Braces improve people's quality of life

Study cannot prove medical benefit : Do you get ripped off with braces?

Does every second child in Germany really need braces? The statutory health insurance companies spend more than one billion euros per year on orthodontic treatments, although their benefits have "not been adequately researched," the Federal Audit Office complained in the spring of last year. And Health Minister Jens Spahn (CDU) felt compelled to commission a study.

Now the result is available - and the key question remains open: For the often expensive treatments, no direct medical benefit, for example with regard to caries, periodontitis or tooth loss, can be proven, according to the 144-page report by the Berlin IGES Institute . However, there is evidence that such treatment improves misaligned teeth and improves the patients' quality of life.

Spending has been rising steadily for years

According to the authors of the study, which is available to the Tagesspiegel, "no final assessment can be made as to whether and what long-term effects the orthodontic therapy regimes used have on oral health" It is therefore not possible to judge whether the expenditure for it “met the criteria of economic viability”. According to the report, the health insurance companies' expenses for orthodontic treatments have been increasing continuously since 2005. Most recently, they were more than 1.1 billion euros per year.

"The Ministry of Health has no doubts about the need for orthodontic services," a ministry spokesman made clear on Thursday. The fact that braces reduce the incidence of diseases cannot be proven, but it cannot be ruled out either. It should now be discussed whether there is still a need for further research. Ultimately, however, it is not the legislature that has to evaluate the benefit of a therapy, but the Federal Joint Committee of Health Insurance Funds, Doctors and Clinics.

Hardly any data on the type, duration and success of such treatments

Also in the interests of the patient, "it should be clarified which services lead to treatment success", demanded the President of the Court of Auditors, Kay Scheller, in April of this year. In other areas of the statutory health insurance, the benefits of a therapy must be scientifically confirmed This could also be the case with orthodontic treatments. ”In addition, there was a lack of nationwide data on the type, duration and success of such treatments, as well as the underlying diagnoses.

The professional association of German orthodontists vehemently rejected the accusation expressed in the media of a "rip off with braces" and emphasized that the treatments made "a significant contribution to the dental health of the population". The central association of statutory health insurers, on the other hand, referred to the thin research situation. Clinical studies with correctly formed comparison groups are complex, but “inevitable” for reliable results on the effectiveness of the treatment.

The SPD health expert Karl Lauterbach also called for the reimbursement practice to be reviewed. The benefits of braces are not as well documented as many doctors and parents think.

Vague budget: The "measure of what is necessary" must not be exceeded

The costs of orthodontic treatments are only covered in full by the health insurers for adolescents between the ages of ten and 18 - and only if the treatment is completed. However, you have to pay your own contribution first, which will be reimbursed later. For the first child it is 20 percent, from the second child ten percent of the costs. In addition, a need for treatment must be attested and the services must, as it is said, “not exceed what is necessary”.

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