For many patients, the diagnosis “root canal treatment” causes double stress: concern about the tooth itself and concern about the costs involved. While we focus on the medical side of preserving your tooth, we would like to clarify the often confusing rules surrounding cost coverage.
As is so often the case in medicine, the answer to the question “Will my insurance cover it?” is: it depends.
How Statutory Health Insurance (GKV) works
Patients insured under Germany’s statutory health insurance system are entitled to treatment that is adequate, appropriate and cost-effective (Social Code Book V, §12). In practical terms, this means that the insurance fund will cover treatment aimed at preserving a tooth—but only under clearly defined conditions.
The basic requirement: The tooth must be classified as worth preserving, and the prognosis of the treatment must be favourable. If the tooth is already too severely damaged or the root anatomy is extremely complex, the insurance fund may refuse to cover the costs and instead only approve extraction.
Special rules for Molars
The regulations are particularly strict for molars in the posterior region. Statutory insurance will only coverroot canal treatment of a molar if at least one of the following conditions is met:
- Preservation of a continuous dental arch: The tooth is part of a complete row extending to the midline. Removing it would create a gap.
- Avoidance of a free-end situation: If the tooth were extracted, there would be no tooth behind it, resulting in a “free-end” situation that complicates and increases the cost of future prosthetic treatment.
- Preservation of existing dental restorations: The tooth already carries a crown or bridge, or serves as an abutment for a denture that would become unusable if the tooth were lost.
If none of these criteria apply, statutory insurance generally covers only extraction. Important: You may still choose to preserve the tooth – in this case, the entire treatment is provided as a private service at your own expense.
Why do additional costs arise?
Even when insurance agrees to cover a root canal treatment, patients often receive a treatment and cost plan including private co-payments. Why?
Statutory insurance covers only the basic level of care (standard radiographs, basic canal preparation, simple filling). Modern endodontics, however, offers advanced techniques that can increase success rates from around 60% (basic care) to up to 95%. These methods are not included in the statutory benefits catalogue.
These advanced options include the “big four” of modern tooth preservation:
- Dental operating microscope: You can only treat what you can see. The microscope reveals extremely fine canals that would otherwise be missed. (Private service)
- Electronic working length measurement: Instead of relying solely on X-rays, canal length is measured electronically – more precise and with less radiation exposure. (Private service)
- Activated irrigation (ultrasound or laser): Bacteria hide in microscopic niches that instruments cannot reach. Activated solutions disinfect these areas far more effectively. (Private service)
- Thermoplastic root filling: Warm, flowable filling material seals even tiny lateral canals more reliably than traditional cold points. (Private service)
Private Insurance and Supplemental Dental Plans
- Private health insurance (PKV): Modern endodontic procedures are usually reimbursed according to the German fee schedule (GOZ). However, individual policies may include limitations or deductibles – always check your tariff.
- Supplemental dental insurance: High-quality plans often cover the portion not paid by statutory insurance (e.g. microscope-assisted treatment). Important: the policy must be in place Before the diagnosis is made – you cannot insure a house that is already on fire.
Our Advice: Transparency before treatment
Do not let costs come as a surprise. Before any procedure, we provide a detailed treatment and cost plan. Ask us openly: What is covered by insurance? What is private? And what concrete benefit does the additional service provide for my tooth?
In the long run, preserving your natural tooth is almost always the better—and often even the more cost-effective—solution compared to extraction, a gap, or an implant.