16/11/2023
Random Q/A.
Q: I need a filling / root canal treatment, but my dentist tells me it’s gonna cost extra, even though I have public health insurance. What the hell?
A: The Krankenkasse only covers very basic fillings (Amalgam or cement) and root canals treatments (manual). Usually we explain all the advantages and disadvantages, risks, and potential additional costs in advance.
In a nutshell it looks like that.
Amalgam or cement usually holds in a tooth mechanically, meaning I have to remove not only infected tissues, but also healthy ones, just for the sake of creating a shape, that’s gonna hold the filling. The alternative to that is composite, it’s sort of glued to the tooth (so-called micro-mechanical adhesion), which means a) it holds a lot better, b) I can ignore, how I shape the cavity, and only remove the tissues, that are infected.
Amalgam or cement is going to be visible. Amalgam is basically a metal filling, cement is a something we usually use under crowns.
With composite I can restore a tooth a lot more anatomically - I put it in layers, light-cure every layer, which gives me plenty of time and opportunity to build the tooth pretty close to what it anatomically used to be. Amalgam and cement are placed in one piece, meaning we put it in and hope for the best.
Roughly about the costs. If I have to restore just one surface, the composite filling is gonna cost you around €60. If two - closer to €90. Bigger filling cost over €100.
My personal-professional opinion, if you’re on a budget:
For 1-surface fillings amalgam is totally fine.
If we need to restore a side wall of a tooth (2-surface fillings), I’d invest in composite, b/c it’s gonna create a lot better contact between 2 teeth, meaning the food is less likely to be getting stuck, and the gum is less likely to be inflamed all the time.
Now about the root canals.
As we all know, machines are better than people. 🙂 That applies to the root canal treatments, too. If I’m to prepare a coot canal manually, I’m basically scratching it with a special needle back and forth. Problem is that most root canals are not straight. As a result, my manual needle removes only that much. If I am however to use a special machine, it’s a whole different story. It rotates the needle, so that it reaches every corner, removing a lot more infected tissues. The less infected tissues are left in the canal, the better is the prognosis for the tooth.
Preparation with a machine costs around €60-70 per canal. The more “front” the tooth is, the less canals it has. Front teeth typically have 1 canal. Back teeth - 3, sometimes 4. In between you can see those weird teeth, that are neither front teeth nor back teeth, they are called premolars, and they usually have 2 canals.
My personal-professional opinion, if you’re on a budget:
Front teeth usually have reasonably straight canals, for those manual root canal treatment could be totally fine. The canals of the back teeth, however, typically bend like hell, I’d rather use the machine on them
