dentist
_Far_East.jpg)
Dentist is the job title for a graduate in dentistry . Exercising the profession is only permitted in Germany on the basis of a valid professional license ( license to practice medicine or professional license ). Approvals authorize you to practice your profession independently in the Federal Republic of Germany. Professional permits can only be issued for a limited time and place. In the area of the former GDR the dentists are also called stomatologists . The study of stomatology was temporarily completed with a specialist examination (specialist in general stomatology) and later with the diploma (Dipl.-Stom. = Diplom-Stomatologist). The professional title Dentist , which emerged from the group of unapproved dental practitioners, is outdated and until 1952 referred to trained dental technicians who were allowed to practice dentistry to a limited extent. The dentist is one of the liberal professions in Germany , just as he is one of the liberal professions in Austria .
The field of activity of a dentist includes prevention , diagnosis and therapy of tooth , mouth and jaw diseases . Patients with recognized stomatological occupational diseases ( abrasion dentium ) and accidents at work are also treated at the expense of the employers' liability insurance association .
There are around 112,000 dentists in Germany, including around 53,000 contract dentists . Around 17,500 are assistants, representatives, salaried dentists working in practices and members who work as dental professionals outside of practices. Another 20,600 are without dental work (as of 2014). The number of dentists in jobs subject to social security contributions rose from 4676 to 8060 between 2005 and 2011, which is 72%.
history
The first dentists practiced as early as the 5th century BC. The first German dentist known by name was a certain Ottinger in the 15th century , from whom various dental treatment instructions have been handed down in a manuscript. The specialist book Le chirurgien dentiste by the French Pierre Fauchard founded modern dentistry in 1728 . Barbers used to treat and pull teeth. They had suitable instruments like levers, needles, scissors and blades and could clean them in the always available warm soapy water.
The Dental History Museum in Zschadraß near Colditz (Saxony) provides an overview of the history of dentistry.
Apollonia is the patron saint of dentists.
| 1825 | The Prussian medical regulations stipulate the first requirements for the dental profession |
| 1869 | The North German Federation defines the first examination regulations and thus protected the term “dentist”; Mandatory: 2 years of study and practical experience at the dentist |
| 1889 | Uniform examination regulations |
| 1910 | Establishment of dental training institutes. Dentists are trained for 2 years, followed by 4 years of internship |
| 1919 | Possibility of a doctorate for dentists, title: “Dr. med. dent. " |
| 1920 | Dentist training is recognized, the professional title “dental craftsman” / “dental artist” abolished |
| 1952 | The Dentistry Act abolishes the dentist / dentist dualism. Dentists also receive the job title "Dentist" temporarily after additional training |
| from 1965 | First admission restriction for the degree in dentistry |
education
The dental training includes
- a ten-semester course in dentistry at a scientific university, which consists of a preclinical and a clinical part of five semesters each;
- the following state exams:
- a) the preliminary scientific examination,
- b) the preliminary dental examination and
- c) the dental exam.
The standard period of study within the meaning of Section 10 (2) of the University Framework Act, including the examination time for the dental exam according to Section 33 (1) sentence 1, is ten semesters and six months. The subject of dentistry is subject to admission restrictions ( numerus clausus ).
After the state examination, the dentist can apply for a license to practice medicine . The details of the licensing procedure can be found in the licensing regulations for dentists .
Around half of the graduates then do a doctorate in Dr. med. dent. This academic title was not introduced in Germany at the beginning of the 20th century. The magazine Die Woche reported a student strike in its 51 issue of December 20, 1913: “In Berlin, dentistry students stopped attending the lectures because the Ministry of Culture had introduced the title of Dr. med. dent. refuses. "
A ruling by the European Court of Justice standardized the definition of the profession of dentist; however, it took a few years to adapt the national licensing regulations across Europe to the judgment.
License to practice
With the license to practice the profession is granted. With the beginning of the professional practice, the dentist becomes a compulsory member of the responsible dental association , whose professional supervision he is subject to until his death. The responsible dental association is the one in whose area of responsibility he has his practice or - without his own practice - his main residence.
