The regulatory framework for dental care provision is laid out in the Dentists Act (Zahnärztegesetz, 2005). All dentists have to register with the Austrian Dental Chamber. Dental care in Austria is mainly provided by private single or group practices and by outpatient dental clinics run by the SHI funds (e.g. in Vienna). In 2015, about 20% of all ambulatory dentists did not have a contract with an SHI fund.
A number of dental care services (e.g. orthodontic treatment, prosthesis or certain surgical procedures) are only partially covered by SHI funds and require prior authorization. Since January 2013 outpatient dental clinics are allowed to provide these services at lower prices than ambulatory independent practices (BMGF, 2017b).
Removable orthodontic appliances for young children are usually fully covered after approval and when performed by contracted dentists (WGKK, 2017b). Since July 2015, this includes also fixed orthodontic appliances for children and adolescents up to the age of 18 with considerable tooth misplacement (Index of Orthodontic Treatment Need > 3). Around 30 000 children and adolescents are estimated to be in need of fixed orthodontic appliances every year. Availability of data on the number of children and adolescents who received appliances is limited to the SHI fund of Lower Austria and Vienna that covered costs for 3032 and 5274 fixed orthodontic corrections respectively between July 2015 and June 2016 (Austrian Court of Auditors, 2018).
Based on self-reported data from the ATHIS 2014, around 5% of the respondents said that they did not consult a dentist for financial reasons (7% with migrant background), while nearly three out of four Austrians aged 15 years or above stated that they consulted a dentist in the last year (Statistics Austria, 2015).
Patients frequently travel to neighbouring countries for dental care. In particular, Austrians increasingly seek care in Hungary for prosthetic treatments not or only partially covered by Austrian SHI. Overall treatment costs and hence also private cost-sharing levels are considerably lower while quality of treatment is very close to Austrian standards (Winkelmann et al., 2013).
The competence centre for oral health with the chief dental officer is located at the GÖG. The centre, established in 1997, is a coordination office for the oral health survey and stimulates discussions on the improvement of oral health care among relevant stakeholders (i.e. SHI funds, federal government, Länder). The health care reform 2017 aims to improve oral health status mainly by reducing caries in 6-year-old children (ZS-G, 2017).
Health promotion and prevention programmes, which are usually provided in kindergartens and schools, are organized at Länder level (GSÖ 2017).