Assessment of minor dental injuries fact sheet

Some of the permanent impairment assessments undertaken by dentists have involved what appear to be minor dental injuries such as chipped teeth, cracked teeth or the loss of a tooth.

Injuries such as these may be assessed by a non-dentist medical assessor* in conjunction with the assessment of other injuries, provided the medical assessor has undergone approved training in regard to the assessment of minor dental injuries.

It is anticipated that these non-dentist medical assessors will assess only minor dental injuries with the proviso that they may refer more complex and/or serious dental injuries to the specialist/dentist medical assessor.

The assessment of dental injuries is undertaken using Chapter 9, AMA 4, Section 9.3b Mastication and deglutition (p 231), and the current guidelines on the assessment of permanent impairment issued by the State Insurance Regulatory Authority (SIRA).

* Non-dentist medical assessors are those medical assessors who do not possess formal training in the specialty of dentistry, but have successfully completed training and been approved by SIRA in the assessment of minor dental injuries.

Protocol for the assessment of minor dental injuries

This protocol applies to disputes where a dental injury has been listed as an injury to be assessed.

1. Receipt of application

SIRA may seek clarification and further information from the parties if a dental injury or associated symptoms are listed, and:

  • the parties have not indicated the site/s of the dental injury, and/or
  • the parties have only listed symptoms such as difficulty eating or chewing.

Depending on the information available/received SIRA will determine whether or not to categorise the dental injury as a minor dental injury.

2. Non-minor dental injuries

The injury should be referred to a dentist if:

  • the dispute involves a treatment dispute about the dental injury
  • a treating dentist report or radiology report indicates there is a dental injury following the motor accident
  • medical/hospital notes indicate intervention by a dentist and/or oral and maxillofacial surgeon has been undertaken, or there is documentation on file that the injured person has been seen or treated by a dentist or oral and maxillofacial surgeon following the motor accident
  • a dental injury has been submitted as the sole injury to be assessed
  • an application for further assessment of dental injuries has been lodged
  • ongoing treatment/intervention by a dentist or oral maxillofacial surgeon is planned, and/or there is
  • a temporomandibular joint (TMJ) injury.

3. Minor dental injuries

The injury will be referred to a medical assessor approved to assess minor dental injuries (non-dentist) if:

  • there is no documentation on file relating to the injury or dental treatment, and/or
  • the injury is a common minor dental injury such as:
    • chipped teeth
    • broken teeth
    • fractured teeth, and/or
    • missing tooth/teeth.

4. Allocation to the medical assessor

The parties will be advised of the appointment and details of the referral provided.  If at assessment the non-dentist medical assessor believes the dental injury would be best assessed by a dentist, they should indicate this to SIRA in the agreed manner. The dental injury will then be referred to a dentist medical assessor for assessment.

5. If either party believes the matter should be referred to a dentist for assessment

Either party should contact SIRA and provide reasons and/or supporting documentation as outlined above.