Orthodontic treatment takes between six and twenty-four months provided that it is carried out using the latest treatment methods according to the current state of knowledge. Unfortunately, treatment in Germany usually takes considerably longer. On average, it takes around 4 years to treat children and adolescents in this country – i.e. at least twice as long as it should take.
There are two reasons why the length of treatment in Germany is absurdly long: weaknesses in the German fee-charging system and the bad training which German orthodontists receive.
Why are German Orthodontists not Trained to International Standards?
The tendency of our fee system to favour nonsensically long treatment duration is further encouraged by the German training system. Germany has been the promised land of removable braces since the 1930s. At that time, so-called functional orthodontics was developed in Germany, as was the idea of having to accompany childhood and adolescence with bulky plastic braces in the mouth.
For many decades, working with fixed braces, which were superior in every respect, was no longer taught at German universities. Even though this has changed since the 1970s, a large part of the older generation of professors is still stuck in the old way of thinking. The training of young orthodontists at many German universities is correspondingly antiquated.
Evidence-based medicine, which is advancing from the Anglo-Saxon countries, i.e. the idea of applying procedures to patients that have been scientifically proven to be particularly efficient, is having a hard time in Germany.
How is Orthodontic Treatment in Germany Paid For?
In Germany, orthodontic treatments are paid for in such a way that each individual hand and each work step is paid for separately. This so-called individual service remuneration makes it desirable for orthodontists to provide as many services as possible for each patient.
In order to make the best possible economic use of the individual patient case, treatment times must be extended at the same time: each additional year of treatment brings the opportunity to provide and bill for more services. Against this background, the orthodontists who work most inefficiently are economically best off.
Without wanting to accuse individual orthodontists of deliberately exploiting this system to their advantage – and to the detriment of patients – it cannot be denied that our nonsensical fee system shapes orthodontic treatment much more than training or scientific doctrines ever could.
It is Quicker in Other Countries
The result is that children and adolescents in particular have to endure unnecessarily long, inefficient orthodontic treatments. The extent to which the fee system and training shape treatment can be seen very clearly in a comparison with orthodontics in the UK: there, relatively low flat rates are paid for orthodontic treatment, and treatments take little more than a year on average. The quality of the results probably does not need to shy away from comparison with German long-term treatments. If you tell English orthodontists that children’s treatments last four years in our country, you will be met with incredulous amazement and the question of how this long time is filled at all.
Tip for parents: In our orthodontic practice in Mannheim, active treatment takes an average of 16.5 months, which is less than half of what is usual in Germany.