Introduction
In dental terminology, the term dental prosthesis is used to describe all devices whose manufacture serves to replace missing, natural teeth. In general, dentures are divided into two major groups, fixed and removable dentures. While the group of fixed dentures includes fillings and bridges as well as partial and full crowns, partial and full dentures are considered to be removable dentures.
A partial denture is used to replace individual missing teeth. It is fixed inside the oral cavity with the help of clasps and bows and is usually very comfortable to wear, as it can be fitted on the jaw ridge without any problems. In contrast, a total denture is equipped with a large number of artificial teeth.
Such dentures are usually made as soon as all teeth in one jaw (upper or lower jaw) have fallen out and need to be replaced. Both the fabrication and the creation of an ideal hold in the oral cavity is much more difficult with a full denture than with a partial denture. The hold of total dentures is mainly created by so-called adhesive forces between the oral mucosa and the denture material.
Contrary to the widespread assumption that a total prosthesis finds a much worse hold in the upper jaw than in the lower jaw due to gravity, the reality is rather contrary. Total dentures of the upper jaw generally have a larger surface area. As a result, greater adhesive forces can develop between the oral mucosa and the denture material. In addition to the precision during the fabrication of the removable denture, the hygienic handling of the denture plays a decisive role. Dentures which are rarely cleaned and therefore show heavy deposits, generally find hardly any hold on the jaw ridge.
Cost of a dental prosthesis
The cost of making and inserting a dental prosthesis varies from patient to patient. When calculating the actual price, it must be taken into account that the extent of the prosthetic work, the choice of material and also the respective dental practice and dental laboratory have a decisive influence on the final price to be paid. For this reason, the costs can vary considerably within Germany.
The cost of a dental prosthesis is generally made up of various billable individual services. One of the most extensive cost items in the production of a dental prosthesis is the dental fee. When a standard service is provided, this fee, i.e. the portion of the work to which the dentist is entitled, is calculated on the basis of the BEMA (German BEMA = German Association for the Evaluation of Dental Services), which has been agreed upon with the health insurance companies.
If the patient wishes a dental prosthesis that goes beyond the standard care (better material, more attractive veneer, etc. ), then in addition to the BEMA values, costs calculated according to the dentist’s fee schedule (GOZ for short) are due. These are private services which are not covered by health insurance and therefore have to be paid by the patient himself.
In contrast to the BEMA fixed price, the dentist has the possibility to include the individual workload of each patient in the cost calculation. For this reason, the dentist’s fee schedule works with so-called rates of increase, by which a basic price can be increased by a certain factor. The mean value is a rate of increase of 2.3.
With written justification the costs can even be increased to 3.5 times the rate. A further cost item in the preparation of the dental prosthesis are the fees to which the dental laboratory is entitled (laboratory costs). These services include the work of the dental technician and material costs. In addition, further material costs that arise from the pre-treatment and the insertion of the dental prosthesis within the dental practice (material costs) must be included in the calculation of the total price.
