Health Dental report

Girls may get braces too often

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According to a recent dental report, children in some regions of Germany are over-treated. There are also gender differences. Experts explain what parents should look out for when it comes to orthodontic treatment – and where costs can be saved.

MAccording to a new analysis, girls in Germany may be getting braces too often. This is suggested by the latest dental report from the Barmer health insurance company. According to the report, 60 percent of girls between the ages of eight and 17 received orthodontic treatment during the study period. That was ten percentage points more than for boys of the same age.

For the dental report, billing data from 53,000 eight-year-olds were evaluated over a period of ten years between 2013 and 2022, i.e. up to the age of 17. This means that valid data on the proportion of children and adolescents who have received orthodontic treatment is available for the first time, explained Barmer. “Beauty ideals, peer pressure and parental care are possible reasons why tooth and jaw misalignments are more frequently requested and treated in girls than in boys,” explained Barmer CEO Christoph Straub.

According to the report, there are also differences between the federal states. In Bremen, for example, 46 percent of children and young people received orthodontic treatment, compared to 60 percent in Bavaria. For girls in Bavaria, the figure was as high as 65 percent, while in Bremen it was only 53 percent. “Above-average rates of orthodontic treatment in some federal states indicate possible overtreatment,” explained Straub.

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“Jaw anomalies and misaligned teeth alone cannot explain the sometimes serious regional differences in such treatments.” However, the cause could be inaccuracies in the assessment of the need for treatment.

Braces: What parents should know

So when does it make sense to wear braces? The Pro Dente initiative recommends that every child between the ages of nine and ten should have been to an orthodontist. This way, misalignments can be identified early on. Treatment then usually begins between the ages of ten and 13.

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Whether the health insurance company covers the costs of braces treatment depends on the severity of the misalignment. Orthodontists divide them into five orthodontic indication groups, or KIG for short. Statutory health insurance only covers the costs of braces for KIG 3, 4 and 5, explains the consumer advice center’s “Cost trap for teeth” portal. Another requirement for the insurance company to cover the costs is that the treatment takes place before the patient turns 18.

One problem: Even in the case of misalignments of the KIG 2, it can sometimes make sense from a medical point of view to have them corrected. However, families then have to pay for this out of their own pocket, according to the consumer advice centers. They recommend asking the orthodontist whether there are actually risks if no treatment is carried out. This is because the line between medical necessity and aesthetic reasons is often blurred, according to “Cost trap tooth”. Incidentally, if families are unsure, they have the right to a second opinion from another orthodontist.

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For children with private insurance, the extent to which the health insurance covers the costs of braces treatment depends on the tariff. Those with statutory insurance also usually have to pay costs. “Cost trap for teeth” points out that parents have to pay 20 percent of the treatment costs themselves. If more than one child is undergoing orthodontic treatment, this share is reduced to 10 percent.

This is how it works: Before the child gets the braces, the orthodontist has to draw up a treatment plan, which is also a kind of cost estimate. Only when the health insurance company has approved this plan can the treatment begin. Parents can have the co-payment reimbursed by the health insurance company after the treatment has been completed – but only if the child has completed the therapy.

The consumer advice center advises collecting all original documents and invoices and insisting on a final certificate at the end of the treatment. Parents then submit these documents to the health insurance company. It is best to ask them beforehand whether there is a special form for reimbursement.

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However, extras that require payment are not included. When it comes to braces, the health insurance company only covers the costs for the simplest option. Anything beyond that – such as ceramic or mini brackets, bracket sealing or a digital dental impression – must be paid for by families themselves. These additional services are not medically necessary, but are intended to provide more aesthetics or supposedly more comfort, according to “Kostenfalle Zahn”.

Important: The orthodontist may not refuse treatment covered by health insurance or make it dependent on additional private services, the consumer advice center makes clear. If parents decide to have extra services, they should insist on a treatment contract in which services and costs are clearly broken down.