Dentures: types, materials, costs & risks
Dentures are crowns, bridges, implants and prostheses. In our guide you will learn everything about the different denture treatments.
Dentures: What types are there??
Crown: A tooth crown can replace larger parts of a damaged tooth. The artificial crown is placed on the broken tooth and glued to it. This form of fixed dentures is mostly used when a tooth filling is no longer an alternative treatment, because the tooth is too badly damaged by caries or an accident.
Bridge: A dental bridge can replace one or more teeth. The natural teeth shown here are crowned and serve as bridge pillars. Accordingly, they must be strong and have healthy tooth roots in order to keep the bridge stable.
Dental implant: Implants are anchored directly in the jawbone. A complete implant consists of three parts: artificial tooth root (anchored in the bone), a connecting piece (abutment) and the visible dentures.
Full denture: A full denture serves as a denture when there are no more natural teeth in the upper or lower jaw or in both jaws. It is used in such a way that it sinks into the mucous membrane due to chewing pressure.
Partial prosthesis / staple prosthesis: Partial dentures are used when there are insufficient anchorage options for a bridge, i.e. more than six natural teeth are missing. It is attached to the remaining teeth with clamps.
Telescopic prosthesis: This is a partial prosthesis that is attached to telescopic crowns. The crowns are firmly anchored while the prosthesis can be removed.
Attachment prosthesis: This variant of the denture works without visible connecting elements. Crowns are placed on the abutment teeth. The attachment is attached to these crowns and the prosthesis is pushed over them.
Bar prosthesis: This is a firmly connected row of artificial teeth that is anchored on a bar. The implant-supported dentures can be removed for cleaning.
Pushbutton prosthesis: This denture works on a push button principle. Hollow forms are incorporated into the denture, which can snap into place on their counterpart. This counterpart is attached to the natural, ground teeth or alternatively to dental implants.
There are three main groups of denture materials.
Metals (e.g. gold, titanium, amalgam, palladium)
Pure metals are never used, but metal alloys (a mixture of several metals).
Dental metals nevertheless have some disadvantages such as e.g. For example: corrosion, toxicity, allergies, electrical conduction / antenna effect.
If you choose metals, you should make sure that no different alloys are used. The more different the metal alloys are, the greater the corrosion. This releases harmful metal ions, which strain the entire body and can accumulate in individual organs.
In addition, all metals used in dentistry can trigger allergies and cause an antenna effect. Frequencies in the environment of the person concerned can amplify electromagnetic fields. The electromagnetic radiation can affect the brain.
How harmful metals actually have in dentures ultimately depends on several factors:
- Predisposition (e.g. to allergies)
- Composition of the metal alloy
- Processing and amount of metals
- Duration of the exposure time
- Localization (where do the metals go? Do they stay in the jaw or do they reach the brain?)
Plastics (composites) are an inexpensive alternative to metals. However, they also have a number of disadvantages.
Loads such as B. Sun and heat quickly make plastic-based dentures discolored and become brittle. Chewing, pressing and crunching cause mechanical wear. Alcohol can remove components from the plastic. In addition, plastics can shrink over time, so that fillings no longer fit exactly and bacteria can penetrate into the depths of the tooth unnoticed. This material is therefore used more as a temporary solution or for small defects.
In addition, plastics and amalgam can cause health damage:
- Changes in genes
- Effect on hormones
Ceramic is mainly used in crowns and implants.
All-ceramic implants have a number of very positive properties such as B .:
- good compatibility
- no antenna effect
- good optics
- no corrosion and thus stress with metal connections
Ceramic crowns are much less noticeable than gold or titanium crowns. Ceramic is often used for veneers (wafer-thin veneers) because the material can be adapted to your own tooth color.
Ceramic is also particularly well tolerated for the gums. With metal crowns or metal implants, the gums appear more red and irritated and in some cases even recede.
Which dentures are right for me?
Which variant is the right one for you depends entirely on your individual case. Both fixed dentures and removable alternatives both have their advantages and disadvantages. While dental implants are considered the highest quality variant of third teeth, they do not necessarily have to be the best solution for every patient.
In the case of small gaps with stable neighboring teeth, both an implant and a fixed bridge can serve as dentures. In the case of larger gaps (e.g. four or five consecutive teeth), a bridge is not recommended, as too high a load would affect the supporting abutment teeth. An implant-supported or removable denture is recommended here.
