Free dental care

Free dental care for adults (except denture services)

The service can be used only at dental care institutions that have entered into a contract with the Health Insurance Fund.

You can check the right to the service in the state portal under the service “Information on dental care and denture services”.

Free dental care does not apply to everyone. The Health Insurance Fund has established certain criteria that a person’s status of health has to meet in order to qualify for free dental care.

The right for free dental care is determined by the patient’s family physician or a medical specialist and not by a dentist. In particular, it is necessary to consult the attending physician and make sure that a corresponding diagnosis has been made and that the physician has entered a statistical code (9072) on the person’s treatment invoice, based on which the Health Insurance Fund pays for the person’s dental care. 

Adults who are eligible for free life-long dental care with funding from the Health Insurance Fund are: 

  • people with physical and mental special needs who are unable to take care of their own oral hygiene;
  • people with certain oncological and haematological diagnoses.

Criteria to be used by a family physician or medical specialist to determine the need for life-long dental care:

Psychic peculiarities of personality that are independent of direct nosology of the disease, which makes a patient unable to take care of their oral hygiene even with adequate instruction:

  • Intellectual disability
  • Autism spectrum disorder
  • Dementia
  • Other severe mental disorders

Physical, disease-related conditions due to which a person is unable to perform oral hygiene procedures:

  • Paralysis that involves both upper extremities and is caused by central nervous system or neuromuscular disease
  • Movement disorders such as Parkinson’s syndrome, generalised dystonia, severe chorea
  • Congenital or acquired physical peculiarities, such as a missing limb or its significant part due to underdevelopment or amputation due to which the person is unable to take care of their oral hygiene

Oncological conditions (diagnoses C00–C14, C30–C32)

  • Persons who have been diagnosed with a malignancy of the head and neck, who is receiving or has received radiation and/or chemotherapy and who has received antiresorptive therapy (bisphosphonates, denosumab)

Haematological conditions (diagnoses C90–C96) 

  • Persons who have been diagnosed with multiple myeloma or a malignancy of lymphoid and haematopoietic tissues and who need health services identified by codes 8101 and 8102 as part of their therapy or antiresorptive therapy (code 486R) 

If, based on the said criteria, a family physician or a medical specialist finds it necessary to prescribe free dental care for a person with special needs, the physician will indicate the statistical code (9072) in the treatment invoice, based on which the Health Insurance Fund will pay for the dental care of the patient.

It may take up to two monthsfor free dental care to become effective. The delay is due to the exchange of data between information systems.

If the state portal shows that the person is eligible for free dental care, the person can contact their dentist to see if the medical institution has entered into a contract with the Health Insurance Fund, and book an appointment.

To provide a service to a person with special needs, a dentist is required to have respective experience and training. For this we are cooperating with the Estonian Chamber of People with Disabilities, who will start organising supporting training.

  • Make sure that the medical institution has entered into a contract for financing treatment with the Health Insurance Fund.
  • You have to provide the patient’s personal identification code to book an appointment.
  • The caller must be prepared to provide information about the condition of the person with special needs:
    • Description of a special need (physical, mental)
    • Does the person move independently, or do they use a wheelchair?
    • Is the person able to sit in a dental chair by himself/herself?
    • Is the person able to understand a dentist’s instructions and what is happening?
    • Can the person describe, for example, the nature of his/her toothache?
    • Is the person able to keep their mouth open and, if necessary, stay still?
    • For how long is the patient able to lie in a dentist chair? Is a visit that lasts more than half an hour too exhausting for the patient?
  • It should be pointed out what a dentist must look out for and what is the best way to contact and communicate with the patient (for example, in case of autistic patients it is very important to know what irritates or soothes the patient).
  • When was the last visit to the dentist and what have the previous experiences been like?
  • If previous experience has been negative, describe what exactly has caused problems?
  • You should indicate the reason for the visit in order to evaluate the duration of the treatment procedure. For example, is the reason for the visit pain, routine check-up, a visible cavity, a need for tooth removal, etc.
  • In case of toothache, you should describe what triggers the pain and how long it lasts, when the pain symptoms started, and try to describe the nature of pain.
  • Previous X-ray examinations of the mouth area would help to assess the extent of treatment needed.
  • Caregivers must accompany the patient into the dentist office to assist with communicating, lifting, etc. if necessary. If the caregiver finds it necessary to contact the doctor before the visit, they may leave their contact details with the clinic’s reception so that the doctor could get back to them.

NB! Bedridden patients can usually not be treated at a regular dentist office, so the service must be provided in a special environment (e.g. at the hospital).

People receiving nursing care services in care institutions have the opportunity to assess the need for dental care on-site and advise staff on maintaining oral health. In collaboration with a dentist, the nursing care service provider conducts video consultations and provides guidance on seeking treatment. They book a video consultation time through the nationwide digital registration system for dental services in hospital settings.

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