Dentists: This is how patients are ripped off with expensive treatments

prolog

Who does not want to have teeth likeMichael T.?Ivory white and evenly, they fall into view when the 31-year-old teacher smiles.And yet his dentist discovered massive treatment needs.She wanted to cut 65,000 euros from his health insurance, but after the first pretreatments he took off.The healing and cost plan, twelve pages thick, included interventions on every tooth.How can that be?

The dentist Eberhard Riedel got the arithmetic as an expert on the table - and says: "This is health destruction."The case is so incredible that the confessing dentist critic wants to be understood as not representative of his guild.And yet here is an example of what is conceivable at a time when more and more dentists are no longer based on the maxim of the medically necessary.They succumb to an almost limitless craze of feasibility - and their pursuit of profit.

Who wants to understand what patients like t.happens, has to realize how dental care has changed since 1989.The then Minister of Health Norbert Blüm abolished the fully comprehensive principle.According to further cuts, fixed subsidies for dentures were introduced in 2005 - since this measure alone, the statutory health insurance companies have saved one billion euros per year.Patients, on the other hand, have got used to having to pay themselves.Regardless of whether legally, privately or additional insured - the dentists have learned to sell their patients health and beauty.

Of course, many representatives of the guild do a good job: According to the oral health study in 2006, the Germans have much healthier teeth than once.In addition to the honest, however, an army of Wegelagers grows.Beautiful people smile on their websites, and keywords such as "aesthetically perfect", "naturally beautiful" and "painless" jump into the eye.Instead of health, it is about beauty that you buy through "bleaching", which can damage gums and melt, or by "veneers" -hip ceramic bowls on the anterior teeth for which the patient sacrifices healthy tooth substance and increases his risk of caries.

Today, dentists are also happy to decorate with additional names that are often only jugwood.Anyone who has studied dentistry may write sounding titles on their practical sign: "Implantologist" (presumably specialist for dental implants), "periodontologist" (for dental beds) or "endodontologist" (for root canal treatments).Of course there are also real specialists who have occupied expensive seminars from the specialist societies.This is gratifying for the quality of treatment, you understand what from the subject.However, they often do unnecessarily great effort and require the multiple of the cash fee of a generalist to get the costs for special devices and training back in.

"The trend towards specialization is driving up the prices," says Celina Schemen, chair of the German Dentistry Working Group, DAZ.In addition, the risk of one -sided consideration of a dental disease is given in all disciplines."If you have a hammer, you can see nails everywhere, which is very natural."An implantologist probably tends to set implants rather than recommend other supply solutions.Another trend: inventing diseases, dramatizing and playing with the patient's fear.So the search for a good and honest dentist becomes an odyssey.

First act: The diagnostic andSsey

The starting point in advance: I am a difficult case.My teeth have some discoloration of the enamel, which could be considered to be suspected of caries.For example on the second most molar tooth at the top right.He resisted six dentists over 30 years of ruined with the drill.I also have older plastic and amalgam fillings.The dentist I trust sees no need for treatment.

For a sample I go in three practices in a German city.I say that I go to the dentist regularly and now have a new search, currently have no complaints, use plasters and dental floss every day.For someone who appears and carelessly takes care of every few years, dentists will take a faster to the drill if finds unclear findings.But I have a professional tooth cleaning before the test and bring a current X -ray image.

The result: First, two of the three want to impose another tooth cleaning, once before the initial examination."As a patient, I would flee right away," says dentist critic Riedel."The same applies to practices in which patients are sent to X -ray or tartar removal before you see the doctor."

Only a young employee agrees with the finding of my dental: no need for treatment.The two colleagues each see caries or damaged fillings on five teeth.One even says that after the tooth cleaning there may be more, which would only have to be assessed safely.She is the dentist, with theMichael T.was.In addition, she finds that my front teeth did not fit together and I crawled."At some point you bite your teeth broken.They are too young for that."But she knew solutions."A rail for the night?" I ask.There are other options, they indicate."But I would put that back now."Does she think: first drill, then a bite correction?

