In France, the Observatoire Prospectif des Métiers et des Qualifications dans les Professions Libérales published in November 2021 a -well detailed- study – on “The dental team in Europe ».

From the comparison of France with 6 countries (Germany, Belgium, Denmark, Italy, Romania, United Kingdom) appears the obvious : the national organization of the healthcare covering and of the out-of-pocket costs is the determining criterion for the organization, size and profitability of a more or less extended dental team.

In that context the study identifies 3 basic trends :

1-The strengthening of grouped practice (in Germany, United Kingdom, Denmark). The economic context is well known :

  • a more and more costly initial investments to set up a practice;
  • a more constrained income (especially in Nordic countries wherein fees are regulated and public spending is controlled);
  • a more intense competition in cities (via the more or less controlled development of dental clinics chains, e.g. in Belgium or Romania) from a profession with a growing workforce (+6% between 2013 and 2018).

Grouped practice allows obviously the pooling of the increasing costs.

2-The increase in the size of dental teams. The practice limited to the pairing of a dental surgeon with a dental assistant is a model under pressure.

  • The number of salaried employees increases (only 66% of German practitioners have their own practice).
  • The number of assistants increases too, with e.g. the introduction of new professions (e.g. dental hygienist in Belgium, administrative manager in Germany).

3-The use of delegated procedures (i.a. x-ray and oral hygiene education). The WHO in its forthcoming global strategy in May 2022 will recommend them. The study emphasizes some advantages:

i) allowing dentists to refocus on high value-added activities;

ii) also allowing patients to gain access to oral care more quickly (especially prophylactic care, hence the WHO proposal), knowing that 97% of dental needs are already met by the European population (source: Eurostat, 2018);

iii) allowing dental staff to have a career development, like in Germany, Denmark and the U-K, where continuing professional education leading to certification is particularly appreciated.