Dentists and Orthodontists Clash Over Orthodontic Care Regulations in Estonia

ESTONIA: Dentists and orthodontists in Estonia find themselves embroiled in a dispute over the scope of orthodontic care. While dentists argue that they possess the capability to undertake simpler orthodontic procedures, orthodontists, who face substantial waiting lists, disagree with this proposition.

Impact on Children Amidst Prolonged Waiting Lists

Children, in particular, bear the brunt of the extended waiting lists for orthodontic care. The prolonged waiting times for corrective procedures have prompted dentists to advocate for expanding the scope of orthodontic responsibilities for dental professionals.

By Estonian law, only orthodontists are authorized to provide orthodontic care. Dentists, however, contend that the law lacks specificity on the range of procedures permitted. Estonian Dental Association president Katrin Metstak proposes that, with the relevant training, dentists should be able to perform simpler orthodontic work, focusing on teeth straightening and alignment without altering classifications.

Orthodontists’ Stance on Liability and Competence

Orthodontists, such as Triin Jagomägi, associate professor of orthodontics at the University of Tartu, argue that all dental anomaly-related work should remain within the purview of orthodontists. Jagomägi emphasizes the importance of competence and liability in medical fields, asserting that orthodontists possess specialized training crucial for addressing the complexities involved in orthodontic care.

Acknowledging the waiting time challenges, the Ministry of Social Affairs refrains from specific regulatory changes. Heli Paluste, healthcare network manager at the Ministry, encourages constructive dialogue among stakeholders and suggests exploring agreements on further training requirements for dentists.

Dentists’ Perspectives and Legal Measures

Dentists express frustration, claiming that orthodontists, earning an average of over €10,000 a month, are uninterested in collaborative discussions. The Health Board supports orthodontists and has issued precepts to three dental care providers where dentists initiated aligner treatment.

Attorney Ants Nõmper suggests the possibility of more precepts, emphasizing the need for legal action by dentists to effect any change. He acknowledges the potential for future updates to dental education curricula but emphasizes adherence to existing training until such changes occur.

The clash underscores the complexities of defining professional boundaries and calls for a nuanced approach in addressing the evolving landscape of dental care in Estonia.