How to proceed correctly with denture treatments
Treatment and cost plan
As soon as your dentist determines that you need dentures, he or she will draw up a treatment and cost plan. There you will find information on the tooth status (findings), the standard care, the planned therapy and the expected total costs.
Review and approval
The healing and cost plan dated and signed by the dentist (with your bonus book, if available) must be submitted to the health insurance company before treatment begins. The latter must check the information received within three weeks, then approve or reject the healing and cost plan and determine the fixed grant. This procedure can be extended to six to eight weeks if the health insurance company has the medical plan and cost plan checked by an expert appointed by the health insurance companies and the dental associations. If such a procedure has been initiated, your health insurance company will inform you.
If you have additional dental insurance, you should generally inform them about the planned treatment and the costs in advance.
Start of treatment
As soon as the healing and cost plan is approved, treatment can begin. However, the health insurance company must have set the fixed subsidy, unless it is an acute repair measure. If the treatment and cost plan is changed again during the treatment, it must be presented to the health insurance company again.
After the treatment, the dentist issues an invoice for the personal contribution to be paid. If you have dental insurance, you should immediately send the invoice to the insurer for reimbursement.
Risks of denture treatment
The risks vary depending on the type of denture.
Risk of dentures: loss of substance of healthy teeth
If a bridge is to serve as a dental prosthesis, two healthy teeth that enclose the gap must be ground by the dentist so that the bridge finds enough support. This will damage healthy tooth structure and increase the likelihood of tooth decay as the hard enamel is removed.
The risk of jaw bone degradation is also not negligible in the case of a bridge, since the tooth root is missing. This normally stimulates the bone and keeps it naturally healthy.
Dental implants pose fewer risks overall. The artificial tooth root grows with the bone because it is implanted directly into the jaw. The bone thus remains vital, without any bone loss.
Risk of dentures: materials
The risk of “wrong” materials is particularly high in so-called dental tourism. The inexpensive offers are particularly attractive in Eastern European countries. However, not all dentists use the materials that meet the strict requirements of the Medical Devices Act.
The guarantee and corrections that may be required also involve a risk: In addition to the treatment costs, the travel costs quickly add up if you have to visit the respective dentist again and again for follow-up treatments.
Pain after the insertion of dentures
Slight pain that occurs shortly after the restoration is completely normal. Regardless of the type of care, dentures always represent a foreign body in the mouth that you have to get used to. In addition, dental implants are always fresh wounds in the jaw bone that need to heal. If you experience severe pain, your dentist can provide you with pain relievers. In addition, a cooling compress can relieve pain and swelling.
Inflammation on the implant
Even if dental implants heal well at first, they can cause pain after a long time. The reason for this is a so-called peri-implantitis, an inflammation near the implant that results from poor oral hygiene. In order to prevent bacterial inflammation and the associated gingivitis, every wearer of dentures should pay particular attention to thorough oral hygiene. This includes brushing your teeth in the morning and evening and using dental floss. If implants are not properly cared for, they can loosen and, in the worst case, even fail.
It is also recommended to use professional teeth cleaning twice a year to free the entire mouth from harmful influences.
The cost of dentures depends on several factors.
Labor costs: Dental laboratories are not bound by a uniform schedule of fees. This can result in enormous cost differences from laboratory to laboratory, which affect the total cost of dentures. Since some dental practices work with a fixed laboratory, the total cost of the treatment also depends on the prices of the respective laboratory.
Dental Fee: The fee varies from dentist to dentist. The fluctuations result from different rental prices and salaries.
Therapy variation: The different forms of dentures have different prices. Several thousand euros can easily lie between a full metal crown and an implant.
materials: For example, metal is cheaper than ceramics. Implants are the most expensive variant.
Region: State and city are also cost factors. Patients in Saxony pay the least for dentures, while patients in Bavaria pay the most.
What does the statutory health insurance do for dental prosthesis treatment??
Since 2005, the system for fixed grants for dentures for health insurance patients has been standardized. The health insurers reimburse 50% of the costs as a fixed grant for standard treatment. A fixed standard care or standard therapy is provided for each finding. Regardless of whether a patient opts for regular care or a solution other than dentures, the fixed grant remains the same.