Interestingly, the two dentists see the problems in my mouth in very different places.The intersection of their findings: a tooth.Together I would have taken at least nine teeth in need of treatment.Three dentists, three opinions, as a patient, I would have to decide who I trust.But how?Dental findings are apparently arbitrary.

Second act: the cost-different

My small sample confirms the results of several larger studies with test patients that impressively show that the treatment costs vary greatly.In 2004, the magazine "Öko-Test" reported that the dentists' cost plans for the bit and the same patient on sums between 175 and 9130 euros-a difference around 51 times.Also the AOK scientific institute and the star together with the ERGO directly insurance discovered in larger studies diagnostic and cost quantities.

The Hamburg Consumer Center found in 2013 that diagnoses and costs varied depending on the district. Ihre Probandin hatte eine Zahnlücke, die nach dem Urteil von drei Gutachtern nicht behandlungsbedürftigwas und mit der sie gut leben konnte.In the socially weaker districts, seven out of ten dentists accepted the patient's wish.In the Reichviertel, on the other hand, eight out of ten urged a supply - for example on the grounds: "Otherwise you will soon be out of your teeth."Of 14 dentists, only two recommended a bridge as a good option - which is paid by the statutory cash register.Many pleaded for an implant that would be largely paid out of their own pocket.Some didn't even mention the bridge as an alternative.

In dentistry, the cash benefit dies - and hardly anyone complains.How often dentists they talk or no longer offer them, there is no reliable data about this.Large health insurance companies would only have to statistically evaluate the problems and complaints with which patients contact their consulting hotlines.The Munich dentist Gabriele Bucerius could tell you a lot.In addition to her practical activity, you will advise up to 200 legally insured persons on the phone six days a month."The absolute hit among the services no longer offered by dentists is amalgam filling," she says."But hardly anyone is upset about that today, the patients only say that they are no longer doing them, which should be poisonous."According to the large-scale studies, the amalgam filling is still the filling material of choice, as will prove in the third act, the material mode,.Further examples from Bucerius ’hit list: Dentists claim that the cash registers only paid for inferior plastic in fillings of the front teeth, which lasted a maximum of a few months."The patients are surprised when I tell them that every legally insured person in the frontal tooth area is due to high -quality fillings made of stories and light -hardened plastic," said Bucerius.But the people who are needed are particularly desperate in which dentures are necessary."When I point out that there are not only implants, but also bridges or prostheses, most of them react completely surprised.Others are heard, that is completely out of fashion."

Such sayings learn dentists in seminars.When asked "Do you want to see gold?", Almost every patient becomes "No!"exclamation-and almost agree to pay a ceramic crown to 3.5 times the billing factor.The cash output, a full metal cast crown, would be better for dental preservation because the patient had to sacrifice less substance.A popular homicide argument against every cash benefit is: "I only use high -quality materials."

In the DVD sales seminar of a dentist and coach, which is delivered exclusively to dental practices, patients appear as easily controllable puppets.There is a saying about consultations: "The patient forgets 90 percent of the person said immediately.Why do you want to waste your time? "Better is his method with the same, pre -punched sentences:" I have to show you something! "SPIEGEL in the patient's hand or camera, show findings, also follow, also drastically - forThe sale of simple tooth cleaning may be threatened with strokes and heart attacks as late complications of gum infections.Then - silence.Wait and, if necessary, tax until the patient asks the key question: "What can you do about it?"Now the treatment options describe the therapy with which the dentist wants to earn money in the medium position - most of them are statistically decidedly speaking to the middle variant.Anyone who develops their business into a "allowance practice", according to the coach, whose clientele is changing that they have "better and more pleasant patients".

Stupid only for those who rely on the cash benefits-just like the 48-year-old accountant Manuela V in the long term.Because of a poorly sitting partial prosthesis, she could not really chew and suffered from chronic jaw joint pain.All dentists that she visited in the course of her ten years of suffering recommended implants."Otherwise the problem will come again and again."Nobody wanted to renew the prothyth sitting in the mouth.Only Celina treasures made her a new one as a "additional payable hardship performance".Today your patient is painless.Dentists who refuse something like that commit the contract: the contracts with the health insurance companies provide for regular care for hardship cases.But guys hear many such stories.It is convinced that only the tip of the iceberg is recognizable."If you can afford it somehow, trust your doctor and pay."

