MANUAL OF DENTAL PRACTICE © The Council of European Dentists November 2008 # 4 / 2008 ___ _______________ ___EU Manual of Dental Practice: version 4 (2008) Council of European Dentists MANUAL OF DENTAL PRACTICE 2008 ***** Authors: Dr Anthony S Kravitz OBE and Professor Elizabeth T Treasure Dental Public Health Unit in Cardiff Dental School, Cardiff University, Wales, United Kingdom © The Council of European Dentists November 2008 1 EU Manual of Dental Practice: version 4 (2008)_____________________________ 2 ___ _______________ ___EU Manual of Dental Practice: version 4 (2008) Preface The revised Manual of Dental Practice in the EU was commissioned by the Council of European Dentists1 in November 2007. The work has been undertaken by the Dental Public Health Unit in Cardiff University, Wales, United Kingdom. Although the unit had editorial control over the content, most of the changes were suggested and validated by the member associations of the Committee. About the authors2 Anthony Kravitz graduated from the University of Manchester, England, in 1966. Following a short period working in a hospital he has worked in general dental practice ever since. From 1988 to 1994 he chaired the British Dental Association’s Dental Auxiliaries’ Committee and from 1997 until 2003, was the chief negotiator for the UK’s NHS general practitioners, when head of the relevant BDA committee. From 1996 until 2003 he was chairman of the Ethics and Quality Assurance Working Group of the EU Dental Liaison Committee. He is an Honorary Research Fellow at the Dental School,Cardiff University, Wales and his research interests include healthcare systems and the use of dental auxiliaries. President of the BDA from May 2004 until May 2005, he was awarded an honour (OBE) by the Queen at the end of 2002. Elizabeth Treasure graduated from the University of Birmingham in 1979, following which she completed a PhD. She then worked in the community dental service before emigrating to New Zealand to become a full-time academic in 1990. She returned to Wales in 1995. She is Dean of the Dental School of Cardiff University and is Professor and Honorary Consultant in Dental Public Health. She has been a scientific advisor to the Department of Health in London. Her research interests include clinical effectiveness, epidemiology and clinical trials. She has been a member of the UK Medical Research Council group on fluoridation and on a European Union Expert group reviewing the concentration of fluoride in paediatric toothpaste. She is one of the authors of the 1998 UK Adult Dental Health Survey and has chaired a review of dental workforce in Wales. She was the leader on the oral health specialist branch of the National Electronic Library for Health. Acknowledgements The authors would like to express their thanks to the staff from all the dental associations of the EU for their contribution. They would also like to acknowledge and thank: The dental associations of 31 EU/EEA countries and Croatia The dental councils of several countries The Secretariat of the CED Rob Anderson Dr Kenneth Eaton (CECDO) Ms Ulrike Matthesius (British Dental Association) The Federation Dentaire Internationale (FDI) The European Commission, including Eurostat The Chief Dental Officers of the EU (CECDO) Conference of Orders and Assimilated Bodies of Dental Practitioners in Europe (CODE) The World Health Organisation (WHO) The Union Bank of Switzerland (UBS) The Organisation for Economic Cooperation and Development (OECD) The CIA Worldfactbook The International Monetary Fund (IMF) Disclaimer The Manual was sent for publication in October 2008, when ratification of the Treaty of Lisbon (2007) had not been completed. 1 CED Brussels Office, Avenue de la Renaissance 1, B - 1000 Brussels, Tel: +32 - 2 736 34 29, Fax: +32 - 2 732 54 07 2 The authors may be contacted at [email protected] 3 EU Manual of Dental Practice: version 4 (2008)_____________________________ 4 ___ _______________ ___EU Manual of Dental Practice: version 4 (2008) Contents Preface .............................................................................................................................................................................................3 Introduction........................................................................................................................................................................................7 Part 1: The European Union.............................................................................................................................................................11 Chart 1 – GDP per capita at PPP in 2007 (some countries 2006):.........................................................................................13 Chart 2 – Comparitive prices, including rent, in 2008 – based on Zurich = 100 – also compared with wages net of tax ...........13 Chart 3 – Comparison of Domestic Purchasing Power, in 2008 – based on Zurich = 100 (also compared with 2003 data) .....14 Part 2: The Dental Directives, Acquired Rights & the Freedom of Movement......................................................................................15 Part 3: Other Directives directly relevant to dentists...........................................................................................................................21 Part 4: Healthcare and Oral Healthcare Across the EU/EEA..............................................................................................................25 Chart 5- (Active) Dentist to Population ratio..........................................................................................................................25 Chart 4 - percentage of GDP spent on health by governments in 2004-05 as reported by the OECD in 2008 .........................25 Chart 6 – (Active) Dental Clinical Worker to Population ratio.................................................................................................25 Table 1 - Healthcare systems in EU/EEA countries...............................................................................................................27 Table 2 - Patient re-examination periods ..............................................................................................................................28 Chart 7 – the average Decayed, Missing, Filled Teeth at the age of 12 years (DMFT)............................................................28 Chart 8 – the proportion of children of 12 years of age with no Decayed, Missing, Filled Teeth (DMFT)..................................28 Chart 9 – the proportion of adults 65 years (or older) with no teeth (edentulous)....................................................................29 Table 3 - Community fluoridation..........................................................................................................................................29 Part 5: The Education and Training of Dentists .................................................................................................................................31 Table 4 – Dental schools, numbers of students and gender ..................................................................................................31 Table 5 – Undergraduate Training greater than 5 years ........................................................................................................32 Table 6 – Mandatory Vocational Training .............................................................................................................................32 Table 7 – Mandatory Continuing Education..........................................................................................................................33 Part 6: Qualification and Registration................................................................................................................................................35 Table 8 - Regulation of dentists (2008).................................................................................................................................36 Part 7: Dental Workforce..................................................................................................................................................................37 Table 9 - Numbers of dentists ..............................................................................................................................................37 Chart 10 – the number of “active dentists” in each country....................................................................................................38 Table 10 - Gender of dentists...............................................................................................................................................38 Chart 11 – the gender of “active dentists” in each country.....................................................................................................38 Chart 12 – the proportion of “overseas dentists” in each country ...........................................................................................39 Table 11 - Types of specialties, and numbers in each...........................................................................................................40 Table 12 - Types of auxiliary recognised in each country ......................................................................................................42 Table 13 - Regulators of dental auxiliaries............................................................................................................................43