Cutting Dental Bills

The roughly 90 percent of Germans insured under the statutory health system have after recent reforms been forced to pay much more of doctors' bills out of their own pockets. This is because the statutory insurers only meet about half of the total costs, and the patients have to pay the rest.

The amount the patient has to pay can vary, depending on treatment. Patient-footed bills are particularly high for dental treatment, where the statutory health insurance only covers the run of the mill procedures. Germans who need crowns, bridges, implants or dentures are thus stuck with paying a hefty bill.

It's against this background that a dental discount chain called McZahn -- or McTooth -- has started operations in Germany.

McTooth plans nationwide expansion

The McTooth dental discount chain started up operations in the western German town of Krefeld and is poised to have a total of some 30 branches throughout the country by the end of the year. It keeps laboratory costs to a minimum by outsourcing all precision work on crowns, bridges and the like to China.

For patients, the cheaper cost is the main factor for them to go to McTooth. Dirk Frank, one of the discounter's first patients in Germany, said he had been considering seeking dental treatment in Poland, where the costs are also considerably lower than in Germany.

"I’d been thinking about going to Poland to get my teeth fixed, but then I had doubts about the quality of the dentists' work there," Frank said. "And I also knew that follow-up treatment would be a bit tricky. I have no problem with the McTooth concept."

"The laboratory work is done in China keeping overall costs much lower. But the quality will be acceptable, because the material for the lab work comes from Germany," he added.

Another patient, Simone Kleber, said she wasn't sure whether she'd be satisfied with the treatment. But she freely admitted that if she didn't give McTooth a try, she'd never know.

"If I'm not satisfied with the end result, I can easily go back to my old dentist," she said. "But it's worth a try, and you have the same sort of warranty for the Chinese lab work. If anything falls apart, I'll be back again in no time, believe you me!"

Experts fear a decrease in quality care

Michael Knittel from the German Dentists' association believes individual dental care is going to suffer. "It is essential that the dentist and patient can discuss openly and frankly what sort of treatment would be proper and sensible in each individual case. This is something patients should remember before jumping at McTooth's offer."

Knittel is referring to the conditions under which dentists join the McTooth chain. They have to buy into it and become share-holders. As the scheme is based on the sale of false teeth and dentures, doctors may be overly inclined to talk patients into getting replacements for their natural teeth when in fact alternative treatment would suffice.

Practitioner's queuing to join franchise, says chief

But McTooth boss Werner Brandenbusch argues that his dentists are responsible enough to refrain from such practices. And he is delighted with the response he is getting from the dental profession.

"The list of dentists wanting to join us is endless," he said. "And I'm not talking about newcomers, but well-established dentists. They are telling us that they would be afraid of this new powerful competition. So rather than living their lives in fear, they decide to jump aboard and be part of this exciting new scheme. We have applicants from all German regions and cities.”

For McTooth customers like Dirk Frank the chain is a success in terms of savings. "I have to pay around 1,000 euros for implants," he said. "That means altogether I will have saved between 500 and 1,000 euros." And the China-made implants are sitting just fine.