Negotiations between the Austrian Dental Association (ÖZÄK) and the Austrian Health Insurance Fund (ÖGK) broke down recently, with patients potentially facing out-of-pocket costs for dental fillings starting January 2025. The dispute centers on a new EU ban on amalgam fillings, effective from 2025, and alternative options like the plastic-based Alkasite, which the ÖGK offered to reimburse with a modest 10% fee increase. The ÖZÄK, however, argues that this proposal does not address the cost realities for dentists or provide adequate compensation for materials used.
An Escalating Dispute
Initially, another negotiation was planned for mid-November. But the talks halted as ÖGK chair Andreas Huss suggested publicly that a 10% fee increase would cover Alkasite’s costs. ÖZÄK contends that this offer is economically unsustainable for dentists, who rely on private practice income to make up for what they describe as underfunded public services. According to ÖZÄK, essential services like tooth extraction and denture repairs are minimally compensated, and consultations with patients receive no reimbursement at all.
Günter Gottfried, ÖZÄK spokesperson, highlights a serious flaw in ÖGK’s approach. Although Alkasite has been available for three years and is now permitted for children, pregnant women, and breastfeeding mothers, he notes it lacks the long-term testing and durability studies necessary for broader use. Moreover, Gottfried argues that other options like glass ionomer cement might be a superior alternative, especially for molars, due to its compatibility and lower risk of tooth nerve irritation. Still, ÖGK remains cautious, noting glass ionomer’s limited durability in larger fillings, and reserves its use primarily for smaller, non-molar fillings.
The Patient Impact
Without an agreement, Austria’s 7.6 million insured patients will likely need to pay for fillings privately from 2025 onward, then submit receipts to ÖGK for partial reimbursement—a system that mirrors private practice arrangements. While this is manageable for some, it could strain those without the resources to cover upfront costs.
For patients, the ÖGK’s dental centers will continue to offer Alkasite as a covered option. However, patients seeking care from independent dentists will face the new private-pay arrangement. The ÖGK argues that this approach ensures broad access, while the ÖZÄK insists that more robust insurance support for high-quality filling materials is necessary.
Shifting Dental Standards in Austria
The tariff conflict underscores deeper issues in Austrian healthcare, as new EU regulations banning amalgam for health and environmental reasons require the adoption of alternative filling materials. Amalgam has not been used for children, pregnant women, or breastfeeding mothers since 2018, but the 2025 ban will extend this to all age groups. This shift has driven up demand for alternatives like Alkasite and glass ionomer cement, but both options come with different cost and durability profiles.
At the heart of the matter is whether a practical, long-term solution can be achieved to maintain Austria’s high standard of dental care. According to ÖGK’s Huss, they are prepared to fund the price difference for Alkasite but argue against ÖZÄK’s push to make it exclusively a private service. Meanwhile, the ÖZÄK’s call for higher reimbursement rates for glass ionomer cement—up to €45 from €23—remains a point of contention, as ÖGK cites concerns over its limited durability in molars.
Future of Dental Care Coverage in Austria
As the situation stands, the standoff between ÖZÄK and ÖGK raises concerns about the accessibility and quality of dental care for Austrians. Should the two parties fail to reach an agreement, independent dentists may increasingly pivot toward offering only private treatments, with public reimbursements covering only a fraction of costs. This could mark a shift in how dental services are structured, placing a greater financial burden on patients or pushing them to rely on ÖGK’s in-house clinics for certain types of care.
ÖZÄK’s Gottfried stresses that the current arrangement undervalues dentists’ time and expertise, pushing many out of the public system altogether. This trend could exacerbate a shortage of insured dentists, potentially straining the ÖGK’s health centers and limiting patients’ options.
The outcome of this conflict will determine if Austria’s dental care system can adapt to regulatory changes without compromising quality or accessibility. For now, patients are left in a state of uncertainty, waiting to see if a balanced solution will be achieved by 2025.