The procedures in question are the removal of cavities, the placement of a sealing material, partial root canal treatment, and the fitting of a prefabricated crown on baby teeth. The French National Health Insurance (Assurance Maladie) had been asked by the national health insurance system to assess the benefits of reimbursing these procedures.
In France, "approximately 301% of 6-year-old children (up to 501% in disadvantaged areas) and 251% of adults aged 35-44 have at least one untreated cavity, with unequal access to care depending on age, territory and socio-economic level," exposes the independent health authority.
Untreated cavities: pain, infections and complications
Besides prolonged pain and local infections, untreated cavities can cause complications in cases of chronic diseases (cardiovascular disease, diabetes, cancer, etc.). And tooth loss, in addition to being a "Aesthetic and social handicap" can eventually lead to nutritional deficiencies.
Some people – those with disabilities or elderly people living in institutions and having difficulty getting around, pregnant women, very young children – are "particularly vulnerable". However, at each stage of a cavity, treatment is possible, sometimes allowing the tooth to be preserved in the long term.
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The HAS, whose opinions are generally followed by the Ministry of Health, is therefore in favor of reimbursement by Health Insurance for the removal of caries via manual instruments – but not rotary ones like the bur – followed by the filling of the cavity with an adhesive dental material.
It also approves the application of a sealant to a small, incipient cavity, and the removal of part of the pulp from a decayed tooth, accompanied by the application of a protective and regenerative biomaterial.
Avoiding problems from a young age
The HAS also recommends reimbursement for the fitting of a prefabricated adaptable crown on a baby tooth, particularly with a bonding technique.
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While the preventive approach is gradually gaining ground in France, the goal in oral health is to avoid problems from a young age, and then to quickly halt the progression of cavities through minimally invasive and conservative interventions. The hope is also to limit, in the long term, the need for more traumatic and costly treatments (dentures and implants).
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