The license to practice medicine for dentists was revised on July 8, 2019 ( Federal Law Gazette I p. 933 ). The new version will come into force on October 1, 2020.
further education
Specialist dentist for orthodontics
The specialist dentist for orthodontics is a dentist who has completed a four-year period of further training after completing his studies, of which at least one year must take place at a clinic . He deals with the detection, prevention and treatment of tooth and jaw misalignments as well as orthopedics of the temporomandibular joint. "Braces" and " braces " regulate and optimize the position of the jaw and teeth. After a successful examination by the responsible dental association, he is awarded the specialist title “Specialist in Orthodontics”.
Specialist dentist for oral surgery
A dentist specializing in oral surgery is a dentist with a field designation who has completed at least four years of advanced training after obtaining his license to practice medicine. An obligatory general dental year is followed by three subject-specific years, of which at least one year must take place at a clinic, depending on the federal state. In some federal states (e.g. Hessen), the clinic year can now be replaced by curricular theory modules. During the further training at a further training facility (practice and / or clinic) authorized by the responsible dental association, comprehensive skills and qualifications are acquired in relation to oral surgical interventions in the tooth, mouth and jaw area and in implantology . The spectrum covered by a specialist dentist for oral surgery - in relation to dentistry, oral and maxillofacial medicine - is the same as the outpatient spectrum of the specialist in oral and maxillofacial surgery who specializes in dentistry, oral and maxillofacial medicine due to its additional dental License to practice medicine is very similar and leads to numerous overlaps. The spectrum of the specialist dentist for oral surgery includes the entire operative dentistry, oral and maxillofacial medicine in the overall medical context. After completing further training with evidence of an operation and further training catalog defined differently depending on the federal state as well as passing the examination before the responsible dental association, he may use the designation “specialist dentist for oral surgery” or “dentist, oral surgery”. Colloquially, the specialist dentist for oral surgery is often abbreviated as "oral surgeon".
Oral and maxillofacial surgeon
The specialist in oral and maxillofacial surgery has completed both a degree in human medicine and a degree in dentistry, whereby a considerable part of the medical degree is credited towards the dental degree, as the two degree programs are very closely related. He is double approved. As a student of dentistry at least 60-month training can be completed as a specialist by the board examination is completed. This takes place in front of the respective medical association, from which the designation “specialist in oral and maxillofacial surgery” is awarded. There is the possibility, after submission of the necessary surgical knowledge, the additional specialist dentist examination before the Dental Association, which, if passed, also confers the designation “specialist dentist for oral surgery”. The specialist in oral and maxillofacial surgery is not recognized in many countries (e.g. in Scandinavia). In the countries of North America (USA and Canada), Japan, Australia and New Zealand, "maxillo-facial surgery" is a dental specialty.
Public healthcare system
A specialist dentist training that is rarely completed is that of a specialist dentist for public health . The further training to become a specialist dentist for public health provides the ability to determine and monitor the state of health of the population and certain parts of the population in the field of tooth, mouth and jaw diseases.
master
There are now some additional qualifications for dentists that can be acquired on the basis of postgraduate studies. Above all, this includes the master’s degree from a college or university. As the first master's degree, the title Master of Oral Medicine in Implantology was awarded to 15 dentists by the University of Münster in 2004. Together with other masters in implantology, they have joined forces in the Implantology Masters Association. The master’s course was in upheaval for a long time; Meanwhile, the uniform title of Master of Science has established itself. According to the Bologna criteria, the academic degree Master of Science is also awarded for dental subjects after postgraduate studies.
Advanced training
The general obligation for further training of the dentist is stipulated in the model professional regulations of the Federal Dental Association and in the professional regulations of the state dental associations .
Through advanced training, the dentist can focus on different areas of activity such as "implantology" or "periodontology", the requirements of which may vary depending on the federal state (this is determined by the dental associations).
Since July 1, 2004, all contract dentists, authorized dentists and dentists employed in dental practices or medical care centers (MVZ) have been obliged to undergo professional training , which is subject to sanctions in accordance with Section 95d SGB V:
- The contract doctor is obliged to undergo professional training to the extent necessary to maintain and further develop the specialist knowledge required for his professional practice in contract medical care. The training content must reflect the current state of scientific knowledge in the field of medicine, dentistry or psychotherapy. You have to be free from economic interests.
