Dental cover continues to be eroded despite well-above-inflation medical aid premium increases, the South African Dental Association (SADA) has noted.

Responding to increases in medical aid premiums of between 10 and 12% for 2017, SADA points out that while premiums were increasing significantly, payments to dentists continued to decrease, reflecting the “low priority” medical aid funders paid to dentistry.

This is despite the fact that oral health is essential to general health, and that dentists can often detect more serious health problems early. Many studies show an as-yet-unexplained association between gum disease and several serious health conditions, including diabetes and heart disease.

While brushing twice a day and flossing daily helps maintain oral health, the only surefire way to ensure healthy teeth and gums are through regular visits to a dentist.

Despite this, SADA notes that dentists only received 2.34% of the total funds paid out to health
Care providers in 2015. This was down from 2.42% in 2014.
“With the exception of dental procedures covered under Prescribed Minimum Benefit (PMB) limits, dentistry is considered low priority to funders,” SADA notes.

SADA says average increases in dental tariffs year on year has been between 5 and 6%.

“From 2014 to 2015, the total funds paid out to dentists increased by 5.44%. This shows that there has been no growth in the benefit structures available for dentistry,” the association notes.

SADA notes that dental professionals “are under pressure to deliver high quality service in keeping with international standards whilst struggling to meet practice overhead expenses in light of consistently declining medical aid benefits”.

Says KC Makhubele, CEO of SADA: “Oral diseases qualify as major public health problems owing to their high prevalence and incidence. There is a synergistic relationship between oral health and overall wellness. The recognition of well-known and established signs and symptoms of oral diseases may assist in the early diagnosis and prompt treatment of some systemic diseases and disorders. Dentists and dental specialists play a fundamental role in the oral health of the nation and play a crucial role in the early diagnosis of many acute and chronic conditions, as well as the prevention. We are therefore very concerned that medical aid funders appear to view oral health as such a low priority.”

He urged medical aids to reconsider the dental benefits they provide.

“While most people see oral health only as having a beautiful smile and minty-fresh breath, research has shown that oral health is essential to general health. Medical aids need to seriously take into account that improving the country’s oral health will contribute to the improvement of health overall in South Africa,” says Makhubele.

Notes:

SADA represents the vast majority of active dentists in the private and public sectors in South Africa. The Association is regarded as the voice of dentistry in Southern Africa and is the most relied on body regarding all aspects of dental practice in the region.