Utskrift från Malmö högskolas webbplats www.mah.se

Oral Health Care System and Services

ORGANIZATION OF DENTAL CARE IN SWEDEN

The Parliament and the Government decide on overall questions concerning dental care, e.g. forming of the dental insurance and number of dentists to be trained.

The National Board of Health and Welfare (Link to Socialstyrelsen, info in Swedish language) has the general supervision of the dental care. The National Board of Social Insurance is responsible for the dental insurance comprising all persons 20 years and older.

The National Swedish Board of Universities and Colleges decides on the education of dentists and dental hygienists. There are four dental schools with a yearly intake of 240 students.

Sweden is divided into 26 county councils. They are responsible for the local planning of all dental care. The county councils run the Public Dental Service for all people up to and including 19 years olds. The county councils are also responsible for specialist dental care. The Public Dental Service gives dental care to about 30 % of the adult patients and the private dentists to the remaining 70 %.


NATIONAL DENTAL INSURANCE IN SWEDEN
(For the new system, introduced in 1999, see end of this page).

In Sweden a general dental care insurance was introduced in 1974. This insurance covers all inhabitants from 20 years of age and onwards. Children and young people up to 19 years of age are offered organized dental care free of charge provided by the National Dental Service.

Almost all private practitioners have joined the insurance system. The dental care for adults within the National Dental Service is also provided according to the rules of the dental insurance.

The same schedule of fees applies in The National Dental Service as well as in private dental practice.


Reimbursement (Sept 1996):

Reimbursement from the
National Dental Insurance

Costs in SEK Percentage paid by the Insurance

0-700

0 %

701-3000

25 %

3001-7000

40 %

7001-

70 %
All kinds of dental treatments are comprised by the dental insurance. The fees of the dental insurance are mainly based on fixed prices per different treatments. Certain treatments, e.g. preventive measures, are paid per hour.

The schedule of fees is based on estimated time required to carry out a certain treatment. It is supposed to be income-neutral e.g. the average dentist should get the same irrespective of which type of treatment he gives. For extensive treatment e.g. large fixed bridges the dentist has to file a prior approval of the treatment plan. The local social insurance offices have consultant dental officers. They examine the treatment plans sent in by the dentists. They check for instance that the dentist has planned for appropriate preventive measures before starting large-scale prosthetic treatments.

In October 1996, the system was changed, and again in October 1997.

Reimbursement (Oct 1, 1997):

Reimbursement from the
National Dental Insurance

Costs in SEK Percentage paid by the Insurance

0-1300*

0 %

1301*-13500

35 %

13501-

70 %

* During the period of time Oct 1, 1996 - Oct 1, 1997, this value was 700 SEK, changed to 1300 Oct 1, 1997.
Precious metals used in crown and bridge constructions are not included in the Insurance, paid in full by patient.


Total cost for the
National Dental Insurance

Year Millions, SEK
1987 2 905
1990 3 750
1993 3 730
1997 approx. 1 800
1998 prel. 1 400


 Source: CDO Sweden/db.


A new insurance plan was introduced 1 Jan 1999. Details are presented below.


NEW DENTAL INSURANCE IN SWEDEN 1999

All adults are given compensation for preventive care, extractions, endodontic treatments and fillings. This is called basic dental care. This does not include examinations and prosthetic treatments. The dental insurance will cover 30 percent of the costs, by year 1998´s rate. 

The insurance gives no compensation for amalgam fillings.

The dental insurance also includes examinations for people in the age of 20 - 29.

For prosthetic and orthodontic treatments the insurance gives compensation as a basic grant corresponding to 60 percent of the costs, by year 1998´s rate. A qualifying amount (3500 SEK, 393 EUR) is deleted from the basic grant.

Persons who need more dental care than normally, resulting from illness and functional handicap, are getting compensation for all dental care with 60 percent of the costs existing 1998.

The schedule of fee for dental care is without regulation for private dental practioners and county councils.

The so-called establishing-contol for private dental practioners is abolished.


County Council´s responsibility 1999

Elderly, unwell and functionally handicapped persons within nursing institutions, will be the subject of visiting work and will have their dental health evaluateded and also, if necessary, obtain dental care against a fee that is to apply to the out-patient health care and medical services. Examination of the present state of the mouth is free of charge. 

Persons, who need dental care as a link in disease control, during a short period of time, will receive dental care against a fee that is equivalent to the fees in out-patient health care and medical services.

The maximum fee for medical services and dental care, during a period of one year, is 900 SEK (100 EUR).

Dr Hans Sundberg is acknowledged for information re the insurance system above.



Oral Health Insurance System - Sweden (2008)

Healthcare is provided through national social insurance system which also covers sick pay, child benefit, disability allowances and pension. The National Social Insurance Board ( Riksförsäkringsverket) operates through local Social Insurance Offices (Försäkringkassan). Health care for the population is paid for through general taxation and a small fee (15 Euros 2008) for each visit to the doctor.

Oral Health Care
Although counties are not required to provide the services themselves, oral healthcare is the responsibility of the Counties.

Public Oral Healthcare

The Public Dental Service (NDS) provides free dental care for children up to 19 years, delivered in local clinics managed by the Counties. They can also choose to attend a private dentist. Adults and elderly could receive subsidised care from NDS or private practitioners.

Since July 2008 a new National Insurance Scheme was introduced.

A dental care voucher was introduced. This voucher can be used as a part-payment for a dental check-up at any dentist or hygienist or as a part-payment for subscription dental care. The value of the voucher is 32 Euros every other year for 30 - 74 year olds, 64 Euros every second year for those aged 20 - 29 and 75 and above.

A high cost protection scheme provides compensation equal to 50% of cost between 321 - 1590 Euros and 85% of cost exceeding 1590 Euros. The first 320 Euros is always paid by the patient.

Dentists in private practice settle their prices themselves. Counties fix the fees for all the clinics within the Counties. Not all dental care is reimbursed. Preventive and disease treatment are prioritised.

Source: Manual of Dental Practice. The Council of European Dentists, Nov 2008. http://www.eudental.eu/index.php?ID=35918 (accessed Nov 2009). 


Tandvårdsförsäkringen is presented in detail here (in Swedish).


Health Expenditure

% of GDP
Spent on Health

Annual Expenditure
on Oral Health Care

% of GDP
spent Dentistry
Year Source
Total 9.1 2.1 billion EUR (2004) 0.68 2006 1)

1) Manual of Dental Practice. The Council of European Dentists, Nov 2008.

Last updated by Gisela Ladda Tayanin