- Proof of advanced training can be provided by advanced training certificates from the chambers of doctors, dentists, psychological psychotherapists and child and adolescent psychotherapists. Other advanced training certificates must meet the criteria set up by the respective working group of the chambers of these professions at the federal level. In exceptional cases, the compliance of the training with the requirements according to paragraph 1 sentences 2 and 3 can also be provided by other evidence; the details are regulated by the National Associations of Statutory Health Insurance Physicians in accordance with paragraph 6 sentence 2.
- Every five years, a contract doctor must provide the Association of Statutory Health Insurance Physicians with evidence that he has complied with his further training obligation in accordance with paragraph 1 in the past five-year period; the period is interrupted for the period of suspension of admission. If the previous approval ends due to the relocation of the contract doctor from the district of his contract doctor's seat, the previous period continues. If a contract doctor does not provide proof of advanced training or does not provide it in full, the Association of Statutory Health Insurance Physicians is obliged to reduce the fee to be paid to him for the remuneration of contract medical services for the first four quarters following the five-year period by 10 percent, from the following one Quarter by 25 percent. A contract doctor can catch up on the advanced training set for the five-year period in whole or in part within two years; The advanced training that has been made up is not counted towards the following five-year period. The fee reduction ends at the end of the quarter in which the complete training certificate is provided. If a contract doctor does not provide evidence of advanced training at the latest two years after the end of the five-year period, the Association of Statutory Health Insurance Physicians should immediately submit an application to the admissions committee to withdraw admission. If the withdrawal of approval is rejected, the fee reduction ends at the end of the quarter in which the contract doctor provides the complete proof of advanced training for the following five-year period.
branch
The dentist can either work as a contract dentist or as a private dentist in an independent practice or work as an employed dentist in a dental clinic , in a medical care center or in a practice. Research is another professional field .
Admission
Since around 87% of people in Germany are compulsorily insured in statutory health insurance , almost all dentists apply for approval as a contract dentist at the admissions committee . After acceptance of your application for health insurance, you will become a member of the Association of Statutory Health Insurance Dentists (KZV) in your state. In doing so, you undertake to adhere to the provisions of the Social Security Code ( SGB V ). According to the KZBV , around 53,000 contract dentists practice in Germany (as of 2014). You will be admitted to the health insurance fund after at least two years of assistance (= preparation time) in an approved practice or in a dental clinic following your studies.
A private dentist is not licensed and is therefore not entitled to bill the statutory health insurance companies. Patients with statutory health insurance are also free to visit a private dentist. The treatment is billed directly to the patient , regardless of the patient's insurance status (statutory, private or not insured) on the basis of the fee schedule for dentists of December 5, 2011 ("private bill", private liquidation ). According to the current legal situation, patients with statutory health insurance do not usually receive any reimbursement of costs from their health insurance companies for treatment by a private dentist (in official German: "non-contract dentist") . This also applies to emergencies and cases of pain! Exception: If this non-contract dentist practices in another EU country, the patient is entitled to reimbursement of the invoice by his health insurance company, up to a maximum of the costs that would have been incurred in Germany.
The contract dentist in the Federal Republic of Germany is obliged to treat all legally insured patients according to the principle of benefits in kind . The services will be billed to the health insurance companies via the respective dental association after the electronic health card (eGK) has been presented by the insured person. Patients with statutory health insurance receive an invoice for their own contribution in the field of dentures for those costs that are not covered by the fixed health insurance subsidies. In the field of orthodontics , the patient (or the payer) must initially pay a quarterly contribution, which is reimbursed by the health insurance company after the treatment has been successfully completed. Dental treatments that go beyond the economic efficiency requirement of § 12 SGB V (medically necessary, appropriate, economical and sufficient) are calculated privately on the basis of the fee schedule for dentists of December 5, 2011 and are to be paid by the patient with statutory insurance. Supplementary dental insurance can reimburse part of the cost.
income
The average gross income of employed dentists differs considerably from the average gross income of dental practice owners.
