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Updated: Jan 9, 2026
Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Dental Care and Oral Health Within the Framework of Bulgarian Public Health Financing
Ralitsa Raycheva1, Ivelina Popova-Sotirova1, Nina Musurlieva1
1Department of Social Medicine and Public Health, Faculty of Public Health, Medical University Plovdiv, 4002 Plovdiv, Bulgaria.
Abstract:
Background/Objectives: Oral health is a critical component of public health, yet disparities in access and financing remain significant. In Bulgaria, dental services are financed through the National Health Insurance Fund and patient co-payments, with coverage differing between children and adults. The aim of this study was to analyze the dynamics of health insurance payments and expenditures for dental care in Bulgaria over the period 2019-2025, with a focus on differences between age groups and the balance between public funding and patient contributions. Methods: A retrospective descriptive-analytical study was conducted using aggregated data from NHIF annual reports, national legislation, and secondary literature. Absolute expenditures (BGN) and relative shares (%) of dental services within total health insurance payments were examined for the period 2019-2025 (actual data). Key dental procedures analyzed included examinations, restorations, extractions, and treatment of pulpitis/periodontitis in children, as well as prosthetic rehabilitation in older adults. Descriptive statistics, trend analysis, and simple linear regression were applied to assess expenditure growth and predictability. Results: Total health insurance payments in Bulgaria nearly doubled between 2019 and 2025, increasing from 4.12 to 8.87 million BGN. Dental expenditures rose from 167,000 to 416,000 BGN, with the share of dental care rising modestly from 4.05% to 4.69%. For children, NHIF covered nearly all costs, with minimal or absent co-payments. Among adults, a co-financing model prevailed, with fixed patient contributions for basic services but full NHIF coverage for prosthetic rehabilitation in edentulous patients aged 65-69 years. Conclusions: Bulgaria's dental care financing reflects a socially oriented model, with full coverage for children and mixed financing for adults. Strategic policy adjustments are needed to ensure sustainability, equity, and alignment with universal health coverage goals.
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