DENIS Dental Benefits
DENIS provides and manages sustainable dental benefits for medical scheme members.
Please check the dental benefit guides to confirm the schemes and dental benefits options managed by DENIS on behalf of the scheme.
Benefits are divided into: Conservative Dentistry; Specialised Dentistry; and Hospitalisation/Anaesthetics.
Conservative dentistry is also known as basic or routine dentistry. It means the diagnosis, prevention and treatment of tooth and gum diseases as well as the repair of defective teeth.
The following treatments and procedures are included:
- Oral hygiene (scale and polish)
- Intra-oral and extra-oral x-rays
- Root canal treatment
- Plastic dentures Pre-authorisation is required.
Please refer to your dental benefit table below for specific conservative benefits applicable to your option.
Specialised dentistry (also known as advanced dentistry) occurs when teeth need to be replaced or when badly damaged teeth need to be repaired and a filling (conservative dentistry) would not be adequate.
Authorisation is required for some treatment before treatment starts.
This includes the following treatments:
- Partial metal frame dentures
- Crown & bridgework (*Pre-Authorisation required)
- Implants (*Pre-Authorisation required)
- Orthodontics (*Pre-Authorisation required)
- Periodontics (*Pre-Authorisation required)
- Maxillo-Facial Surgery
- Oral Pathology
Not all options have specialised dentistry benefits; please refer to the dental benefit guides to confirm which schemes and options have specialised dentistry benefits.
Certain dental procedures (e.g. removal of impacted teeth or extensive dental treatment) might require IV conscious sedation in the rooms or even general anaesthetics (GA) in hospital.
Authorisation is required before treatment.
Some options offer limited access to hospital for dental treatment; please refer to the dental benefit guides to confirm schemes and options levels of access to this specific benefit.
NB: DENIS shall be entitled to update the information presented in the Chairside Guide from time to time, subject to the provision of notice thereof on www.denis.co.za. Such information shall be superseded as and when it is updated by the updated version thereof.
DENIS Dental Provider Chairside Guide
2023 DENIS Chairside Guide
2024 DENIS Chairside Guide available from 7 December 2023
Dental Benefit Tables per Scheme
Dental benefits are subject to clinical protocols and managed care interventions which may include the requirement of treatment plans and/or radiographs prior to benefit application.
Scheme exclusions apply to dental benefits. In the event of a dispute, the rules of the scheme will prevail.
2024 Dental Benefit Tables available from 7 December 2023
Insurance Based Wellness Programmes
|Essential Employee Benefits*||2023*|
|NHG MediClub Elite*||2023*|
|Old Mutual Health Solutions*||2023*|
|Standard Bank Health Insurance*||2023*|
* Please note these are not Medical Scheme Products, they are primary healthcare/hospital indemnity products that are registered within the Demarcation Exemption Framework