Even the most diligent groomers and flossers are not necessarily immune to needing dentures one day. Reasons abound and so do options, both local and financial. All this will be reflected in the following guide.
Why dentures?
The problem with dentures for our health care system is the frequency of this diagnosis coupled with the almost always high cost of treatment. Decades of dentist appearances in elementary school classrooms, advertising, product development and preventive care appointments have all accomplished one thing: Germany’s need for dentures for “age reasons” is diminishing. As the Fifth German Oral Health Study proves, today only one in eight younger seniors (between 65 and 74), or 12.4%, needs a full denture. By comparison, in 1997 this figure was 24.8%, or one in four members of this group. This is a very respectable figure in itself, but it becomes even more impressive when one considers that there are also more seniors in this age segment today than there were back then. However, even the most careful treatment of one’s own dentition unfortunately does not protect against losing teeth. Although caries and periodontitis are still the most significant tooth destroyers, there are also reasons that have nothing to do with a lack of hygiene:
- Accidents (falls, blows, blunt force trauma).
- Poisoning ( for example, by mercury).
- Deficiency diseases (scurvy)
- Diabetes
- Rheumatic inflammation
- Osteoporosis
- Bacterial diseases
They can all lead to the need to replace one or even all teeth. And then good advice is often literally expensive.
The role of insurance
Often, expensive all-ceramic or composite crowns are used, but a special resin allows them to bond well to the tooth. The problem with this is that both tooth preservation and dentures are comparatively expensive affairs for what they “provide.” Of course, a missing canine tooth, for example, is not particularly pretty and also limits one’s quality of life. However, and this is the crucial point, it is not a truly life-impairing disease and also not one that, if left untreated, will get worse until life is in danger. In addition, even according to today’s reduced figures, teeth are one of Germany’s most widespread diseases, primarily due to caries, but a disease that is rampant in all social classes and age groups without distinction. And treatment, as mentioned, is expensive. Not only do replacements generally have to be made. It also has to be adapted to the jaw, which is different for practically every person, and fixed there in the most elaborate way. An incredible effort comparable to a full-blown abdominal surgery. High frequency, high prices, a bad combination – which already in 2005 so overwhelmed the health insurance companies that they implied a fixed subsidy system. Since then, every dental finding there has its own code and a fixed value that is subsidized (read: paid for by the health insurer). The rest has to be provided by the patients themselves – currently a whopping 50 percent. And the problem with this is that the services paid for are always just standard care. A “good enough” solution, but not one that restores the affected teeth “like new”. Anyone who needs a bridge, for example, is fitted with a loose implant that is not veneered according to the standard rate – in other words, steel or titanium, fixed with bonding cream or metal brackets and, at the expense of the health insurance fund, only fitted with a ceramic cover in the visible front area that matches the color of the teeth. If you don’t want to show that your molars are already replaced when you yawn, or if you want to risk having your incisor bridge fall out if you laugh too hard, you have to dig deep into your pocket. It is also of no use that by regularly keeping a preventive care booklet, the personal contribution can be further pushed down – because even with ten years of “good behavior” and semi-annual checks, between 35 and 40 percent of the costs still remain with the patient.
Alternatives
Supplemental dental insurance is a comparatively inexpensive long-term remedy. However, care should be taken to ensure that professional cleanings are also covered. In light of these facts, a number of possible assistance options have been established since the introduction of this system in 2005.This is especially true given that dental prostheses can quickly run into the thousands or even tens of thousands because of the complexity of the procedures and prostheses mentioned above. Hardship regulation: Even people who belong to the middle class today often fall into a financial hole in old age, because the current pension level after deduction of all costs is just 44.7 percent of the last salary. This is where the hardship scheme of the health insurance funds steps in: Anyone with a monthly gross income of less than 1190 euros (married couples living together 1636.25 euros) does not have to pay a co-payment for dentures. This group is extended by social welfare, Hartz IV, and basic security recipients. But even those who only slightly exceed the income limit have a good chance of at least receiving a subsidy from their health insurance fund for the normal 50 percent care. Credits: Even the fifty-fifty share of the standard care and, even more so, more expensive treatment methods can put even a household that is not among the lowest earners in a financial bind that requires additional funds to be obtained in order to be able to bear the treatment costs. A viable option here is to rely on institutions that do not perform a Schufa query – because even an inquiry can negatively affect one’s grade, even more so a loan taken. Supplementary insurance: Virtually everything can be insured, including the cost of replacing teeth. Supplementary insurances are literally a dime a dozen at the moment, often at low monthly costs in the range of ten euros. But with so many to choose from, careful selection is essential. This is because the very low-cost offers in particular only cover treatments – and generally not in the first few months after signing the contract, as well as only if they are notified before treatment begins. It is also important to make sure that other services such as dental cleanings are included in the insurance policy – because prevention is always better than treatment. Treatment abroad: The last option is to take advantage of the fact that dental treatment – all other things being equal – is often considerably cheaper abroad than in this country. It is precisely this market that dental clinics in Poland and Hungary have recently discovered for themselves. The advantage: payment is made in exactly the same way as if you were going to a German dentist. The foreign doctor draws up a treatment plan, which has to be approved by the insurance company, and then gets started. Insurers also like this option, because it reduces not only the real cost of the co-payment, but also their costs.
