Towards prevention--changing dental care structures in the Federal Republic of Germany

The West German sick funds offer one of the most generous benefit packages in the world; all in- and outpatient services are included under medical and dental care although preventive dental services were not, until recently, covered by the plans. Since the beginning of 1989, however, several changes concerning coverage and cost-sharing have been implemented to curb the steep increase in oral health care costs and shift the traditional orientation of the system from restorative and replacement treatment towards prevention. The features of the old system, the changes, and the preliminary results are described.