When planning a travel to a different country, one cannot help but ask oneself, how does their health system work? And what treatments they share with my country and which do not? Given that dentistry is one of the least, let’s say, likable professionals to attend to in regards to health problems, it is completely normal to be reluctant to go to a dentist outside your home-country. That is why, in this article, I will try my best to inform you about medical treatments in general, what the procedures to follow are and buccal treatments and dentists in more detail.
Unless one is in a state that requires immediate action, you need to register with a doctor (for the sake of this article I will include dentists in the doctor category unless I specify otherwise. This is to make the reading more fluid and not stopping myself each time I say doctor to clarify that I am also including dentists – Geoallo dentiste urgence) as your médecin traitant. The process of registration commences when you join the health system, either through a local Caisse Primaire d’Assurance Maladie (CPAM) if you are ‘non-active’, or as part of the process of business registration if you are to become self-employed. You will be given receipt by the doctor when you pay for medical services each time you have a pay him a visit, until you obtain your health insurance card. The doctor will also issue a prescription that should be taken to a chemist in order to obtain whatever medicine one might require. The chemist should attach any extra information like the cost of the medicine by using sticky labels. Should it happen that the chemist does not do it you will find the labels on the medicine containers and you will have to do it yourself. Also, you will need to take the receipt, the prescription and your attestation, meaning the European Health Insurance Card details, to your local CPAM for reimbursement. You will be asked to sign the receipt.
If you need to see a consultant then your doctor will provide you with a letter of referral. You are likely to find that French general practitioners do not hesitate to refer you on for a more specialist assessment if your circumstances are more than just a routine. Your doctor may recommend a suitable consultant, however you do not have to accept their recommendation if for some reason that’s that you wish. Whether you looked that recommendation up and it is not someone you like, or you know somebody that can attend to you, the choice is completely yours.
Some consultants may be working in their own office, others in a private or public clinic. Independently from where you see your doctor, the cost will still be the same, or at least it will not be affected by the workplace of the doctor. This is due to an inexistence of difference between the private and public health sectors, as it happens in the UK. That part of the health system that is truly private is very small.
You are normally expected to make your own appointment with the consultant, unless you require assistance, in which case the doctor is allowed to make the appointment for you. The consultant then will advise you of the results of your examination, which for obvious reasons will be communicated to your doctor as well. Depending on your results, you may want or have the need to make a further appointment in order to discuss those results with your doctor. There are two circumstances where you are allowed to directly see some specific consultants without the need of passing through a doctor and with no financial repercussions. This happens when you need to see a gynaecologist or ophthalmologist, and if you are 26 years old or below, you are also allowed to see the psychiatrist directly, without any monetary penalty. The second occasion is when you find yourself in an emergency, for example, if you are away from home, and are taken seriously ill.
Since 2008, chemists have been permitted to sell some medicines without a prescription and it is estimated that there are around 500 medicines authorised for this kind of sale. With the price of prescription medicines strictly controlled and with the more widespread obligation to use lower margin generic alternatives, chemists are inevitably using sales from over the counter medicines to make up for lost revenues.
At least for the time being, you will not be able to purchase over the counter medicines anywhere else other than at a chemist, given that they hold a monopoly over the distribution of medicines. Though it might look like it, it is not inherently something bad, as it ensures that all areas of the country have a local service. Supermarkets have been asking for years to be granted permission to sell non-reimbursable medicines, in other words, non-prescription medicines, assisted by the French Competition Authority in this campaign. Despite their efforts, the government is still reluctant to accept any change; however some supermarkets nowadays have a chemist inside some of their building, as a way of dealing with the regulation. Also since January 2013 it has been possible to purchase over the counter medicines on French websites, but only chemist are authorised to sell over the internet, with notable lower prices.
Now, let talk a bit about dental care in France, some basic rules and the treatments they do. Dental services in France operate on a very similar basis to that of the general medical services; however, unlike these services, you do not have to be referred by your family doctor in order to receive treatment without financial penalty. Hence, you are completely allowed to see any other dentist you like, without the need to go to the same one for all of your treatments. Nevertheless, as it is the case in many other European countries there is a shortage of dentist in many parts of the country, so there might not be much of a choice. Most of them work within the framework of the public health system, so your general dental treatment is reimbursed in very much the same manner as that of other medical specialists. In other words, you will receive a reimbursement from the social security system at 70% of official rates and your voluntary health insurance policy will pay for balance.
