Oral Health and Public Health Systems in Europe

Opinion

Oral health care in Europe is provided by a diverse range of services. In the Nordic countries children are eligible for public dental services, whereas adults and the majority of older people receive health care from private dental practitioners with national and local co-payment systems [1].

In southern Europe, private dental practitioners dominate, and third-party payment is based on private insurance or costs are paid by employers [2]. While in eastern Europe and central Asia, oral health services are based on a blend of public and private systems [3,4].

The current situation is like that the use of oral health services varies significantly by country. In all countries the poor and disadvantaged population group are underserved [5,6]. Price J et all in a retrospective observational study concluded that the socioeconomic status (SES) gradients indicate inequity in the orthodontic outcomes, with children from disadvantaged communities having poorer outcomes compared to their more affluent peers [7]. Over a third of cases had unreported Index of Orthodontic Treatment Need (IOTN) outcome scores, which highlights the need to improve the outcome monitoring systems. While 7.6% of treatments ending in discontinuation (£2.3 m) and 5.2% ending with residual need (£1.6 m), showing Substantial inefficiencies evidence of the National Health Service in England [7].

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