How much does it cost to have caries removed?
The costs of removing caries are covered by the health insurance company in case of patients with statutory health insurance. Since this requires several steps, it is not possible to name the costs of removal alone. Not every patient has to go through all these steps.
For the sake of completeness, however, every point that is subject to costs should be mentioned here: Vitality test (is the tooth still alive? ), possibly an X-ray, anesthesia (numbing), excavation (removal of caries), special measures during the placement of the filling beyond the usual extent, protection of the pulp in case of deeper lesions, etching of the hard dentin and enamel, so-called bonding, placement and hardening of the filling material and finishing of the surface. All billing figures of public and private health insurance companies always include the placement of a filling in combination with the insertion of the sealing material. When using a laser, however, the health insurance companies do not pay anything, since this service is not included in the legal catalog of services and, according to the GKV, therefore exceeds the normal sufficient level and must be calculated as a private service. Therefore additional extra costs arise, which amount to between 40€ and 70€ for a small filling depending upon offering dentist.
The filling materials for caries
While plastic materials (composites/plastic and amalgam) are placed directly into the tooth and shaped there, rigid filling materials (for example inlays) must be made outside the mouth. They are hardly used for small carious defects because of their high price, but they are more stable than plastic filling materials. The removal of caries is generally covered by the public health insurance companies, but both plastic fillings and treatment with rigid materials require co-payment by the patient.
Patients with diagnosed renal insufficiency are the exception, because in these cases the health insurance company has to cover the costs of each plastic filling completely. In case of deep dental caries (caries profunda), where more than 2/3 of the dentin is affected, it is necessary to protect the “dental nerve” (pulp) in addition to the actual removal of the caries. For this reason, a so-called underfilling must precede a filling.
A drug containing calcium hydroxide, which is supposed to stimulate the dentin reproduction in the depth of the hole, is inserted at the bottom of the hole. Only then is the actual tooth filling carried out. If the outer wall of the tooth has been damaged by caries and/or the removal of the caries (“drilling”), so-called matrices are used for shaping.
If deep caries is not treated, the so-called penetrating caries (caries penetrans) develops. The defect passes through the dentin to the pulp cavity (pulp cavity), so the pulp is in direct contact with the bacteria causing caries. These bacteria lead to inflammation, damage the pulp and the nerve fibres inside.
If the dentist wants to remove these caries and preserve the tooth, he can no longer do this with a filling including underfilling, but rather he has to clear out the entire pulp and the nerve fibers lying within it (root canal treatment). The resulting cavity in the root of the tooth must be filled with the help of body-compatible materials (root canal filling) and the tooth must be closed. Root canal treatment is considered the most important way to preserve the affected tooth in cases of very deep caries defects. In the case of very extensive caries defects, it may also be necessary to make a dental crown.
