Malocclusions and braces – what patients should know

Which malocclusions need to be treated, which brace suits when – and what statutory health insurance covers.

Misaligned teeth and braces – what it is about

Orthodontics moves teeth and jaws into a position in which they meet cleanly. That is not a question of appearance alone: a bite that does not fit overloads individual teeth, makes cleaning harder and can affect the jaw joint and speech. Treatment therefore follows the findings, not a wish.

A tooth is always moved in the same way: light, sustained pressure, upon which bone is broken down on the pressure side and built up again on the tension side. That takes time and cannot be hurried. What produces the pressure – fixed braces, a removable plate or an aligner – is decided by the findings.

Four jaw models with different misalignments side by side

What shows a misalignment

Not every irregularity has to be treated. These observations, though, are reason to take a look:

The upper front teeth protrude noticeably
The teeth are crowded, crooked or rotated
The front teeth do not meet when biting down
The lower jaw shifts to the side when closing
Milk teeth fall out very early or very late
Persistent thumb or dummy sucking after the age of four
Breathing through the mouth instead of the nose

The timing matters too

As long as the jaw is growing, that growth can be worked with – it is the most effective tool orthodontics has, and it costs nothing. The professional bodies therefore recommend a first check-up between the ages of seven and nine. In most cases the result is: keep watching, come back in a year. That is precisely the point of the appointment.

In adults this growth is absent. Teeth can still be moved at any age; only changes to the position of the jaw are then possible by surgery alone. And whatever the age: once the braces come off, a retainer holds the result – without it the teeth drift back.

Frequently searched

The five questions almost everyone starts with

Main topics

Three ways into the subject

Misaligned teeth

Overbite, underbite, crossbite, open bite, deep bite, crowding: which deviation is present decides the effort, the timing and the cost.

Braces

Fixed braces, a removable plate or a clear aligner – it is not the design that decides the result, but whether it suits the findings and is actually worn.

Costs and health insurance

Statutory health insurance pays for children from KIG level 3 – but at first only 80 per cent. What that means and what comes on top privately.

Current news from orthodontics

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The key facts at a glance

Not every crooked row of teeth needs treatment. A correction is medically justified when chewing, speech, breathing or oral care suffer.
Whether the statutory health insurance pays is decided by the classification into the orthodontic indication groups – from grade 3 upwards, the costs are covered.
The best time for the first examination is at eight to nine years of age; during growth, more can be guided than afterwards.
After the brace comes the retainer. Without it the teeth drift back – that is the rule, not the exception.

Answered briefly

Frequently asked questions

Does my child really need a brace?

That is decided by the findings, not by appearance. Treatment is given when the malocclusion has consequences or will foreseeably have them – overloaded teeth, worn-down edges, areas that cannot be cleaned, or a bite that forces the jaw joint. Ask to have the classification explained to you.

Who pays for a child's braces?

For children and adolescents with a pronounced malocclusion, statutory health insurance covers the treatment; you advance 20 percent and get it back after successful completion. For minor misalignments and for adults, the treatment has to be paid privately. The figure only becomes reliable with the written cost plan.

Can it be done without a visible brace?

Yes – with aligners or with brackets bonded on the inside. Both are more expensive than the classic fixed brace and not suitable for every case. What is possible in your case is determined by the examination.

For how many years do you wear braces?

One to three years of active treatment, depending on the extent. This is followed by stabilisation with a retainer, which accompanies many people permanently.

The KFO-Berater is an independent information portal for patients – without advertising, and none of these pages replaces an examination. Under News you will find current reports, under FAQs the short answers. Gums and bone loss are covered by the Parodontologie-Berater, dental implants by the Implantat-Berater.