Dental prostheses

Types of prostheses

There are two types of dental prosthesis:

• Removable dentures (partial or full)
• Fixed dentures

Removable dental protheses

The choice of a removable prosthesis depends on the number of teeth to be replaced and the materials used:

• Partial dentures are held in place by clasps or attachments.
• Full dentures work on the principle of the juxtaposition of two identical surfaces: the saliva between the gum and the plaque creates an "adhesive suction".

Fixed dental prostheses (crowns, bridges, ...)

There are different types of fixed prosthesis:

• Crown: This reinforces a "filled" tooth that is no longer strong enough. A crown can also be used to anchor a bridge designed to replace one or more teeth.
• Bridge: This is made up of crowned abutment teeth and elements that replace missing teeth.
• Pivot tooth: It completely replaces the visible part of the tooth and is fixed in the root.

Conditions for coverage

Estimate and authorisation

Estimate

Some procedures are labelled DSD (dépassement sur devis, which means surcharges on estimate), allowing dentists to exceed the official tariffs, but only if they have presented you with a detailed estimate and with your agreement. Dentists are free to determine the fees for these procedures "with tact and moderation".

Authorisation

In addition to DSD, some dental prosthesis services are labelled ACM (autorisation du contrôle médical). In this case, the prior estimate must be sent to the CNS, as it requires the authorisation of the Medical Board of Social Security (CMSS). Usually, your dentist in Luxembourg will send the estimate to the CNS, or will ask you to send it.

First, the CNS carries out administrative checks, then submits the request to the CMSS for medical assessment. If the CMSS gives a favourable opinion, the CNS will send you an authorisation on the estimate itself. This authorisation specifies the exact amount that the CNS will reimburse.

At the end of the treatment, you send the CNS the paid and receipted invoice with the authorisation on the estimate to request reimbursement.

Right to a new dental prosthesis

Fixed dentures

These dentures are renewed every 12 years.

Removable dentures

These dentures are renewed every 5 years.

However, the Medical Board of Social Security (CMSS) may reduce the renewal period in the following cases:

• maxillofacial bone fracture;
• neoplasia affecting the maxillo-buccal region;
• very high-dose biphosphonate treatment;
• dental prosthetic treatment before the age of 17.

Limitations

Temporary dental prostheses

These prostheses are only covered if they are declared functionally essential by the Medical Board of Social Security (CMSS) and if the masticatory coefficient is less than fifty per cent.

Relining

Relining is the reshaping of the resin plate or skeleton to adapt the prosthesis to the mouth.

The total (DA75) or partial (DA74) relining of a removable denture is covered once per denture and per calendar year starting with the second relining.

Reimbursement