Some of the general treatments like fillings, extractions and treatment for gum diseases are covered by the social security and voluntary health insurance systems. The level of the charges will depend on the type of treatment, even though they are not excessive by the standards of many countries.
Here is a list of buccal treatments that you can get in France:
Bonding is a treatment which is a restorative procedure that uses tooth enamel-coloured composite resin (in other words, plastic) to repair teeth that have decayed, chipped, fractured or discoloured. Tooth gaps can also be closed, unlike veneers, which require laboratory work, whereas the bonding is done in the dental office.
There is also the treatment of dental braces, which is a device used to correct the alignment of teeth and bite-related problems, such as the likes of underbite and overbite. Braces straighten teeth by exerting steady pressure on the teeth.
Bridges and Implants are two ways to replace a missing tooth or teeth. Bridges are false teeth anchored in place by its neighbouring teeth. It consists of two crowns on the anchoring teeth along with the false tooth in the centre. Dental implants are artificial roots used to support replacement teeth.
Periodontal or gum disease is an infection that affects the gums and jaw bone, which can lead to a loss of gum and teeth. There are two major stages, gingivitis and periodontitis, gingivitis being the milder and reversible form. Periodontal disease is often more severe and, in some cases, gum surgery will be required to reverse the effects of such disease.
Oral cancer examination is, as its name indicates, an examination of the whole buccal cavity in order to determinate if there are any signals of oral cancer. This disease starts in the cells of the mouth, tongue or throat. Oral cancer screening is usually a routinely part of a dental examination. The examination consists in your dentist looking for lumps or irregular tissue changes in your neck, head, face and inside your mouth. Your dentist will also look for sores of discoloured tissue in your mouth.
Root Canals treat diseases or abscessed teeth. Once a tooth is injured, cracked or decayed, it is necessary to open the tooth and clean out the infected tissue in the centre. Then the doctor proceeds to fill the spaces that remains and seals the opening.
Dental Sealants, usually applied to the chewing surface of the teeth, act as a barrier against decay-causing bacteria. More often than not, the sealants are applied to the back teeth, for an instance, premolars and molars.
Teeth naturally darken with age; however staining may be caused by various foods and beverages such as coffee, tea and berries, and also some drugs such as tetracycline, smoking or a trauma to a tooth. In order to prevent this, a dentist will apply the teeth whitening treatment, which can be done by the dentist at his own office or by you at home.
Veneers are strong, thin pieces of ceramic or resin material that are bonded to the teeth and are used in order to repair teeth, whether from being chipped, decayed or stained. Depending in the situations, in some cases they might even be able to help in closing gaps between teeth.
Crowns are dental restorations that are used to protect teeth which are in a broken, damaged or cracked state. Dental crowns, which can also be called caps, are set over the entire part of the tooth that lies above the gum line.
In order to replace lost teeth, dentists make use of dentures, which are essentially prosthetics devices that do precisely that. One can find two types of dentures, partial and full. This last one is more commonly referred to as ‘false teeth’.
Should a dentist need to repair a teeth compromised by cavities or trauma, he will restore them with dental fillings and repairs.
According to the French Health System, all children are entitled to having a free dentist check every three years, between the ages of 6, 9, 12, 15 and 18, which is a service called le bilan bucco-dentarie (BBD). If, after this checking, a kid requires any treatment, most of this work will end up being free of charge, with the few exceptions being prostheses and orthodontics, meaning braces.
To be able to get the 100% reimbursement, the treatment must have been started within nine months of the checking that determined the need for that treatment. You will be asked to pay the treatment when done, but it will be reimbursed by your caisse. You will be advised by the Caisse Primaire d’Assurance Maladie one month previous to your child’s birthday for their entitlement to a free dental checking, which must be carried out within six months after the child’s birthday. This letter will contain tags and stickers that you should hand over to the dentist in order for him to recover his fee.
Prostheses and orthodontics, like teeth and jaw irregularities treatments, more often than not have no reimbursement and dentists are entitled to impose their own charges. This is due to the official rates for general treatment is considered to be so low on dentists that they see this as their only way of making some profits. Dentists are only entitled to apply reasonable rates for such treatments; however the enforcement of this norm is weak. The dentist is forced by law to provide you with detailed estimates of the proposed treatment. It is worth noting that, if your situation puts you in a situation where you will have to live with a metal crown for the rest of your life, charges are more reasonable.