Employed dentists
The average income of a salaried dentist in Germany was € 5,245 monthly gross salary, that of a salaried dentist € 3,609. (Status: 2010) According to the sales-related calculation, the starting gross salary of an assistant dentist is around € 1,500 per month, for an employed dentist around € 4,000. According to a study by the Federal Employment Agency, salaried dentists earn a median gross monthly amount of 4,323 euros (26.27 euros per hour) - (as of 2018).
According to an evaluation by APO-Bank from 2019, it is recommended that after the assistantship, a gross starting salary of 4,500 euros per month is agreed if it is a fixed salary. After 10 to 20 years, the fixed salary can increase to 65,000 to 85,000 euros per year. With specialization, the fixed salary can be between 45,000 and 115,000 euros per year. In rural areas, an average fixed salary (excluding revenue sharing) of 55,000 euros per year can be expected, in large cities it is 60,000 euros per year.
Dental practice owner
For dental practice owners in Germany, the average annual net income is 175,000 euros (as of 2015) and the median of the annual gross income is 150,500 euros (as of 2016).
| Turnover to disposable income per practice owner 2016 (median) | Germany |
|---|---|
| Turnover (average) | € 495,100.00 |
| Sales per treatment hour a (average) | € 344.00 |
| Cost (average) | −334,200.00 € |
| Income surplus (average) | € 160,900.00 |
| Median revenue surplus b | € 144,000.00 |
| Income tax, church tax, solidarity surcharge, social security | −57,400.00 € |
| Disposable income per year c | € 86,600.00 |
| Disposable income per month | € 7,216.00 |
| Weekly working hours d | 45.8 hours |
| Net fee per hour | € 35.86 |
The share of expenditure on dental treatments in total expenditure in the German health care system (2014: € 193.6 billion) fell from 15.1% in 1976 to 6.7% (2014: € 13.0 billion) in 2014 .
According to the National Association of Statutory Health Insurance Dentists, the average gross income of dental practice owners in Germany in 2016 was 160,900 euros. (As of 2016)
The average values according to the practice location can be read from the following table (rounded to the nearest thousand euros):
| Practice location | Average gross income per practice owner 2016 ( rounded to EUR thousand ) |
|---|---|
| Dental practices (Germany) | 161,000 EUR |
| Dental practices (West Germany) | 167,000 EUR |
| Dental practices (East Germany) | EUR 131,000 |
However, there are large differences between the incomes of dental practice owners. In 2016, 27.9% of all practice owners had a gross income of less than 100,000 euros and 13.3% of the practice owners had a gross income of more than 250,000 euros. The differences in income were also clearly evident in relation to the practice location. While 38.7% of the East German practice owners had a gross income of less than 100,000 euros in 2016, this value was only 25.6% for West German practice owners. In contrast, 14.8% of all West German practice owners had a gross income of over 250,000 euros, while this was only the case for 6.0% of all East German practice owners.
In addition, the income levels of dental practice owners have been subject to major changes for years. From the mid-1970s to the turn of the millennium, the real value of the average incomes of practice owners decreased by about 50%. A sustained positive development can only be seen again since 2006.
The real value development of the west German practice owners can be read from the following table (rounded to thousands of EUR):
| Year number | Gross income (nominal) in EUR | Real value 2020 |
|---|---|---|
| 1976 | 103,000 EUR (201,000 DM) | 256,000 EUR |
| 1980 | 114,000 EUR (223,000 DM) | EUR 243,000 |
| 1985 | 107,000 EUR (210,000 DM) | 190,000 EUR |
| 1990 | 94,000 EUR (184,000 DM) | 155,000 EUR |
| 1995 | 98,000 EUR (192,000 DM) | 139,000 EUR |
| 2000 | 100,000 EUR (195,000 DM) | EUR 133,000 |
| 2005 | 110,000 EUR | 136,000 EUR |
| 2010 | EUR 131,000 | 150,000 EUR |
| 2015 | 163,000 EUR | 174,000 EUR |
According to a study by the German Institute for Economic Research (DIW) from 2012, the average net hourly wage after graduation / training is € 12 for men and € 9 for women. The DIW study is based on data from the microcensus from 2005 to 2008. According to this study, the average “net wage” for dentists is € 19.33 and for female dentists € 15.50. (The average hourly wage was calculated using the maximum possible employment phase. For this purpose, the hourly wages in each age, occupation and training course were added up and compared with the maximum possible length of work [44 years].)
