Corporate Dentistry in the European Union: Legal Frameworks and Structural Characteristics

Introduction and aims: The aim of this study was to collect and analyze country-specific information on corporate dental chains in the European Union, with a particular focus on their prevalence, organizational structures, business models, and legal frameworks, as well as the role of national dental associations and chambers in this context. Methods: A standardized questionnaire developed by the Council of European Dentists (CED) was distributed to its national dental associations from EU member states, Iceland, Norway, the United Kingdom of Great Britian and Northern Ireland, and Switzerland. Results: The response rate was 86.6% (26/30). In 22 countries (84.6%), non-dentists can own a dental practice; 4 countries prohibit such ownership. Dental chains are permitted in 24 (92.3%) and present in 21 countries (80.7%). In 9 countries (34.6%), dental chains not exclusively owned by dentists must include a dentist in management. Since 2018, 11 countries (42.3%) report an increase of dentists working in chains, while 5 (19.2%) observed no change. Dental chains mainly operate in large cities (n = 12; 46.2%). Their preferred models are opening new practices (n = 9; 34.6%) or acquiring existing ones (n = 8; 30.8%). Unethical conduct toward patients by dental chains was observed in 5 countries (19.2%), while 6 countries (23.1%) reported unsatisfactory, poor working conditions and employment contracts for dentists. Conclusion: The European dental care sector is undergoing structural transformation. While dental chains are permitted in most countries, legal clarity and professional oversight remain limited. Reports of unethical conduct and inadequate working conditions highlight the need for further research. Clinical relevance: The increasing presence of dental chains in Europe highlights regulatory gaps and ethical concerns. This study emphasizes the importance of clear legal frameworks and professional oversight to maintain high standards in patient care, particularly as market-driven models reshape dental service delivery.