In dentistry, conservative services are by definition (according to the definition) prophylactic (preventive) and therapeutic measures that serve to preserve teeth. Naturally, any tooth preservation concept cannot be limited only to the consideration of the tooth structure to be preserved, but must be effectively implemented with constant attention to criteria from other dental specialties, so that ultimately in the decision around the preservability of a tooth, the knowledge and findings also contribute from the following co-mentioned specialties:
- Preventive (preventive) dentistry: aims to prevent tooth damage from occurring in the first place through early education and motivation of the patient and fluoridation measures;
- Restorative dentistry: measures for the care of tooth structure defects;
- Periodontology: treatment of the inflammatory altered periodontium, in which beyond gingivitis (inflammation of the gums), there is already an inflammatory involvement of the bony tooth compartment;
- Endodontics: treatment measures on the pulp to prevent extraction (removal of the tooth);
- Prosthodontics: preservation of teeth with large defects by means of partial crowns and crowns; restoration of chewing function by means of dentures and thus avoid consequential damage to the remaining tooth stock still preserved;
- Orthodontics: by eliminating tooth position anomalies and jaw deformities, a dentition treated in this way is less susceptible to caries, because a regularly shaped dental arch does not have plaque-prone tooth gaps (, which are more susceptible to the formation of plaque,);
- Surgery: the apicoectomy of a devitalized, endodontically treated (the surgical removal of the root tip of a market dead, root-treated) tooth can still preserve it for a long period of time.
Thus, although tooth-preserving treatment planning understandably draws on findings from the specialties listed above, health insurance systems make a billing distinction between:
- Prophylactic services / individual prophylaxis.
- Conservative services
- Surgical services
- Periodontology/services for diseases of the oral mucosa and periodontium (periodontium).
- Orthodontics
- Dental crowns and dentures/prosthetic services
- And other service areas.
Conservative services
From the billing narrower perspective, therefore, the following measures belong primarily to the conservative dentistry, whereby here congruence between the benefits of statutory and private health insurance exists only in the following points:
- Clinical and radiographic examinations;
- Sensitivity testing of the teeth;
- Treatment of hypersensitive teeth;
- Fillings, e.g. composite fillings (with co-payment for those with statutory insurance);
- Fabricated deciduous crowns in the posterior region;
- Treatments of the pulp (the dental pulp): indirect and direct capping (medicinal treatment of the pulp almost/opened during caries removal), pulpotomy (amputation of the vital pulp of a deciduous tooth) or root canal treatment along with root canal filling;
- Oral mucosa treatment, for example, gingivitis (inflammation of the gums) and periodontitis (inflammation of the periodontium).
Not included in the benefit content of the statutory health insurance funds are:
- Inlays, onlays and overlays made of composite, ceramic or gold casting,
- Fissure sealants on premolars (Dens praemolaris, Pl. Dentes praemolares; also premolar tooth or molar tooth),
- Fabricated deciduous crowns on anterior teeth.
While the statutory health insurance companies offer the following services as part of individual prophylaxis until the age of 18, they are included in the private insurance companies in the area of conservative services:
- Fissure sealants on molars,
- Fluoridation measures to improve the enamel structure.
Also with regard to crown care, differences are made depending on the health insurance. While partial crowns and crowns in the private health insurance sector are counted as conservative services, they are listed by the statutory health insurance under the area of prosthetics with its separate billing modalities.