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Dental Implants
The stance adopted by certain other indemnity providers in relation to implants leads to a regular stream of enquiries being made to our Membership department.
Implants are used not only in prosthodontics and restorative dentistry but also in orthodontics, where mini implants are sometimes used to provide anchorage. All the above forms of implants are covered by this position statement.
For subscription purposes, Dental Protection defines a dento-alveolar procedure as one which involves the intra-oral tissues, teeth and tooth-carrying bones i.e. mandible and maxilla only. Any implant placed and wholly contained within these tissues - with or without bone grafting which is also contained within these tissues - is considered to be a dento-alveolar procedure and is generally included within our standard subscription rates.
There are three main exceptions to this, where additional subscriptions might apply:
1. Where surgical dento-alveolar procedures (including, but not restricted to the placement of implants) are occupying more than 10 hours per week on average (more than 500 hours per subscription year), whether or not a member's total clinical activity exceeds this - Grade OMD applies. Members should take note that this cumulative threshold relates to all kinds of dento-alveolar surgical procedure, including third molar removal, for example. Refer to the subscription section of our website for the precise details and for the rate which currently applies .
2. Where any part of the procedure or associated procedures (such as bone grafting) includes or extends to tissues other than those defined above, Dental Protection defines such procedures as "Group 1 Maxillofacial procedures". This includes any kind of sinus lift and/or bone harvesting from outside the dento-alveolar tissues.
The correct membership grade (and hence, subscription level) is then determined by two factors:
a) Firstly, the number of hours per year that the member is undertaking procedures of this nature.
b) the total number of hours per year that the member is working in private (ie, non-employer indemnified) practice.
A choice of several categories is available to cater for members who do (or do not) spend any part of their clinical time working in an employer-indemnified position.
Refer to subscription section of our website for details of the available categories, and for the rates which currently apply.
3. Where an individual dentist is felt to represent a disproportionate risk for the mutual fund, by virtue of his/her own risk profile (involvement in implant dentistry might be one of many considerations within this evaluation, but a significant history of implant-related cases would be more relevant), that member may be invited to join the Active (managed) Phase of Dental Protection's Risk Partnership (RPP) programme.
Additional subscriptions are then payable in one of 10 membership grades according to the assessed level of risk, and a structured and targeted risk management support programme is provided with the aim of reducing the risk and allowing the member to return to normal subscription grades wherever possible.
Dental Protection's view is that that this supportive, member-by-member approach is more equitable than simply loading the subscriptions of all dentists who are involved in implant dentistry, many of whom are well trained, highly competent and extensively involved in these procedures with no problems.
Training
Dental Protection is not the arbiter of clinical opinion, nor of the adequacy of training courses in this or any other field. But as with all procedures, members should ensure that they are suitably trained and experienced before undertaking these procedures without supervision. Dental Protection strongly advocates the use of mentoring as a key part of a structured implant training programme. Members are referred to our separate Position Statement on this subject.
Placing implants outside the UK
When setting subscription rates, there is no cross-subsidy between medical and dental rates, nor between members working in different countries. Subscription rates in each country are set on expert actuarial advice and they aim to be fair and equitable across the whole membership. This position statement applies to the UK only. In some international jurisdictions where Dental Protection membership is available, a disproportionate share of the total case-related expenditure is incurred in connection with dental implants. In these countries (for example, Hong Kong, Israel and some countries within the Caribbean region) additional subscription rates are payable by any clinicians who have any level of involvement in implant dentistry.
Reviewing our rates and categories
Dental Protection's membership categories are continually under evaluation and the subscription rates are reviewed in April of each year. If there is any future change to our policies in relation to implant dentistry, it will be reflected in an updated version of this position statement in due course.
To see a list of frequently asked questions, please click here.
Last revised August 2009