These frequently asked questions represent some of the common queries to both SADA and DPL membership departments. If the answer is not here then please contact SADA or DPL directly and we will be pleased to answer your questions.
1. How do I know if I need to pay a maxillofacial subscription?
Maxillofacial surgery is all surgery that cannot be classified as dento-alveolar surgery. Dento-alveolar surgery involves surgery to intra-oral tissues, teeth and tooth carrying bones ie mandible and maxilla only. This includes procedures such as:
• Exodontia including wisdom teeth removal
• Apicectomies
• Minor cyst removal
• Dental cyst removal
• Placement of dental implants (excluding sinus lifts or bone augmentation which involves the floor of the sinus, or extra-oral bone harvesting, all of which are regarded as maxillofacial procedures)
• Minor pre-prosthetic surgery.
Maxillofacial procedures include:
• Extra oral procedures to the face, head and neck
• Excision of maxilla
• Hemi-maxillectomy
• Osteotomies
• Prosthetic replacement of temporo-mandibular joints including arthroplasty
• Reconstruction with axial and microvascular flaps
• Blocked section
• Surgical treatment of thyroid and parathyroid glands
• Surgery involving the orbital complex
• Rhinoplasty (other than immediate trauma after care)
• Facial cosmetic surgery including face lifts, dermabrassion, otoplasty, blethroplasty and liposuction.
Cosmetic surgery that does not form part of the training programme for maxillofacial surgery does not fall within the scope of maxillofacial membership grades.
2. What grade do I choose if I wish to carry out a treatment involving Botox for cosmetic purposes?
It is recognised that many dentists carry out some cosmetic and adjunctive procedures. There is an increasing use of Botox and other types of cosmetic treatments. There is a debate at present as to whether this constitutes the practise of dentistry or not. However Dental Protection's view is that dentists are best placed to provide these procedures provided they have had suitable training.
These techniques are almost entirely used on an elective basis. The patients who request such treatment tend to be a self-selecting group with high and sometimes unrealistic aesthetic expectations. Any of these factors alone gives these techniques an above average potential for litigation however taken together they represent an increased risk. This is why Dental Protection charge a separate rate for dentists undertaking these procedures. The grade is DC1.
3. Is the DC1 an additional subscription?
No. DC1 covers all treatments but would not extend to formal arrangements to treat overseas residents.
4. What information is required by Dental Protection if applying for DC1 membership?
We require details in writing of the curriculum of the training including experience of the procedures carried out. This includes the source of training and over what period the training was obtained in addition to copies of certificates of any training undertaken.
5. Will DPL cover alternative cosmetic treatment techniques?
DPL does not currently indemnify South African members for treatments other than those set out in the section "cosmetic and adjunctive procedures". This may change in due course if more of the profession are carrying out techniques and they become part of mainstream dental practice however the number of practitioners carrying out such procedures at the moment is limited and in fairness to the membership as a whole we feel it is not appropriate to indemnify other cosmetic procedures at this stage.
6. I am placing some implants and intend to undertake some bone harvesting. Should I pay a maxillofacial subscription?
If the bone is harvested intra-orally and with an intra-oral approach then this falls within the context of dento-alveolar surgery. If the bone is taken from elsewhere in the body or requires an extra-oral approach then this is a maxillofacial procedure.
7. I am treating a patient who has moved abroad and returns to South Africa for dental treatment. Do I need to pay the YDU grade?
No. The YDU grade is only necessary if you have entered into a specific arrangement (formal or informal) to treat overseas patients. It is accepted that many patients move abroad for a number of years and may wish to continue to be treated by the practitioner in whom they have confidence back in South Africa. The normal practitioner grades apply in these circumstances.
Please note that this does not extend to assistance in USA or Canadian jurisdictions.
8. I have an arrangement with local hotels whereby visiting tourists are referred to me in the case of a dental emergency. Do I need the YDU grade?
No. The YDU grade is not required for emergency treatment of patients. It would however be required if there were any further arrangement to provide elective treatment for such patients whilst they were in South Africa
9. I have an arrangement with the local Embassy to treat staff. Do I need the YDU grade?
You do not need YDU grade if you are treating residents of Southern Africa. If, however, you are treating non-resident overseas nationals by such an arrangement then this increases the possibility of an action in the country of origin. Such an arrangement would be taken as active soliciting of patients and therefore constitute a formal arrangement. The YDU grade would be required.
10. If I am in the YDU grade am I covered for cosmetic and adjunctive procedures?
Yes. The YDU grade includes cosmetic and adjunctive procedures for South African residents only. It does not extend to formal arrangements for cosmetic procedures to non-residents. Please refer to our information sheet on cosmetic and adjunctive procedures for guidance on the documentation required if carrying out cosmetic procedures.
11. What is a resident?
A resident is someone who holds the right of permanent or temporary residency in South Africa and is permitted to work.
12. A UK citizen has approached me. They are visiting friends in South Africa but would like their dental treatment carried out whilst here. Do I need the YDU grade?
No. As long as you have not actively solicited or entered into any arrangement to attract such patients then the YDU grade is not required.
13. I want to work in the UK as a locum - what membership grade do I need?
The cost of indemnity in the UK is over 10 times that of a South African subscription and therefore a further subscription would be required. If you are moving to the UK for a single locum period then it is possible to do this with a temporary membership.
If you intend to provide locums on a number of occasions over a year then it may be better to take out a UK membership which may cover you for your work in South Africa. Please contact SADA or the MPS Membership Department to discuss the best way to meet your membership needs.
14. Is my Dental Assistant covered?
Dental Protection allows three Dental Assistants to be included within a dentist's membership package. The employer is normally vicariously responsible for the acts and omissions of an employee. Dental Protection believes that each registered employee should hold their own indemnity when they are treating patients however this is not the case with Dental Assistants. Dental Protection will include the vicarious liability for such Assistants within the benefits of membership of the dentist.
15. What happens if a claim is brought under US or Canadian Law?
MPS does not provide indemnity to health professionals working in the USA and Canada. Other than for Good Samaritan acts, MPS is unlikely to exercise its discretion to assist with claims brought under US and Canadian law.
Typically, legal proceedings are started in the country where the alleged negligence occurred, which is usually the country in which the patient was treated. It is highly unlikely that a patient would be allowed to initiate proceedings in Canada or the USA for harm incurred in another country. In more than 100 years, MPS has never dealt with a case where the US or Canadian courts have successfully imposed judgment on a member practising in another country.
Although courts in the USA or Canada are reluctant to claim jurisdiction over acts committed in other countries, it is a theoretical possibility. If a court in one of those territories did try to impose its judgment on an MPS member in a country outside of its jurisdiction, MPS would ordinarily support that member in strongly opposing such an attempt. In the unlikely event that a US or Canadian court succeeded in imposing its judgment in another country, MPS is likely to limit any indemnity to the level of damages that would have been awarded by UK courts.
Accordingly, you may provide professional services to all patients in the country in which you are registered to practise, safe in the knowledge that you can apply for assistance should any legal proceedings ensue in the country in which you provided care.
You should also remember that the benefits of membership are available to you if you are involved in a claim or other proceedings arising from a Good Samaritan act anywhere in the world. In the unlikely event that legal proceedings follow, you would be entitled to apply for assistance no matter in which country legal proceedings are commenced.