Implants and dental prostheses finally reimbursed? The High Health Authority issues a positive opinion

According to the World Health Organization, complete edentulism is expected to affect 30% of the world's population by 2030. This is due to the increasing life expectancy despite better oral and dental prevention.

As for single edentulism, it is common since in 2001, a third of people aged 18 to 24 had a missing tooth, other than a wisdom tooth. And this figure increases with age.

A functional, aesthetic and social disability

In this context, the question arises of the management of edentulism while the cost of dental care is a barrier for many people. According to a report from the Department of Research, Studies, Evaluation and Statistics (DREES), published in 2022, 47% of people who give up dental care do so for financial reasons. Yet, “the loss of one, or even all, of the teeth, following loosening or infections, constitutes a functional, aesthetic and social handicap with consequences on health (nutritional deficiencies for example)”.

Health Insurance has therefore contacted the High Authority for Health (HAS) in order to assess the relevance of reimbursement for:

• a complete removable implant-retained prosthesis (PACIR) in the context of complete edentulism;
• a single supra-implant fixed prosthesis (PFUSI) for single edentulism.

In a press release dated November 6, the HAS issued a positive opinion for the reimbursement of these two devices. According to the health authority, PACIR “improves the stability of removable prostheses (commonly called “dentures”) and the patient’s quality of life (comfort, chewing, social life, etc.)”. As for the PFUSI, it is a much less invasive device than the traditional bridge which requires the alteration of adjacent teeth to fix it.

A care pathway also supervised

For HAS, this care must include a strictly supervised care pathway for patients with:

• a pre-therapeutic phase: it must evaluate the treatments in consultation with the patient. Planning, development of treatment and essential prerequisites, particularly regarding oral sanitation.
• the therapeutic phase: this includes the placement of implants and prosthesis, and management of complications.
• the postoperative phase: it includes professional maintenance and treatment methods for peri-implant diseases such as mucositis (inflammation of the mucosa) and peri-implantitis (loosening of the implant of bacterial origin).

In France, implant-prosthetic care is the most used therapeutic solution, with nearly a million dental implants placed in 2023. Three categories of health professionals can care for patients: dental surgeons, oral surgeons and doctors specializing in maxillofacial surgery and stomatology.