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Dynamics of Dental Education, Organization, and Regulation of Dental Practice in Europe 2016-2023
Thomas Gerhard Wolf1, Peter Lingström2, Jacques Deniaud3
1Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Germany; Free Association of German Dentists FVDZ (Freier Verband Deutscher Zahnärzte), Bonn, Germany.
Background:
This study examines shifts in dental education, organization of dentists, changes in regulation of dental practice across European countries and comparing differences between 2016 and 2023 of member states of the FDI World Dental Federation and WHO-Europe region.
Methods:
Surveys conducted by the ERO-FDI in 2016 and 2023 included 45 countries (34 ERO and 11 non-members). Data on practice types, legal frameworks, education, and organization were collected via national dental associations. Statistical analyses employed t-tests and Fisher's exact tests to compare the two surveys over time.
Results:
Private practice (self-employment) remained the dominant model (48.65%±28.28%, confidence interval (CI) [43.11 / 54.19]), followed by employment in private practice (24.32% ± 20.33%, CI [20.34/28.30]) and group practice (15.27%±20.39%, CI [11.27/19.27]), public health system (13.76%±20.17% (CI [9.81, 17.71]), municipal/national clinic (8.98%±17.86% CI [5.48/12.48]), oral healthcare center (6.61%±14.19% CI [3.83/9.39]), university clinic (4.90%±6.82% CI [3.56/6.24]), and industry (0.36%±0.78% CI [0.21/0.51]). Statistically significant growth was observed in group practice (two-tailed; F=14.53 P < .01) and oral healthcare center (two-tailed; F=30.72 P < .01). Male/female dental student ratio remained stable at approximately 1:2 (two-tailed; F=0.87, P = .66 (m); F=0.85, P = .60 (f)). A total of two-thirds of the countries allow non-dental investor-led oral healthcare centers (P = 1.00).
Conclusions:
European dentistry is currently undergoing significant changes, including an increasing adoption of corporate and group practice models, approximately a 2:1 female to male ratio in dental education, and a growing urban-rural divide in care. Legal frameworks and the increasing involvement of non-dental investors could affect the quality and accessibility of care, particularly in rural areas. Future research should examine the long-term impact of these changes on patient care, dentist satisfaction, and the demand for flexible working models.
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