance companies are well known for providing benefit estimates that don't always match what they ultimately pay. When a claim comes back short, here's exactly what we do:

• Our billing team will review the explanation of benefits and re-submit the claim with a detailed narrative of medical necessity if the denial or underpayment is disputable.
• If applicable, we'll also attempt to bill your medical insurance for any qualifying out-of-pocket remainder — a step many offices skip but we pursue on your behalf.
• If the issue remains unresolved after 90 days from your date of service, we will formally file a complaint with the New Jersey Department of Banking and Insurance (NJDOBI) and the National Association of Insurance Commissioners (NAIC) on your behalf at no cost to you.

We know this process can feel frustrating. We're on your side throughout — chasing down every dollar your insurance owes before asking anything additional of you.

Yes. We offer financing through CareCredit, a third-party healthcare credit program that lets you spread the cost of treatment over 6 to 24 months. CareCredit offers various promotional plans, including interest-free periods for qualifying applicants.

You can apply for CareCredit online before your visit or ask our front desk to walk you through it at the time of your consultation. Approval is typically quick.

With the exception of wisdom teeth management and biopsy evaluations, a written referral from your general dentist is required for treatment at Apex. This isn't about insurance requirements — it's about patient safety and care coordination.

A referral ensures that:

• Your condition has already been evaluated by a qualified provider and all conservative options have been considered — we'd never want to extract a tooth that could have been saved with a simple filling.
• All parties are aligned on exactly what needs to be done. A written referral eliminates any ambiguity about which tooth, which procedure, and what's been tried before.

If you don't have a referral yet, contact your dentist and ask them to send one to ApexosNJ@gmail.com. We're happy to follow up with their office directly if needed.

In most cases, no — and this is intentional. Consultation appointments are specifically sized for evaluation and discussion, not for procedures. Attempting both in one visit doesn't allow adequate time for either.

That said, we can make exceptions in select circumstances — it depends on a patient's overall health, current medications, and the complexity of the proposed treatment. If you'd like to explore same-day treatment, give us a call before your appointment and we can discuss whether it's feasible for your specific situation.

It depends entirely on the type of anesthesia you receive:

• IV sedation or general anesthesia: You cannot drive yourself home. A responsible adult (over 18) must be present to receive your aftercare instructions and take you home. Rideshares and taxis are not acceptable — we need someone who can stay with you and be accountable for your care.
• Local anesthesia (novocaine) only, or local with nitrous oxide: You are permitted to drive yourself to and from the appointment. Nitrous oxide clears your system within minutes of being turned off.

We generally recommend avoiding air travel for approximately one week after surgery, for two reasons:

• Accessibility: We want you close by for the first week in case you need to see us for a follow-up concern. Being out of reach complicates care significantly.
• Sinus pressure: Changes in cabin pressure can cause pain, inflammation, and complications — particularly if your procedure involved the upper jaw or sinus region. For sinus lift patients specifically, flying during this window carries additional risk.

If travel is unavoidable, please call us to discuss your specific situation before booking anything.

No. Do not stop any medications on your own. This includes aspirin, Plavix, Eliquis, Xarelto, Warfarin, and any other blood-thinning medications.

Before modifying any medication, two conditions must be met: (1) the physician who prescribed it has confirmed it is safe to pause, and (2) Apex has given you a firm, confirmed date for treatment. Treatment on the day of your consultation is never assumed.

Clinical guidelines on antibiotic prophylaxis have changed significantly in recent years, and the answer is: it depends on your specific medical history.

Per the American Dental Association, patients with prosthetic joint implants are not routinely recommended to take prophylactic antibiotics prior to dental procedures to prevent joint infection.

Per the American Heart Association, only a small and specific subset of patients benefit from pre-procedural antibiotics:

• Patients with prosthetic valve materials or ventricular assist devices
• Patients with a history of infective endocarditis
• Patients with unrepaired structural heart defects
• Patients with a history of cardiac transplant

The AHA does not recommend prophylactic antibiotics for patients with cardiac stents, pacemakers, defibrillators, or uncomplicated heart murmurs.

At Dr. Cappetta's clinical discretion, antibiotics are typically prescribed for patients who are immunosuppressed, currently in or recently completing chemotherapy, have had radiation to the head or neck, or have taken bisphosphonate medications within the past 10 years.

For most straightforward procedures, a scheduled follow-up is not required as a matter of routine. Dr. Cappetta takes great pride in the quality of our outcomes, and the large majority of patients heal without complication.

That said, you are always welcome to come in for a check-up — whether you have a specific concern or simply want the peace of mind of a post-op look. We will never turn away a patient who wants to be seen.

Certain more complex procedures — such as bone grafts, implant placements, or biopsies — may have a recommended follow-up scheduled at the time of your surgery. Your discharge instructions will indicate whether one is needed for your specific case.

In almost all cases, no — this is completely expected. We use only dissolvable sutures, which are designed to unravel and fall out on their own as the tissue heals. Stitches coming out within the first 5–10 days is normal.

Start with your aftercare instructions — a large number of common post-op concerns (bleeding that hasn't completely stopped, swelling, mild discomfort, and diet questions) are addressed there. You can find the full set of procedure-specific aftercare guides here.

If your concern isn't addressed in the instructions or you want to talk it through with someone, please call us at (973) 210-7076. Our trained staff can help you assess whether what you're experiencing is within the normal range of healing or something that warrants a visit.

After hours: call (973) 210-7076 and follow the prompts to reach the on-call surgeon.