What does public health insurance cover at the dentist in Germany?

Most people in Germany are insured with a public health insurer — the gesetzliche Krankenversicherung (GKV), usually called “Krankenkasse”. At the dentist it pays for treatment that is sufficient, appropriate and economical. What exactly this includes is defined in guidelines of the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA).

Covered treatment is provided as a benefit in kind (Sachleistung): the practice bills your insurer directly, so you do not pay upfront — provided the dentist is approved for statutory patients. If you want more than the necessary treatment, you pay the difference yourself (Mehrkosten).

• Adults: one dental check-up every half year.
• Tartar removal (Zahnsteinentfernung): once per calendar year.
• Periodontitis screening: every two years.

Professional teeth cleaning (professionelle Zahnreinigung, PZR) is more than tartar removal: it also removes plaque and discolouration and smooths the tooth surfaces. PZR is not a regular GKV benefit. Many insurers pay a voluntary subsidy — whether and how much depends on your individual Krankenkasse.

Medically necessary fillings, root canal treatment and periodontitis treatment are covered. Since 1 January 2025 dental amalgam is generally banned in the EU. For back teeth the GKV generally pays for self-adhesive filling materials — usually glass ionomer cement, in exceptional cases bulk-fill composite. For front teeth and canines it pays for tooth-coloured composite. If you want a different filling, you pay the additional cost.

A comprehensive periodontitis treatment must be applied for and approved by the insurer beforehand. Orthodontic treatment is generally only paid for children and teenagers: the misalignment must reach at least grade 3 of five severity grades (KIG), and treatment must start between ages 10 and 18. Adults are covered only for certain severe jaw anomalies.

For dentures — crowns, bridges and removable prostheses — special rules apply. The insurer pays a fixed subsidy (Festzuschuss) towards the standard care (Regelversorgung): the treatment that is medically necessary for a specific diagnosis, as defined by the G-BA in its fixed-subsidy guideline.

Since 1 October 2020 the subsidy is 60% (previously 50%). Important: the percentage refers to the average cost of the standard care for your diagnosis — not to your actual bill. If you choose a more elaborate or a different type of denture, for example a ceramic crown, you pay the extra cost. Everything above the subsidy is your own share (Eigenanteil).

Implants usually have to be paid for privately; only in a few particularly severe cases does the insurer cover them. People with low income or on social benefits can have the full cost of the standard care covered under the hardship rule (Härtefallregelung).

From the age of 12 you can have your check-ups confirmed in a bonus booklet (Bonusheft). If you can prove that you attended the yearly check-ups for five years, the denture subsidy rises to 70% of the standard care cost; after ten years to 75%.

Before dentures, the dentist creates a treatment and cost plan (Heil- und Kostenplan). It lists your findings, the possible standard care and the treatment actually planned, with insurer benefits and private extras shown separately. With your consent the practice sends it digitally to your insurer, which must approve it before treatment starts and then states the subsidy.

The typical gaps are the own share for dentures, professional cleaning, fillings or materials beyond the standard care, implants and orthodontics for adults. A private supplementary dental insurance (Zahnzusatzversicherung) can cover part of these costs — depending on the tariff.

Tariffs differ considerably: check reimbursement levels, annual limits in the first years, waiting periods and whether treatments that have already been recommended or started are excluded. A final review of the tariff conditions is always necessary.

This article describes statutory health insurance only. If you have private health insurance (PKV), your contract defines your dental benefits; the GKV rules described here, such as the fixed subsidy or the bonus booklet, do not apply in the same way. Before choosing a supplementary dental tariff, check in its conditions whether it is available with your type of health insurance.