Dental Treatment

Types of dental providers

There are many different healthcare providers who provide dental and dental-related services.

Here are the different names and a description of each healthcare professional’s responsibilities.

TERMINOLOGY

DESCRIPTION

Dentist

Dentists generally deal with the normal maintenance of oral hygiene, for example fillings, extractions and root canal treatment.

Prosthodontist

Prosthodontists specialise in replacing absent teeth and tooth structures as well as the restoration of natural teeth. This includes crowns, bridges and dentures.

Periodontist

Periodontists specialise in the diagnosis, prevention and treatment of gum disease, for example root planning, flap surgery and gingivectomies.

Maxillofacial and oral surgeon

Maxillofacial and oral surgeons specialise in the treatment of structures in and around the mouth, for example extraction of impacted teeth, orthognathic surgery and the repair of fractures to the jaw and other facial bones.

Orthodontist

Orthodontists correct and preserve the ideal position of the teeth and dentofacial structures using braces, retainers and other appliances.

Oral pathologist

Oral pathologists deal with the diagnosis and study of the causes and effects of diseases of the oral cavity.

Dental therapist

Dental therapists (also known as oral hygienists) work with a dental practitioner doing oral examinations, X-rays, scaling and polishing, oral hygiene instruction, and fluoride treatment.

Dental technician

Dental technicians do not see patients directly. Working from models of the patient’s mouth, they make appliances like dentures, crowns and orthodontic plates after referral from a dental practitioner.

Severe Dental and Oral Surgery Benefit

We will pay certain maxillofacial procedures from the Severe Dental and Oral Surgery Benefit, which covers a defined list of procedures - with no deductibles and no overall limits - including:

  • Severe life-threatening infections
  • Internal temporomandibular (TM) joint surgical procedures
  • Cancer-related surgery
  • Cleft palate repairs

This benefit is subject to preauthorisation and the treatment must meet the Scheme's treatment guidelines and managed-care criteria. We cover approved procedures in full if you use a specialist with whom we have a payment arrangement - you may have a co-payment (an amount you have to pay yourself) if you use other specialists. Click here to see the cover for each plan.

All other dental treatment in hospital (excluding severe oral and dental surgery)

You do not need preauthorisation for in-hospital dental treatment, other than those covered from the Severe Dental and Oral Surgery Benefit. You need to pay an amount upfront (deductible) to the hospital or day clinic for dental treatment done in hospital.

This applies to all plans except the Essential Smart and KeyCare plans.

This upfront amount applies to all plans, except for the Essential Smart and KeyCare plans

 

Hospital

Day Clinic

Member younger than 13 years

R2 400

R1 100

Member 13 years or older

R6 200

R4 000

Click here to see the in-hospital dental treatment cover for each plan.

Basic Dental Treatment

There is no overall limit for basic dental treatment on our plans. Cover depends on the plan you choose. We pay for basic dental treatment done in the dentist’s or dental specialist’s rooms from the available day-to-day benefits at 100% of the Discovery Health Rate. If you don’t have money available in your Medical Savings Account, where applicable, you must pay the dentist’s and dental specialist’s account from your pocket.

Dental cover across our plans

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