For example, if the standard treatment costs 800 euros, the health insurance company will reimburse 400 euros. If you want a higher-quality restoration, you will only receive the fixed subsidy of 400 euros, even if the selected denture is used, for example. B. costs 1,200 euros.
Fixed grants for dentures 2018
The fixed grant is adjusted annually. The following list shows three examples of how high the fixed grant for dentures 2018 will be for certain treatments without a bonus.
|Anterior tooth gap with four teeth missing next to each other||€ 458.03|
|Remaining teeth up to 3 teeth in the lower jaw||€ 395.03|
|Preservable tooth with extensive destruction of the clinical crown||€ 155.80|
How to save costs with a denture treatment
The bonus book
Since 2005 there has been a fixed grant for crowns, dental bridges and prostheses for those insured by law. In addition, statutory health insurance provides additional grants for a fully managed bonus book.
This yellow booklet is stamped once or twice a year during the regular check-up. This grant only applies to dentures. If the bonus booklet has been kept in full for a period of 10 years, the fixed subsidy increases to up to 80 percent. At 5 years you get a fixed subsidy of 60 percent. If there is no dental check-up in one year, the bonus remains at the standard of 50 percent.
Second dentist opinion
Different dentists often make different results. In addition, there are usually several solutions for one finding. Furthermore, the costs vary depending on the dentist treating you. For these reasons, too, it makes sense to get several opinions about your dental treatment. The statutory health insurance companies are in favor of this approach. Even if a treatment and cost plan has already been approved, you can have another plan drawn up by another dentist. However, please note that you only sign a healing and cost plan if you really want to have the treatment carried out by the respective doctor.
If the desired denture requires more time and difficulty, the treating dentist may charge private services. In such cases, it is worthwhile to have different dentists prepare and compare healing and cost plans (HKP). The preparation of a medical and cost plan is free of charge. It is also worth comparing the material and laboratory costs, which vary from dentist to dentist.
Know the regular care
Denture treatments can be divided into regular care, similar and different care. Dentists need to educate patients about the different options and the associated risks and costs. Regular care is the cheapest and most minimalistic option. The personal contribution is the lowest here and the health insurance company reimburses about half of the costs. Therapies that go beyond regular care are often proposed. These are advertised as more valuable and can therefore be more expensive.
Double allowance for hardship cases
The hardship case regulation grants a double fixed allowance to people with very little money. So you not only receive 50% of the costs for standard care, but up to 100%. It is legally regulated for whom denture costs can represent an "unreasonable burden". This group of people includes:
- Welfare recipients
- ALG II recipients
- BAföG recipients and other recipients of training grants
- War victims receiver
- People with low income (gross less than 40% of the average salary of the statutory pension insurance each month)
Dentures from abroad
The cost of producing dentures abroad can be lower because wages there are sometimes lower than in Germany. This does not necessarily have to be accompanied by a loss of quality. You will receive the fixed grant regardless of the country of origin of the denture. However, the costs can increase immensely due to travel, hotel or follow-up treatments, so that the initially supposed savings are not worthwhile in most cases. The total cost of a denture treatment abroad can therefore be higher than that of a treatment in Germany.
Supplementary dental insurance DFV dental protection
With the DFV-ZahnSchutz you do not have to worry about high dentures costs. The supplementary dental insurance of the Deutsche Familienversicherung is the test winner at Stiftung Warentest for the fourth time in a row with the top grade “very good” (0.5). You will receive up to 100% reimbursement in all dental and orthodontic service areas. There is no limit to the maximum number of implants for dentures.
FAQs about dentures
When does one speak of implant-supported dentures?
One speaks of implant-borne dentures whenever the dentures are anchored directly in the jaw. This can be the case for individual teeth, but also for a bridge or even a complete set of teeth.
The implant itself, like a small screw, is inserted into the jawbone and then fuses with it. It serves as a kind of attachment for the desired or required dentures when there is no more natural tooth root.
This “artificial tooth root” is then the basis for the crown or bridge – that is, the dentures that are carried by the implant.
Compared to a simple adhesive prosthesis, the implant offers the implant-supported dentures a much more secure grip and a much better chewing efficiency because the implant takes over the function of the natural tooth root. So nothing can slip and there are no pressure points.
Which teeth can be replaced by implant-supported dentures?
