EXPLAINED: How dental care works in Germany

The first things you should know about dental care is that Germans have great teeth. According to a recent international comparison, only the Danes have shinier, whiter gnashers.

That great score is due to the fact that dental hygiene is a top priority here. Foreigners who visit a German dentist's practise are often pleasantly surprised by the thoroughness of the care and the modern equipment being used.

These things come at a cost though. The down side is that statutory health insurers are careful about what they pay for. 

That makes it all the more important to know what your rights are and how you can make sure you are getting the best deal.

1) Best in class

A 2016 comparison of dental care in different countries in Europe put Germany on top.

“The outstanding oral health of the German population, which has been established in various studies, has now been put into the context of the health care system,"  stated Dr Peter Engel, President of the German Dental Association at the time.

"The majority of the population is statutorily insured. This creates a system that is well equipped to manage crises and has an innovative and investment-friendly foundation, thereby assuring secure and modern dental care for the general public,” he added.

2) How do dentists in Germany work?

Back in the day, dentistry was a lonely business. After a Zahnarzt had qualified from medical school he would set up his own practise as a self-employed businessman. At best he might have gone into partnership with another dentist.

But things have been changing in recent years. A 2007 law allowed for dentists to start employing one another, leading to practises with several dentists working together.

Of the 100,000 dentists licenced to work in Germany today, only around half have their own practises. A lot of this change has been driven by female dentists moving into this once male-dominated world.

Some dentists even let you take your pet in with you. Photo: DPA

Many female dentists like the flexibility offered by being employed in a practise, as it allows them to combine work and family more easily.

While this is all interesting general knowledge in itself - who wouldn't want to know that there are 50,000 niedergelassene Zahnärzte (practicing dentists) operating nationwide? - it is also relevant to know how to find the right dentist for you.

Each dentist's practise will have its own style - and its own prices. So its worth visiting a few in your area to get a feel for their work culture.

Also - talk to German friends! Everyone will have an experience (positive or negative) that they'll want to share.

3) Check ups

Generally, health insurers will pay for a regular check up every six months, plus a yearly removal of dental calculus from your teeth. 

Getting your teeth checked at least once a year has knock on benefits, too. If you can show that you have had a check up five years in a row, your health insurer will increase its contribution to a tooth replacement from 50 percent to 60 percent. 

If you’ve been really well behaved and haven’t missed a dental appointment for ten years, your insurer has to raise its contribution to 65 percent. 

Critical here is that you record the visits yourself in a so-called Bonusheft (bonus booklet).

The dentist does not inform your health insurer that you've paid them a visit. So if you need a replacement tooth, you will have to provide the documentation yourself that proves that you regularly visited your Zahnarzt.

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4) Professional cleaning

If you want a full and thorough professional tooth cleaning (and believe us, they can be very thorough - and somewhat bloody) you will probably have to pay for this yourself, with the costs coming in at around €80. 

Most of the major health insurers do not pay this procedure, encouraging you instead to take out an extra dental insurance.

5) What about fillings?

If you need a filling, your health insurance has to pay for you to receive the most basic kind of material for filling up a cavity. If you need work done on your molars, health insurers will pay for you to get a copper amalgam filling.

They are obliged to do a bit more though for your front teeth, where you are covered to get a synthetic filling that has the same colour as your little biters.

If you want a more expensive form if filling, you need to talk to your health insurer about what they cover. Generally they should pay the cost up to what the more basic option would cost.

Photo: DPA

6) Gum disease

If your dentist thinks that there are good medical reasons for you to have an operation due to gum disease, your Krankenkasse (health insurance) will cover the costs.

It’s important though to consult your dentist on a plan that covers both the costs and the healing process. You need to send this plan onto your health insurer, who will then green light it if it meets the legal requirements. 

With some health insurers, which as TK, the dentist will directly send the plan to the insurer. So it’s advisable to ask your insurer what steps you need to take first.

Its pretty common that a dentist will try and upsell you on extra services such as a professional tooth cleaning. But be careful! Your insurer is unlikely to cover the costs here.

7) Pulling and replacing teeth

Got a rotten tooth at the back of your mouth that needs to be pulled, but you're scared of the costs? Fear not, your health insurer is obliged to come to your aid.

They are also legally required to cover half of the costs of a replacement tooth. But, again, this is only for a basic metal replacement in your molar area and a synthetic tooth in the front of your mouth. If you want a slightly better looking replacement, they should still pay a portion of the costs, though.

Also, if you are on welfare or earn less than €1,190 a month, you are considered as someone who needs support which means your insurer will cover 100 percent of the cost of a new tooth.

8) What care do children get?

Good news on the kiddie front. Young children up to the age of six are entitled to three free check ups, each of them at least a year apart. From the age of six to 18 they can have two check ups a year. And kids who are at risk of developing cavities can also receive free treatment with fluoride varnish twice a year.

There is also good news if your teenager has wonky fangs. Statutory health insurers have to pay 80 percent of the costs of orthodontic treatment for your first child and 90 percent for every subsequent sibling.

9) How to save cash

As we said above, it is important to understand that you are not obliged to stick to one specific dentist. Dentists are self-employed, which means that you can shop around and pick the one who you feel will offer the best prices for the service they are offering.

There are several online portals, eg zahngebot.de that allow you to compare prices. You can then visit a dentist in person to see whether you want to undergo treatment with them.

If you have a favourite dentist, the national consumer rights group Verbracuherzentrale recommends getting a few quotes elsewhere and then confronting him or her with a cheaper offer. Apparently many are willing to negotiate.

Another option is getting the treatment at a hospital from a trainee dentist. This is much cheaper, although it takes longer as it is done under the watchful eye of a qualified tooth doctor.

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