European perspective on opportunities and challenges for the dental profession
The Council of European Dentists (CED) has expressed great concern about the pressures that both the liberal profession and its patients are facing. Purely market-driven dental chains put patient safety at risk through mismanagement and mistreatment of patients and employees. While advertising by dentists is tightly regulated, dental chains are able to take a more aggressive approach. Therefore, national legislators have a responsibility to put patients first and ensure that they receive the oral care they deserve.
The CED is a European not-for-profit association, previously known as the EU Dental Liaison Committee, that represents over 340,000 dentists across Europe. Its objectives include promoting high standards of oral health, dentistry and dental care, contributing to safeguarding public health and promoting the interests of the dental profession in the EU. To this end, the CED has worked tirelessly over the years on improving EU legislation and putting issues that concern dentists on the political agenda. These include matters as diverse as professional qualifications, patient safety, health workforce planning, antimicrobial resistance, dental materials, medical devices and e-health.
The dental profession and dental services are constantly evolving. New technology, new materials and new devices create both immense opportunities and great challenges. On the one hand, dentists nowadays must be more digitally savvy, follow strict data protection regulations and work within the constraints of tight healthcare budgets. On the other hand, they have access to more research, better instruments and improved materials.
Despite all these developments, the CED’s guiding principles remain the same: Europeans should have access to high-quality oral healthcare, which must be provided by well-trained, skilled and fully competent dentists using the latest and most appropriate technology with an evidence-based approach. The CED, therefore, strives to ensure that the dental profession continues to be adequately regulated and that today’s dental teams can face new challenges and provide patients with the best possible treatment.
It must be stressed that dentists and other healthcare professionals provide a unique service. Provision of healthcare is not a commodity and falls outside of the market-driven supply and demand logic of other regulated professions, such as those of plumbers, ski instructors or translators. Unfortunately, some regulators do not differentiate and try to apply competitive free-market ideology to dentistry, either because of budget pressures or for political motives.
With this in mind, the CED has noted with concern the latest developments regarding corporate dentistry in Europe. Organisations, usually run by investment companies, are setting up dental offices in a number of locations, either in a single country or across a number of different countries, often motivated more by creating a return on investment than by delivering good dental care to patients. Frequently, these organisations are headed by a manager who is not a dentist, and the dentists are relegated to the role of employees. The CED is concerned that the commercial interests which are driving the business model of such organisations may impact patient safety overall through a variety of factors, including poor treatment, unsatisfactory employment conditions and inadequate provision of care. Incidents in Spain and France have shown upsetting examples of some dental chains’ disregard for patient safety. Patients were left without proper care and, in some instances, even harmed. To draw attention to these worrying developments, the CED General Meeting adopted a resolution on corporate dentistry in Europe in November 2018.
Advertising of dental services is another widely discussed issue in Europe. The European Court of Justice issued a preliminary ruling in May 2017 in which it concluded that an overall prohibition of advertising is excessive, but that the protection of health may be an objective that justifies advertising restrictions. The Court considered that promoting inappropriate or unnecessary care, misleading patients, damaging the image of the profession and distorting the relationship between dentist and patient undermine the protection of health and compromise the dignity of the profession. While dentists are bound by national legislation, regulations or codes of conduct setting out rules for advertising by healthcare professionals, dental chains are not. Anecdotal evidence shows that some chains try to recruit patients through more aggressive marketing focused on prices and payment plans. It is up to national legislators to put an end to this to ensure that patients are not misled and that they receive the oral care that they deserve.
The CED is proud to represent 340,000 practising dentists across Europe and we stand ready to seize the opportunities and face the challenges that the present and future hold for oral health and dentistry.