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ECJ rules on professional recognition of dentists in Austria

The European Court of Justice has ruled that individuals with non-university dental training of three years’ duration are not entitled to engage in their occupation under the name of dental practitioner or dentist.

The judgement comes following an enforcement action brought by the Commission against Austria, for failure to comply with two Community Directives relating to the dental profession on:

- mutual recognition of diplomas ("Recognition Directive")

- coordination of training required by the various Member States ("Coordination Directive")

The Directives were adopted with a view to facilitating the free movement of workers as well as freedom of establishment and freedom to provide services.

The European Commission claimed that Austria had infringed the provisions of the Directives on two grounds:

Concerning the profession of "Dentist"

The ‘Coordination Directive’ provides that dentists must complete a five-year full time dentistry course at university. However, the ‘Recognition Directive’ provides for an exception (in order to take into account the situation in Italy, Spain and Austria) whereby those having undertaken medical training in a university can also avail themselves of the title of dentist [1].

Austria’s national legislation still allowed for individuals with non-university training to present themsleves as dentists. The Court therefore concluded that Austria had failed to fulfill its obligations under Community law.

Concerning the profession of specialist in dental surgery

The European Commission also claimed that Austria had failed to comply with the Directives by not requiring doctors specialising in dental, oral and maxillo-facial surgery to use the title "Dental practitioner".

However, the Court rejected this complaint on the following grounds:

- the European Commission had failed to show that this might lead to a genuine risk of confusion between specialists in dental surgery and other doctors;

- a requirement for doctors to give up their professional title in favour of the title of "Dental practitioner" would effectively oblige them to hold themselves out to patients as dentists without indicating their skills as a physician, which would be harmful to the pursuit of their profession;

- the possibility for them to continue to use the title "Doctor specialising in dental, oral and maxillo-facial surgery" appears to be justified on the grounds of transparency, enabling patients to distinguish between the two professions.

EPHA section on the ECJ

Footnotes

[1] The training must have begun before 1 January 1994 and must be accompanied by a certificate issued by the competent Austrian authorities certifying that the person had been lawfully engaged in the activities specified in Article 5 of the Coordination Directive for at least 3 consecutive years during the 5 years prior to the issue of the certificate

Last modified on December 18 2005.

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29 January 19:33, by Sheila Kirby

POSTSCRIPT to: ECJ rules on professional recognition of dentists in Austria

Postscript to message already sent (as shown below): I should probably have mentioned the prescribed drugs that I take and that Prof Lang described me as an "at risk" patient who should have had a special medical plan. The dentist in fact made no medical plan at all. She said in Court that her general quotation (in German, which I do not understand) listing her prices for me to send to the medical insurers (in Germany) for their consideration was the medical plan. It was agreed all information about the treatment would be in English. Prescribed Drugs: For the past 36 years I have taken phenytoin 100mg x 2 daily for epilepsy (no seizures for many years). I have a severe allergy to erythromycin. I have allergic asthma and allergic rhinitis which was quite a problem over the 24 day period that the four lengthy treatments were given. I was on Symbicort throughout the duration of the dental treatment as well as taking anti histamines for the allergic rhinitis. I also had gingivitis. Later, my mouth became very inflamed because of the treatment which made the many repeat injections given even more painful. (Thus, the dentist said she would give me some of the "normal" injection as well - the first indication I was not getting the normal injection.) I also take vitamin pills C and E, and fish oil every day. The dental practice was informed of all of this. Noted roughly on her medical records was the epilepsy, phenytoin, allergy to erythromycin, and just "asthma" - no mention of type and no reference to the allergic rhinitis.

After the extreme reaction following the unnamed substance and the mefenamic acid, the dentist would not let me go home and wanted to keep me there to finish the treatment because she was working to a deadline (she was going on maternity leave). I had a second bad attack and again she kept me there to finish the work. I had a third milder attack and she kept me there. After she was satisfied she was finished, she rang for a taxi for me to go to hospital. Prof. Lang described it as a “monster treatment”.

I still do not know what kind of qualification this dentist has!!!

ORIGINAL MESSAGE

I was interested to read this item. I had very bad dental treatment in Vienna resulting in (eventual!!) hospitalisation for analphylatic reaction to the treatment. It turned out I had had internal bleeding. The dentist gave me a 500mg dose of mefenamic acid during treatment to save giving me even more top up injections of mepivacaine without vasco constrictor - her choice of anaesthetic for major bridgework. She also gave me another substance but denies this. As she listed none of the substances or quantities used in the medical records (and has in fact broken Austrian law on the dental record) I cannot find out what it was. It was only by a thoughtless comment from the dentist during the last treatment that I found ou she had a "thought" I was allergic to epinephrine (I am not) and had not given me the normal injection. Fortunately, the dentist invoiced me for the mefenamic acid (as this also is not recorded in the medical record). The case is too long and complex to deal with here, but thanks to the help of an official source in the EU and a referral to Prof Niklaus Lang at Bern University, I have been able to provide a report that exposed the shortcomings of the initial report of the so-called independent court appointed dentist. (I am the one being sued by the way. I paid in full for the treatment and offered to pay half for the bridgework never received but she was not satisfied and was confident that the system in Vienna would support her.)The court appointed dentist had to make another report after the one I presented from Prof Lang, and his other report was very different. For example, it now comes to light that she also put a toxic material in my mouth. The case is still proceeding and I have had temporary bridgework for over two years now. Professional Qualifications in Europe??? But I was shocked to learn during all these problems that anyone can set up as a dental hygienist in Austria as the government does not recognise it as a profession and there is absolutely no regulation. This I think is truly shocking. As an EU citizen, I expect to have medical treatments only from people who are trained and qualified to give them.

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