Health insurance companies and politicians ignore that an entire branch of the solidarity says goodbye.At a small request from the DIE LINKE party, the Federal Government lets it know that "is no data and evidence" about the misconduct of the dentists."Only from the third hand, for example the media", knew about an alleged trend, the top association of statutory health insurance (GKV) reports on request in writing."Individual cases!" Commented representatives of the Association of Statutory Dentists Berlin, when Celina treasures described the problem before the Senate's health committee at the beginning of the year.From the perspective of the health insurers and doctors, it is a win-win-win situation: According to surveys, patients are largely satisfied with dentists who earn a lot of private services, the health insurers save money and administrative effort.

Third act: the materials-modesey

Every filling material, every denture is a foreign body in the mouth - this causes fear of allergies, intolerances and poisons in some patients.Capital is made from this fear.I sit in the waiting room of a "holistic" dentist known in Germany alongside two older women, one with a thick cheek."Was a tooth pulled you?" I ask."No, I had a jaw treatment yesterday," she explains.A molar tooth with amalgam filling had contaminated the jawbone.The tooth was pulled, the jawbone "softly softened" that the dentist must now remove the top layer again and again.For this they travel 500 kilometers."Doctor (...) is just a luminary."The other woman interferes that her friend is here with the same diagnosis.Both had already paid about 10,000 euros."I have dissolved a home savings contract for this.You have to know what is more important to you, "says the woman with the thick cheek.

In practice, brochures are available that fear teaches.Tooth metals and dead teeth supposedly trigger depression, allergies, anxiety disorders, thyroid problems and much more.An illness called Nico, caused by amalgam fillings and dead or rooted teeth, is a chronic, X -ray invisible otitis.

As so often, when alternative doctors use the knowledge of science, the matter has a real core.In fact, chronic herd of inflammation can promote serious diseases in the mouth."This connection is undisputed for gum diseases," says periodontologist Thomas Kocher, professor at the University of Greifswald, who has been dealing with the topic for almost 20 years.In addition, it is discussed whether inflammation of dead teeth could cause heart disease and diabetes.The disease, however not proven with usual methods, on the other hand, is not accepted in conventional medicine, nor is the alleged effects of dentures containing metal.It is also questionable whether the procedure of the "holistic dentists" is suitable to combat tooth and gum diseases.It is literally a matter of faith whether a "leveling off" of the most compatible tooth material to choose the right choice is in the truest sense of the word.Chemical studies for tracking down "corpse toxins", ultrasound examinations for the diagnosis of Nico, laboratory, gene and allergy tests are also offered.Taken together, they can cost several thousand euros - and then no tooth is dealt with yet.

Gang and existing not only among holistic dentists are the less specific allergy tests, which are often prompted if patients feel uncomfortable after an intervention."Even materials are tolerated in the mouth, against which a patient would react allergic to other parts of the body," says dermatologist Peter Thomas, who has been collecting cases of allergies against denture materials at the University Hospital in Munich for years."This is partly due to special protective factors of the immune system in saliva and in the oral mucosa."Real denture material allergies are rare.

One of these rare cases is the 70-year-old Angela S.that has 16 gold crowns and has been fighting with annoying inflammation of the oral mucosa for years. Ihre Zahnärztinwas ratlos, Gewebeentnahmen ergaben keinen eindeutigen Befund, und so landete Angela S.finally with dermatologist Thomas.After several tests, he diagnosed a gold allergy.It is interesting that Angela S.Never one of the diffuse symptoms showed that unsuspecting and holistic dentists like to diagnose as allergic: no depression, sleep disorders, nerve pain, concentration or digestive disorders."An allergy to dental materials causes local symptoms in and around the mouth, everything else is speculation," says Thomas.

