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Dentistry in rheumatic diseases

Rheumatic disease can lead to increased expenses for dental treatment. Certain diseases involve coverage of expenses

Refund of dental treatment expenses (dental treatment) for diseases rare in Norway

Refund schemes from HELFO (NAV)

  • Having a rare disease that affects teeth and gums can provide a basis for reimbursement
  • Can also apply to dry mouth and tooth damage caused by Sjögren's syndrome and other chronic, autoimmune, rheumatic diseases (see bottom section on this page) although these are not defined as “rare”.
  • Possible tooth damage related to drugs usually does not provide a basis for reimbursement of dental care expenses

Definition of rare disease

Rare medical conditions are defined as single diagnoses occurring in numbers up to one per 10.000 individual or up to 500 persons with the disease in Norway. It is also required that the rare medical condition must be long lasting. The list (SMT list) is further divided into two: A list and B list (follow the link here, click on the SMT list that leads to Excel file with all diagnoses in the A and B lists).

  • You need a doctor's confirmation of the diagnosis
  • If a person has a diagnosis listed on the A list, the conditions for benefit for the required dental treatment are fulfilled
  • Diagnoses covered by the B list presuppose that the dentist in each case assesses whether the condition has led to increased dental needs
  • Symptoms of dry mouth: Please refer to the last section on this page

A list (an extract that includes rheumatic diseases)

Rare rheumatic (and related) diseases that receive dental expenses refunded (as of July 2017) ("A list") (reference: Helfo 2016)

B list (an extract that includes rheumatic diseases)

It is necessary that the dentist in each case assesses whether the disease has led to increased need for dental treatment

  •  You need a doctor's confirmation of the diagnosis and dry mouth (for example, by measuring saliva production (sialometry, saliva measurement) that can be done by a specialist in rheumatic diseases or a similar dentist
  • The Norwegian National Insurance (NAV) definition of dry mouth (reference: Ministry of Health and Care, The Yellow Booklet 2016, s 23)
    • The National Insurance Benefit to Cover Dental Costs for 2016: "There is given benefit to dental treatment in cases where hyposaliation leads to increased caries activity. Benefits are only given in cases where there is evidence of hyposaliation over time, minimum one year. Exceptions from the observation period of one year can be made where there is very elevated caries activity and if the values ​​for unstimulated saliva are <0,10 ml / min and for stimulated saliva is <0,70 ml / min ”. "However, taking a drug that can potentially cause dry mouth is not good enough documentation to receive benefits under this provision."

Rheumatic diseases on B-list (Per January 2017)

(reference: Helfo 2016)

Mouth dryness of reduced saliva production (hyposaliation) that may give (partial) reimbursement

  • If your dentist documents that the results show that you are suffering from dry mouth and that this has caused several holes in teeths, you may be entitled to any benefit from HELFO. This applies to Sjögren's syndrome
  • The dentist must have observed and documented the condition for at least one year before you can get a refund
  • In case of a lot of caries and saliva production is lower than the limits stated in the circular, exceptions can be made from the requirement for observation time
  • HELFO provides primarily benefit for preservative dental treatment (fillings and fillers) for caries. If teeth are lost, you can also become refund for dental prostheses
  • You have to pay yourself deductible for treatment and any supplement if the dentist's price is higher than the National Insurance Tariff

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