Recovery of Dental Prophylaxis: What You Need to Know

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Summary

Oral health is a vital element of overall well-being. Good hygiene helps to prevent diseases and avoid heavy long-term treatments. Dental prophylaxis, which includes various preventive measures, plays a key role in this process. However, these treatments incur costs, and it is important to know to what extent they are reimbursed by Health Insurance and mutual insurance companies. This article guides you through the different options of financial coverage of prophylactic care.

🦷 What is dental prophylaxis?

Dental prophylaxis is a preventive approach aimed at maintaining oral health by reducing risks of diseases such as cavities, gingivitis, and periodontal infections. It relies on a set of regular care and good hygiene practices, provided by a dentist or performed at home.

The main objectives of dental prophylaxis are:

• Eliminate dental plaque and tartar to prevent bacteria buildup responsible for oral diseases.
• Reinforce tooth enamel through fluoride application, reducing demineralization and cavity formation.
• Protect high-risk areas by sealing molar fissures, especially vulnerable to cavities.
• Educate patients on good oral hygiene habits, including brushing, flossing, and using appropriate mouthwashes.

🦷 Main acts of dental prophylaxis

Here are the essential treatments that are part of dental prophylaxis:

• Complete scaling: removes plaque and tartar accumulated on teeth and under gums. A scaling every six months is recommended.
• Fluoride application: helps strengthen enamel and prevent cavities, especially in children and at-risk adults.
• Fissure sealing: involves covering molar fissures with a protective resin to prevent bacteria from settling.
• Root surface therapy: a treatment for those with advanced periodontal disease, allowing deep cleaning of the roots.
• Tooth polishing: smooths tooth surfaces after scaling to delay plaque reformation.

🦷 Why is it essential?

Without dental prophylaxis, bacteria present in the mouth can cause diseases such as:

• Cavities: caused by bacterial acid attack on enamel.
• Gingivitis: gum inflammation due to plaque buildup.
• Periodontitis: more serious infections affecting supporting tissues, potentially leading to tooth loss.
• Bad breath: often caused by poor oral hygiene or bacterial infections.

💡 Tip: For effective prevention, it is recommended to see a dentist at least once a year and adopt a strict hygiene routine with brushing at least twice a day and using dental floss.

The dental prophylaxis includes all preventive measures aimed at avoiding the appearance of oral diseases. It involves several essential acts:

• Complete scaling: to eliminate plaque.
• Fluoride application: to strengthen tooth enamel.
• Fissure sealing: to prevent dental cavities.
• Personalized advice: to adopt better oral hygiene.

These treatments help to reduce risks of cavities, gingivitis, and periodontal diseases.

💰 Reimbursement by the Health Insurance

Reimbursement of dental prophylaxis by Health Insurance depends on several criteria, including patient’s age, the procedure performed, and coverage modalities. Some preventive acts are partially reimbursed, while others are not covered at all.

The purpose of these reimbursements is to promote a good oral hygiene and prevent dental diseases, especially among young patients. However, preventive treatments are not always well covered, leading patients to seek additional supplementary insurance to limit costs.

📊 Reimbursement details

⚠️ Important to know

• Scaling: It is recommended at least once a year and is partially reimbursed. However, for additional treatments (polishing, gum treatment), additional costs may apply.
• Fissure sealing: Very effective against cavities, it is covered only up to 14 years old and only for permanent molars. After that age, it becomes entirely paid by the patient.
• Fluoride application: Considered a non-priority preventive treatment, it is not reimbursed by the Health Insurance, although it is strongly recommended to strengthen enamel.

💡 Tip: To limit costs, it is recommended to see a certified dentist, check your mutual insurance coverage, and request an estimate before any non-reimbursed procedure.

The Health Insurance covers some preventive dental treatments, but modalities vary depending on the procedures performed.

⚠️ Important to know: Outside this age range, fissure sealing is at free cost and not reimbursed.

🏦 Reimbursement by mutual insurance companies

Health mutuals play a key role in additional coverage of dental prophylaxis treatments. Depending on the contract subscribed, they can cover partially or fully the costs remaining after the intervention of the Health Insurance.

📊 Different coverage levels of mutual insurance

🏥 Which acts can be reimbursed by a mutual insurance?

• Complete scaling: Usually covered in addition to the reimbursement from the Health Insurance.
• Fissure sealing: Some mutuals may reimburse beyond 14 years old, depending on the coverage options.
• Fluoride application: Not covered by Social Security, but may be reimbursed by some mutuals.
• Preventive consultations: Some plans include an annual allowance for preventive care not covered by the Health Insurance.

🔍 How to choose your mutual insurance wisely?

Before subscribing, it is recommended to compare offers considering the following criteria:

1. The level of dental coverage: Check if the mutual reimburse preventive acts not covered by the Social Security.
2. Reimbursement caps: Some mutuals impose annual maximum amounts for dental care.
3. Waiting periods: Some plans require a delay before the reimbursement of dental treatments.
4. Prevention packages: Check if your mutual offers a specific coverage for preventive care.

💡 Tip: Take the time to review your mutual contract and adjust your coverage according to your specific dental needs to avoid unexpected expenses.

The health mutuals offer additional coverage, depending on the subscribed contract.