Dental prostheses

Types of prostheses

Removable dental prostheses

There are two types of dental prostheses according to the method of implantation:

  • the hybrid fixed removable prosthesis (partial or complete) and
  • the fixed prosthesis.

Removable dental prostheses

The choice of a fixed dental prosthesis depends on the number of teeth to be replaced and on the kinds of material being used.

Partial prostheses are held in place by hooks or attachments.

Complete prostheses work on the principle of juxtaposing the two identical surfaces: the saliva between gum and plate creates a kind of “suction effect”.

Fixed prosthesis (crowns, bridges ...)

Fixed prosthesis
  • A crown reinforces an unstable filling. A crown may also serve to anchor a bridge intended to replace several teeth;
  • A bridge consists of crowned abutment teeth and elements replacing the teeth which are missing;
  • A false tooth completely replaces the visible part of the tooth and is fixed into the root.

In certain cases, the dentist first inserts a shaped metallic piece called the inlay core. He then fastens a crown, which holds everything together.

 

Conditions of coverage

Authorisation and quotation prior to treatment

Some dental prosthetic treatments need an authorisation by the Medical Board of the Social Security.

Treatments subject to authorisation are marked by the abreviation ACM (Autorisation du Contrôle médical de la sécurité sociale requise - Authorisation by the Medical Board of the Social Security required).

In general they are also marked with the abreviation DSD (dépassement sur devis - quotation exceeded).

To be subject to coverage, a written quotation by the dentist prior to treatment must be obtained for these treatments.

The quotation should be sent to the CNS or to the competent public sector fund which will hand it to the Medical Board of the Social Security for agreement. Following positive opinion from the Medical Board of the Social Security, the competent health fund informs the insured person by return of post of the refundable amount, indicated on the quotation.

In case of dental prosthetic treatments marked by the abreviation DSD (Dépassement sur devis - quotation exceeded), dentists are indeed free to set the price for such procedures “with tact and moderation” in relation to fixed dentures where this price exceeds the maximum amount reimbursed by the health insurance, as determined by the nomenclature. 

In any case, dentists are required to notify the insured person of this in advance through a detailed estimate.

As a general rule, the quotation must be presented to the competent health fund only when the treatment is marked by the abreviations DSD and ACM, therefore requiring an authorisation by the Medical Board of the Social Security.

Renewal intervals

Fixed prosthesis (crowns, bridges ...)

Fixed prostheses (DB21 - DB51) are only replaced after twelve years.

Removable dental prosthesis

Removable prostheses (DA11 - DA45) are only replaced every five years.

Notwithstanding the above, the renewal times can be reduced by the Medical Board of the Social Security in the following cases:

  • maxillofacial bone fracture;
  • neoplasia affecting the oral maxillofacial region;
  • treatment with bisphosphonates in very high dosages;
  • dental prosthetic treatment before the age of 17.

Limitations

Provisional dental prostheses

Provisional dental prostheses are covered only if they are deemed by the medical board to be indispensable from the point of view of functionality and if the masticatory coefficient is below 50%.

Rebasing

Prosthesis rebasing is the reshaping of the resin-made or skeletal plate to adapt the removable prosthesis to the mouth.

The total (DA75) or partial prosthesis rebasing (DA74) is covered once within a period of 365 days following the second rebasing.

 

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