Judgments No teeth cleaning by dentist on cash costs

BSG: Brushing your teeth is your own responsibility
Regular weekly tooth brushing by a dentist does not have to pay the statutory health insurance. This also applies if a physically and mentally handicapped person is not able to brush his teeth himself, judged on Tuesday, 11 July 2017, the Federal Social Court (BSG) in Kassel (Az .: B 1 KR 30/16 R).

The plaintiff originating from the area Hanover and born 1975 could not clean his teeth because of his handicap. The man is classified in Care Level III for spinal fusion and mental retardation. His mother was not allowed to do regular oral hygiene with him.

Every second cashier pays the professional teeth cleaning. Picture: Kzenon - fotolia

At his own expense, the disabled person was once a week with his dentist a total of ten times to clean the teeth. The dentist did this with the help of ultrasound, the use of toothbrushes and the introduction of an antibacterial chlorhexidine gel.

The application for reimbursement refused his health insurance, the health insurance DAK.

However, the Social Court of Hannover convicted the health insurance to refund the plaintiff 150 euros. The state social court confirmed this decision.

But the BSG was now the health insurance right. Tooth cleaning is a "not at the core medical, but generally sensible approach to the prevention of dental disease", which the insured in principle must provide on their own responsibility. If necessary, however, the long-term care insurance covers the needs of people in need of care and those with disabilities, according to the Kassel judges. fle