The prices set by the National Health Insurance Fund for dental services and the evaluation fees dentists have to pay do not encourage them to enter into contracts with CNAS, according to Patronatul Medicilor Stomatologi din Romania. The maximum monthly amount currently paid by CNAS is 4,000 lei per month, dentists say.

On the other hand, approximately 80% of dentists in Romania practice in cities, mostly in university centers, which creates a large imbalance in patient targeting.

“We want to be patient-centered, not bureaucracy-centered!”

The Dental Association of Romania states that if some urgent problems faced by dentists in Romania are not solved as soon as possible, they will have consequences for the health of patients in the near future and for the medical system.

There are currently 27,649 dentists in Romania working in approximately 15,000 private dental offices or clinics. Bucharest has the most dentists at 6,557, while Calaras County has the fewest at 94, according to the Romanian College of Dentists.

Every year, the number of dentists is increasing, as evidenced by the information of the National Institute of Statistics, according to which in 2020 the number of dentists increased by 10% compared to 2019 and by 25% compared to 2011.

However, Romania may run out of dentists in a few years. Onerous taxes for the state and more than 20 contracts and agreements that dentists, owners of offices are obliged to bear in order to carry out their professional activities and which are added to the initial investment in offices, which is not insignificant, discourage young people from starting to engage in this free profession, and many dentists, tired of the bureaucracy, force them to quit their profession or go to work abroad.

“Every year, Romania puts more than 1,000 dentists on the market in addition to the existing needs. Most choose to work in university centers rather than in small towns and villages. The population of Romania and the financial capabilities of Romanians are decreasing, which leads to a low addressability in the conditions of an annual increase in the number of dentists. It is necessary to legally encourage young doctors to provide dental care also in settlements where access to medical services is limited or absent,” said a university researcher. Dr. Christian Vlad, president of the Romanian Dental Association, dentist in Timisoara.

80% of dentists in Romania work in cities

Approximately 80% of dentists in Romania practice in cities, mostly in university centers, which creates a large imbalance in patient access.

The Association of Dentists of Romania states that the Romanian state “does not support this branch of medicine at all” and “on the contrary, imposes more and more fiscal and bureaucratic burdens through legislative measures that do not reflect realities and needs. our society. Bureaucracy and taxes fall on patients through the rates charged by dentists, who are thus forced to cover their costs and through less time allocated to the profession to complete the notices and documents required by various government agencies.’

Dentist rates in Romania vary tremendously precisely because of the challenges dentists face, they say.

The prices set by the National Health Insurance Fund (CNAS) for dental services and the assessment fees dentists must pay do not motivate them to enter into contracts with CNAS, dentists say.

“For the most part, CNAS tariffs do not cover the purchase price of materials used in treatment. Currently, the monthly maximum amount set by CNAS is insufficient to provide adequate dental services. The amount of contracts with dental practices is much lower than the amounts concluded by other medical specialties, but the evaluation fee is the same for a dental practice with a monthly calculation of 4,000 lei (the maximum possible for a specialist in an urban environment) and for other medical specialties,” said Dr. Anda Tiron, General Secretary of the Association of Romanian Dentists, dentist in Bucharest.

In conclusion, the Association of Dentists of Romania puts forward 7 proposals to the Romanian authorities:

• 1. Simplification and clarification of the legislation on dental offices.

• 2. Annual determination of the number of students at specialized faculties in accordance with the approved actual statistics of dentists in free practice and the requirements of the labor market.

• 3. Creation by the Ministry of Health of national oral hygiene programs, especially prevention.

• 4. Equalization of rates established by CNAS at the level of current prices for minimum mandatory materials and equipment in the fund.

• 5. Setting limits to help patients who pay National Health Insurance contributions to manage their oral health problems.

• 6. Reduction of the CNAS approval fee in proportion to the cost of the cap and applications for other specialties.

• 7. Programs for financing and stimulating the placement of dentists and other specialties in areas where medical and dental services are not available to a large number of citizens.

“We want to be patient-focused, not bureaucracy-focused. We want to primarily practice medicine, but have the opportunity to develop professionally and develop our business. Currently, small single-doctor dental practices are largely affected. We appeal to the authorities that we need a tolerable legislative framework that is reality-based and supportive, otherwise it will be worse. Many dental practices will be closed and patients will no longer have access to dental services,” says a university researcher. Dr. Christian Vlad, president of the Association of Dentists of Romania.