Angela S.must have all crowns replaced.But what?Allergies often occur frequently.Advice for cases like Angela S.Together with the dental toxicologist Franz Reichl from the International Consulting Center, Peter Thomas offers the tolerance of dental materials at the University of Munich.From a large database, he can choose the most compatible tooth material for those affected.To offer a flat rate of "metal -free total renovations", as many holistic dentists do, is extremely questionable for diffuse general symptoms.Hans Jörg Stähle from the dental clinic of the University of Heidelberg, who has repeatedly dealt with the methods of alternative dental physicians, knows dramatic cases in which many teeth were drawn and then entire jaw sections were "milled out"."Sometimes these patients are so damaged that we can no longer take care of them at first," says Stähle, "Extensive prosthetic measures or even implants are very risky, especially then."The necessary reconstructive interventions can result in chronic inflammation - exactly what the patient wanted to avoid - such as peri -implantitis.According to the latest numbers, it meets every fifth patient with implants, one of the megatrends in dentures.The jawbone disappears, and at the end of a costly passion and treatment path, the implants often have to get out again.Because, according to parodontologist Thomas Kocher: "There are no established therapy concepts against it."Amalgam renovations" are also controversial, which offer many dentists naturally and often unsolicited.First, the recommended therapies for the development of mercury from amalgamen are bogged down significant health risks.Second, amalgam fillings according to study results last significantly longer than the alternative of the composite plastics.Thirdly, the latter are affected with far -undisclosed risks than the Amalgam examined in many major studies.To this day, institutions such as the world toothed doctor FDI and the scientific advisory committee for health and environmental risks of the European Commission see little dangers from amalgam.In many industrialized nations, the mercury -containing metal alloy is still the first choice.

According to studies by the dental toxicologist Franz Reichl, plastic fillings emit a variety of fabrics that are swallowed, including those that can be converted into potentially carcinogenic "epoxy connections" in the body.At the moment, several research groups are breeding about the question of whether these substances could promote changes in the genetic material of oral mucosa cells and thus ultimately tongue and oral cavity cancer.

The plastic fillings are also swallowed by the plasticizer bisphenol A, which has long stirred up fears: it unfolds estrogen -like effects in the body and is suspected of influencing fertility and the development of the genital organs. Schon im Jahr 2010wasnten Wissenschaftler in der Zeitschrift "Pediatrics", dass Schwangere möglichst keine Kompositfüllungen bekommen sollten.Bisphenol A was banned in baby bottles, but people take it out of many sources - out of tinoses, the abrasion of cash register and parking certificates and also from tooth fillings.The dose was previously considered unproblematic, but at the beginning of this year the European Food Safety Authority set the limit to less than a tenth of the previous value."Because effects have already been observed at very low doses," says dentist Georg Meyer from the University of Greifswald - and forecast: "In public opinion, plastics will soon take the path of Amalgam."

Toxicologist Reichl hopes that the discussions will then be led more objectively than in the amalgam debates of the 80s: "You have to continue to suspect, but there is no reason to panic.Only one thing you have to say: plastics are not more tolerated than amalgam.So if you take Amalgam, you drive better."

epilogue

After my sample, two dentists send me healing and cost plans.I would have to pay 600 euros for one 250, on the other,.Not really dramatic.ButMichael T's dentist.Had announced that this was just the beginning.I will never find out what she was going to do with me because I don't let my allegedly carious teeth renovate with her.Michael T.But she missed a so-called Mago rail to correct the bite in her opinion. Sie hatteMichael T.A mis-regulation of the muscle or joint function of the temporomandibular joint: the "craniomandibular dysfunction" is actually a serious disturbance that goes hand in hand with chronic pain.But she too is developing into a fashion diagnosis.Michael T.Never complained about pain.

After just a few months with the Mago rail, he hardly got the molars while chewing-a problem that the dentist wanted to solve by all of them overcrowed his 28 healthy teeth.The 65,000 euros for diagnostics and therapy are explained. Dabei brauchteMichael T.Just a bite rail for the night.Every statutory health insurance company would have paid this.