# Corporate Dentistry in the European Union: Legal Frameworks and Structural Characteristics

## TL;DR

This study examines the legal and structural aspects of corporate dental chains across the European Union, highlighting regulatory gaps and ethical issues.

## Contribution

The study provides a comprehensive analysis of corporate dental chains in EU countries, focusing on legal frameworks and operational models.

## Key findings

- Dental chains are permitted in 24 out of 26 responding countries, with non-dentist ownership allowed in 22.
- Unethical conduct by dental chains was reported in 5 countries, alongside poor working conditions in 6.
- Most dental chains operate in large cities, preferring to open new practices or acquire existing ones.

## Abstract

The aim of this study was to collect and analyze country-specific information on corporate dental chains in the European Union, with a particular focus on their prevalence, organizational structures, business models, and legal frameworks, as well as the role of national dental associations and chambers in this context.

A standardized questionnaire developed by the Council of European Dentists (CED) was distributed to its national dental associations from EU member states, Iceland, Norway, the United Kingdom of Great Britian and Northern Ireland, and Switzerland.

The response rate was 86.6% (26/30). In 22 countries (84.6%), non-dentists can own a dental practice; 4 countries prohibit such ownership. Dental chains are permitted in 24 (92.3%) and present in 21 countries (80.7%). In 9 countries (34.6%), dental chains not exclusively owned by dentists must include a dentist in management. Since 2018, 11 countries (42.3%) report an increase of dentists working in chains, while 5 (19.2%) observed no change. Dental chains mainly operate in large cities (n = 12; 46.2%). Their preferred models are opening new practices (n = 9; 34.6%) or acquiring existing ones (n = 8; 30.8%). Unethical conduct toward patients by dental chains was observed in 5 countries (19.2%), while 6 countries (23.1%) reported unsatisfactory, poor working conditions and employment contracts for dentists.

The European dental care sector is undergoing structural transformation. While dental chains are permitted in most countries, legal clarity and professional oversight remain limited. Reports of unethical conduct and inadequate working conditions highlight the need for further research.

The increasing presence of dental chains in Europe highlights regulatory gaps and ethical concerns. This study emphasizes the importance of clear legal frameworks and professional oversight to maintain high standards in patient care, particularly as market-driven models reshape dental service delivery.