Use of (still) uncertain

The orthodontist in Germany, you will need to have no fear of consequences – even though the Federal court of auditors had missed in 2018, a kind of slap in the face: Because almost half of the children and young people for more than a billion Euro is to be treated, without the nature, duration and success of treatment are not clear, needs to be explored is the Use of “finally”, as requested by the Federal court of auditors, 2018.

Research although. After months of talks between the Federal Ministry of health, health insurance and dental profession, a Plan with four measures is now on the table. Critics are not impressed: “the long slumber of the Federal government to take revenge,” says Kirsten Kappert-Gonther, for the Green party in the health Committee of the Bundestag. To be available “to data type, length and success of treatment, are years to go.”

The four-point Plan provides for the following measures:

  • Patient question: any data on the incidence of Dental(false)to get to this in the next German oral health study (DMS) collected. Since 1989, are examined in these studies on a regular basis several thousand people dental and extensively interviewed. 2022 the sixth oral health study is planned. Tooth positions were previously contained only in the first DMS. This will now allow for a comparison over three decades.
  • Billing data: The health insurance companies and the dental associations should, in retrospect, your orthodontic billing data to evaluate. To clarify, how many tooth positions were treated, and in what form, for how long and with what cost.
  • A guideline for time of Treatment: A new guideline to the “ideal treatment point” for “orthodontic anomalies” identify. However, she was logged in already since January. The justification addresses the question of whether braces are really necessary, but is of very positive effects, such as caries and periodontal disease “by the correction of misaligned teeth would be partially influenced preventive”.
  • People with and without braces compare: The so-called NAKO-health study also in terms of the consequences of orthodontic treatments can be evaluated. The NAKO (National cohort) is a long-term population study of more than 20 years to the causes of people’s diseases. If here now orthodontic data will be collected, one could compare the oral health developed in people with and without braces.

The Federal Ministry of health finds that these measures will Know about the orthodontic care of the population and the effects of various treatment leave “policies in a manageable time frame of two to three years to expand significantly”. It had to be assumed “that the proposals of the report can be implemented”.

The audit Committee of the Bundestag has taken note of the report of the Ministry is now aware of and stresses the fact that they expect to 31. March 2022 a report entitled “about the measures, said”.

The original proposals of the Federal court of auditors were clearly went further: he specifically recommended that not only is the orthodontic care situation, treatment need and treatment goals and to evaluate, but also a Review of the Fund performance and the number of self-pay services requested.

“What we need is a fundamental Reform of orthodontics,” says Alexander Spassov, self orthodontist and critic of his colleagues, since he is researching the topic. You’ve long since “a mountain” of evidence about Benefit, harm, effectiveness: “If the planned measures are not embedded in an overall strategy, the results will be useless.” About payroll data that you need at the same time quality criteria. “We need to have a discussion about it”, calls Spassov, “what should apply in orthodontics as a Benefit, and harm, and what is really medically necessary.”

Already patients need to be better protected from interventions with questionable Benefit, asks Kirsten Kappert-Gonther. Needed about easier ways to obtain second opinions, and a cost estimate review be.


The author of the text is in addition to her work as a freelance journalist at the Verbraucherzentrale NRW as a speaker for the healthcare market hired.