Orthodontic indication groups
The orthodontic indication groups ( KIG ) are the diagnosis-related classification scheme in Germany for classifying the need for treatment within the framework of the orthodontic indication system. On January 1, 2002, the KIG replaced the therapy-oriented indication system that had been in effect until then.
On the basis of the orthodontic indication groups , the orthodontist determines whether there is a misalignment of the teeth (tooth and / or jaw misalignment) for the treatment of which the insured person is entitled to benefits from his health insurance company . To do this, he classifies the finding into one of five degrees of treatment need. The health insurance companies pay benefits for treatments of severity levels 3 to 5. The treatment costs for levels 1 and 2 are not covered by the health insurance companies, since these treatments are not part of the GKV service catalog and can only be provided as a private service.
- Grade 1 includes the slight misalignment of teeth , the treatment of which may be desirable for aesthetic reasons, but not at the expense of health insurance.
- Grade 2 includes minor misalignments of teeth that require correction for medical reasons, but the costs of which are not covered by health insurance companies.
- Grade 3 includes pronounced misaligned teeth that require treatment for medical reasons.
- Grade 4 includes severely misaligned teeth that urgently require treatment for medical reasons.
- Grade 5 includes extremely pronounced misaligned teeth which, for medical reasons, require treatment.
The need for treatment can in principle arise from eleven groups of causes. Depending on the degree of severity, they are then classified into grades 1 to 5:
- Developmental disorders in the head area
- Number of teeth ( hypodontia )
- Tooth eruption disorder
- distal bite position (usually by reclining the lower jaw)
- mesial bite position (mostly due to protruding lower jaw, progeny )
- Open bite
- deep bite
- Buccal or lingual occlusion (crossbite in the posterior region)
- Deviation in jaw widths (e.g. head bite)
- Contact point deviations (e.g. crowding)
- Lack of space
The orthodontic indication groups were introduced in order to limit the expenditure of the statutory health insurance for orthodontic treatment (see also: prioritization of medical services , two-class medicine , economic efficiency requirement ). Orthodontic treatments are very cost-intensive and a scientific demarcation between needing treatment and not needing treatment has been discussed since 1900 with varying results. The transitions between normal dentition ( eugnathia ) and false bite ( dysgnathia ) are fluid. Over the years, the need for orthodontic treatment has continued to grow, as the limits have shifted towards cosmetic corrections of the tooth position . As part of the economic efficiency requirement according to § 12 SGB V, to which the treatment of patients with statutory insurance is subject, the legislature saw itself forced to drastic reductions in benefits in orthodontic treatment and introduced the very restrictive orthodontic indication groups .
The indication groups are based in order to make the orthodontist's decision verifiable, in particular for experts and for reviews within the scope of the performance audit (with subsequent recourse claims against the orthodontist), but also to have an objective decision and justification criterion for the demanding parents of the children in need of treatment on objective measurements (in the millimeter range) on the plaster model of the jaw.
In Austria , the Index of Orthodontic Treatment Need (IOTN) has been used in a similar way since 2015 .
