When Anna brought her son to the orthodontist for the first time, the doctor said just one word: «KIG-3». Anna didn't understand anything, but from the doctor's expression she sensed it was good news. She was right: that number meant the state would cover most of the treatment costs. Eighteen months later her 14-year-old son had straight teeth, and the insurance refunded all 20 percent of the Eigenanteil that Anna had paid upfront.

This is a classic scenario for families in Germany. Many parents have heard «European dentistry is expensive» and never even consult an orthodontist. But if the child has indications (KIG 3-5), the treatment is effectively free. I tell every family with kids aged 9-13: «See an orthodontist at least once. If KIG 3+, you only lose time on the consultation. If KIG 1-2, you'll learn that cosmetic treatment isn't covered.»

Germany's orthodontic system revolves around one classifier: KIG. Understanding its logic means understanding how much you'll pay and why.

What is KIG and how does the system work?

KIG stands for Kieferorthopädische Indikationsgruppen. orthodontic indication groups. The scale was introduced in 2002 to standardize the key question: when should the state pay for dental alignment?

1

KIG 1–2. Mild/moderate anomaly

Insurance does not contribute. Treatment is possible at the patient's request.

2

KIG 3–5. Pronounced/significant/severe anomaly

GKV covers the costs. KIG 5 (cleft palate etc.). full coverage, treatment is mandatory.

Important: GKV covers treatment for KIG 3–5 only for children and adolescents under 18. For adults, exceptions are made only in surgical cases.

How the Eigenanteil system works

Even with KIG 3–5, the patient pays upfront. At the start of treatment, you pay 20% of the cost. If you have a sibling undergoing treatment with the same orthodontist, the second child pays only 10%. After successful completion, the insurance refunds the entire Eigenanteil. making treatment effectively free.

If the patient drops out mid-treatment, the money is not refunded.

How much do braces cost?

🦷 Metal brackets: €2,000–4,000

🦷 Ceramic brackets: €3,000–6,000

🦷 Invisalign / aligners: €3,500–6,500

🦷 Lingual brackets: €5,000–10,000

Braces or aligners?

The honest answer: it depends on the case. Aligners work well for crowding and small gaps. For significant bite anomalies (crossbite, open bite, deep bite) traditional brackets usually provide more predictable results. The advantage of aligners: they are removed before eating. The downside: they must be worn 22 hours a day.

If you have a Zahnzusatzversicherung (dental supplemental insurance), check the contract: many private insurers cover 50-80 percent of orthodontic costs for adults. But only if the policy was taken out before treatment begins.

Treatment steps with braces

Standard treatment path:

  1. First consultation (60-90 minutes). The orthodontist examines, takes an OPG, photo protocol. Determines KIG. If treatment is needed, drafts a preliminary plan. Usually for children aged 9-13.
  2. Heil- und Kostenplan. Document with detailed plan and cost, submitted to insurance. Insurance approves in 2-4 weeks. After approval treatment can begin.
  3. Tooth preparation. If there's caries, it has to be treated. PZR. Tartar removal.
  4. Installation of the appliance (45-90 minutes). Brackets are bonded to each tooth with adhesive. The archwire is placed and fixed with ligatures or clips. Bite check.
  5. Checkups every 4-6 weeks. Wire change, correction of tension. 20-30 minutes per visit. 15-25 visits total over the course.
  6. Removal of braces (60-90 minutes). After 18-24 months. Brackets removed, teeth polished. Control photos.
  7. Retention (forever). Removable night retainer or fixed wire behind the teeth. Without retention teeth drift back.

The first 3-5 days after fitting are painful and uncomfortable. Give your child soft food (soup, yogurt, pasta), pain medication as needed. Adaptation in about a week.

Hygiene with braces

Brushing with braces is its own art. Without proper hygiene, caries can develop under brackets, visible as white spots on the enamel after removal. Permanent, no whitening helps.

  • Electric toothbrush with an orthodontic head. 2x daily, 3 minutes each.
  • Interdental brush. Cleans between brackets and around the wire.
  • Floss with threader (Superfloss). Special floss with a stiff end to thread under the wire.
  • Fluoride mouthwash. Once a day in the evening.
  • PZR every 6 months. Important during active treatment, GKV covers it for children via IP visits.

If your child struggles with hygiene, I recommend considering aligners (Invisalign Teen). They're removable, easier to brush. But private cost.