Basically, a single tooth, but also several teeth, can be replaced by dental implants. Missing z. B. an anterior tooth, an implant with a single crown is an optimal restoration, because in this case no neighboring teeth need to be ground, as would be the case for a bridge. The crown that would be placed on the implant in this case is then the implant-supported denture.
However, if several teeth are missing in one row of teeth, several implants can be fitted with individual crowns. If the missing teeth are right next to each other, implants can be placed on the right and left and the missing space can be replaced by a bridge.
In this case, the bridge would represent the implant-supported dentures because the bridge is supported by implants.
How can I reduce my additional payment for dentures??
The additional payment for dentures can be reduced by a fully managed bonus book. This leads to an increase in the fixed subsidy to 60 – 80%.
How long is the guarantee on dentures??
The legal guarantee for dentures is 2 years. If your dentures show any damage during this time that has not been proven to be caused by you, the dentist must repair the damage.
An extended guarantee on dentures can be given by the dentist in addition to the statutory guarantee. It is voluntary. There is no legal requirement for a denture guarantee.
How long do I have to wait for approval from the health insurance company for a new denture??
The waiting time for approval of the dentures is 7 days to 4 weeks. The waiting times vary depending on the health insurance company.
How to clean dentures?
The best way to clean dentures is with a hard denture brush and liquid hand soap or only with lukewarm water. After cleaning, you should wash the denture thoroughly with water. It is best to brush the dentures after every meal, but at least twice a day.
Dentures from the Czech Republic?
Germany is the main customer for high-quality dentures from the Czech Republic. The reason for the high decrease is the good training of the dental technicians and the low prices for dentures.
Who pays dentures in children?
The same rules apply to dentures for children as for adults. There is the regular care of the health insurance company as well as the care for which a higher own contribution has to be paid.
Who pays for dentures in an accident at work?
In the event of an accident at work, it is not the health insurance that is responsible for the assumption of costs, but the accident insurance provider. This also applies to dental treatment and the provision of dentures. The benefits correspond to the regular care provided by health insurance companies.
Who pays dentures in the event of an accident?
In the event of accident-related costs for dentures, there is usually a right to reimbursement from the health insurance company. A well-documented course of the disease and reporting to the insurance company are important.
Who pays dentures for unemployment?
Patients who are financially weaker due to unemployment and need dentures fall under the hardship regulation. Those affected therefore receive financial help for medically necessary dentures.
What does the health insurance company pay for dentures without a bonus booklet??
Statutory health insurance companies pay a fixed grant for dentures. This is 50% of the total costs and is based on fixed rates. With a fully managed bonus booklet, the health insurance companies pay another 20-30% more.
Where do I enter dentures in the tax return??
Dentures must be entered in the tax return on page 3 of the main form in lines 67 – 70 (extraordinary burdens).
Why is an expert involved in dentures??
If the health insurance company wants to make sure that the requested prosthesis is really necessary in the desired form and scope, it can obtain the opinion of another expert. The patient must then contact the expert named by the health insurance company and make an appointment with him.
What dentures for missing molars?
For dentures with a single missing molar tooth, the regular care of the statutory health insurance plans provides a classic fixed dental bridge. However, an implant as a denture is gentler on the neighboring teeth because they do not need to be ground.
Which dentures in the front area and when there is snow >If the complete tooth is missing in the front area, a bridge or an implant is recommended. Both types of dentures are durable. However, adjacent abutment teeth must be ground on the bridge.
What dentures for periodontal disease?
There are several options for periodontal dentures. It depends on how many teeth need to be replaced. A fixed dental bridge is recommended for a broken tooth and stable abutment teeth. Once the periodontal disease has progressed, implants are recommended.
What dentures for bone loss?
If there is too little jaw bone for implants in a patient, there are possibilities to build up a bone so that the implants can still be inserted if the jaw bone shrinks.
What does dentures cost and what are the options? Dentures that look deceptively similar to your own teeth and can hardly be distinguished from them are…
Dental bridge: types, treatment and costs
Dental bridge: types, treatment and costs In the event of tooth loss, the gap between the teeth can be closed using a dental bridge. This denture can be…
Inexpensive dentures The dentist Dr. Magunski from Düsseldorf answers questions from patients during this expert consultation. Special: Inexpensive…
Beautiful third teeth – possibilities and costs Beautiful third teeth are no longer rocket science. Most people associate dental prosthesis with…