Prevention at the dental practice
More than the tooth cleaning — and part of it costs nothing.
Prevention at the dental practice is more than professional tooth cleaning, and a considerable part of it is free of charge for those with statutory insurance. Many people do not know this, because the cleaning takes up the most space in conversation — it is the service that has to be discussed, because it has to be paid for.
The check-up
Adults are entitled to one examination per calendar half-year. All the teeth are inspected individually, fillings and dentures are checked, the oral mucosa is looked at and the condition of the gums is assessed. Anything unusual on the mucosa is expressly part of this — the mouth is one of the few places in the body that can be viewed completely and without effort.
What a check-up is not: a cleaning. It records the findings. What follows from them is discussed afterwards.
The gum findings
Every two years an examination of the gums is part of this, the Periodontal Screening Index. Using a blunt measuring probe, several sites are checked for how deep the groove between tooth and gum is and whether it bleeds. It takes a few minutes and is the most informative single examination in the whole of prevention — because periodontitis causes no pain for years and therefore goes unnoticed without measurement.
If the findings show elevated values, there is a defined course of treatment that the health insurer covers: an explanatory consultation, cleaning of the root surfaces and structured follow-up care over two years.
X-rays in measure
Caries between two teeth cannot be seen with the eye while it is small. X-ray images close this gap, but they are not taken routinely, only where there is a reason. The interval depends on the caries risk; where the findings are unremarkable, several years between two images are defensible.
For children and adolescents
Here prevention is more closely regulated than for adults, and it is fully covered by the health insurer:
- Early detection from the sixth month of life to the sixth birthday: six examinations, three of them in the first year of life. These include advice for the parents and, from the first tooth, a fluoride varnish.
- Individual prevention from the sixth to the eighteenth birthday: twice a year instruction in oral hygiene, staining, fluoridation and the recording of an oral hygiene status. Where the caries risk is increased, more appointments are possible.
- Sealing of the permanent molars as soon as they have come through.
These appointments are the reason why the caries burden among children in Germany has fallen sharply over the past decades. Anyone who lets them lapse gives up the most effective part of dental prevention there is.
The bonus booklet
Every check-up appointment is entered. Adults need one entry per calendar year, adolescents between 12 and 18 two per year. Anyone who can show five unbroken years receives a health insurance contribution towards dentures that is 20 per cent higher, and after ten years 30 per cent. A single gap resets the count.
With dentures running into four figures, that is an amount worth having. Many insurers now also keep the booklet digitally.
The essentials at a glance
- For adults, the check-up is a service of the statutory health insurer once per calendar half-year.
- The gum findings (PSI) are part of it every two years. It is the most important single examination in prevention, because periodontitis does not hurt for a long time.
- For children and adolescents there are series of preventive appointments of their own: early detection from the first tooth, individual prevention from the sixth birthday.
- The bonus booklet lowers the amount you pay yourself for dentures later. Five unbroken years means 20 per cent more contribution, ten years 30 per cent.
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