Is dental care in Europe inadequate?

A report by the European Observatory on Health Systems and Policies assesses access to dental care  across 31 European countries and shows the potential for dental tourism.

The report, ‘Oral health care in Europe: Financing, access and provision Health Systems in Transition, Vol. 24 No. 2,’ states that oral diseases are increasingly recognised as one of the most prevalent conditions in Europe, affecting nearly half of the European population. Despite their high prevalence, statutory cover of dental care is limited in many European countries as evidenced by restricted service packages and high private funding compared to other health services.

The review investigates a broad range of topics of oral health care across Europe, ranging from oral health and inequalities, cover gaps, financial protection and unmet needs, preventive community care, workforce, corporate dentistry and cross-border care. It identifies common trends and challenges in financing, access, coverage and provision of oral health care in 31 European countries.

Key conclusions include:

• Oral diseases remain an important burden of disease despite decreasing prevalence in all age groups and stronger focus on preventive care.
• Data is lacking on virtually all areas of oral health care, particularly on the underlying causes and the prevalence of oral disease, as well as the effectiveness of community preventive activities and oral health services. This situation impedes informed policy making.
• Private expenditure plays an important role in many countries for covering dental care services. In particular for adults, public cover is more limited on average than for children and other vulnerable groups.
• Dental care is the most frequent type of care for which people report unmet needs due to financial reasons particularly affecting vulnerable and low-income populations.
• There are large differences in dentist ratios across European countries, but most countries have seen an increase of dentists associated with the growth of the private sector and increased cross-border dental tourism.
• Dental costs varying widely between countries across Europe leads to dental tourism.

Varying state cover for dental care is also identified as a driver of dental tourism. In France and Germany, the state health insurance package including dental treatment has specific limits but allows dental treatment abroad at lower costs to avoid cost-sharing at home.

This travel for dental treatment is mostly from Western Europe to Central Europe plus bordering countries including Austria and Hungary. Budapest is considered as the dental tourism capital of Europe although this is based on historic information and views rather than actual statistics. Romania and Croatia see dental tourism as having potential.

As well as an increasing number of private dental clinics in Hungary and Poland targeting dental tourists, many dentists are moving across borders to Germany, Sweden and Norway to offer locals dental treatment at lower costs.

The report does offer more detail on dental tourism but has to be read with care as many statistics are very old – some as historic as 2010.  While it shows that dental tourism may have been in existence for a long time, current information and statistics are very limited, so it is unclear how dental tourism has changed in the last decade as to who goes from where to where and why.