Professional law
Dentist is a classic chamber profession .
German dentists are subject to various professional regulations: the Dentistry Act , the license to practice medicine and the professional code of the responsible dental association . The fee calculation is based on the fee schedule for dentists (GOZ) and the assessment standard for dental services (BEMA).
In addition, special provisions apply, for example for a dentist website: since March 1, 2007, such Internet presences, like all websites , have been subject to the provisions of Section 5 of the Telemedia Act (TMG). Limiting specifications for the design of a practice website are only rudimentary in the professional regulations of the dental associations.
Heilpraktikergesetz
Injections of wrinkles in the forehead, eyes and neck area, to fill the lips and wrinkles and to treat migraine disease are permitted by licensed doctors and naturopaths , but forbidden to dentists and other health care professionals and laypeople. ( § 5 Heilpraktikergesetz ). The Higher Administrative Court for the State of North Rhine-Westphalia affirmed the unreliability of a dentist, which is required for the withdrawal of his license to practice medicine, in view of his violations of the ban on wrinkle injections for years. The dentist was reproached for his longstanding and persistent behavior, which he could only have eliminated by a serious change in attitude.
Occupational diseases
Dentists often suffer from acquired diseases of the spine such as herniated discs. All areas of the spine are at risk; there is an accumulation in the area of the cervical spine. Dentists, like dental technicians, often suffer from allergic reactions of the skin and from toxic contact dermatitis, especially of the hands. The reason for this is frequent direct or indirect contact with toxic (damaging) substances and materials such as B. uncured plastics (methyl methacrylate), mercury , palladium and solvents. In front of a hepatitis B protect vaccinations.
Trade association
A dental practice is one of the contributory companies in the professional association for health and welfare services (BGW). All employees and employers with compulsory insurance are insured. Entrepreneurs who are not subject to compulsory insurance can take out voluntary insurance. Volunteers or unpaid workers are also insured. In the event of an insurance claim, BGW bears the costs for a large number of services. State health service institutions are not looked after by the BGW. The public insurance carriers ( accident insurance funds ) are responsible here . Self-employed dentists can voluntarily take out comprehensive insurance from BGW against the consequences of accidents at work and commuting as well as occupational diseases . BGW bears the costs of individually tailored medical, occupational and social rehabilitation , pays injury benefits as compensation for loss of earnings during medical rehabilitation, provides a pension in the event of a reduction in earning capacity and takes care of the surviving dependents in the event of death: depending on the circumstances pays pensions, death grants , repatriation costs or allowances.
Major dentists
- Edward H. Angle
- Sanford Christie Barnum
- Greene V. Black
- Pierre Fauchard
- Alfred Gysi
- Willoughby D. Miller
- Carl Partsch
- Philipp Pfaff
- Horst Sebastian
- Maria Schug-Kösters
- Otto Walkhoff
literature
- Peter Guttkuhn: Of teeth, warts and corpse thorns. From the practice of the Lübeck dentist Jacob Levy (1784–1840). In: Schleswig-Holsteinisches Ärzteblatt . 47 (1994), No. 1, pp. 7-9.
- Dominik Groß : The Difficult Professionalization of the German Dental Profession (1867-1919) . In: Europäische Hochschulschriften , Series 3, 609, Frankfurt a. M. 1994.
- Dominik Groß: Dentist and tooth breaker . In: Encyclopedia of Medical History. Edited by Werner E. Gerabek, Bernhard D. Haage, Gundolf Keil and Wolfgang Wegner, Walter de Gruyter, Berlin and New York 2005, p. 1515 f.
- Gereon Schäfer, Dominik Groß: Between work and profession: The late professionalization of the German dental profession and its background . In: Deutsche Zahnärztliche Zeitschrift , 62/11, 2007, pp. 725–732.1
Web links
- National Association of Statutory Health Insurance Dentists
- German Society for Dentistry, Oral and Maxillofacial Medicine
- Stone Age boreholes. On: Wissenschaft.de of April 6, 2006 about an article in Nature (Vol. 440, 2006, p. 755)
Individual evidence
- ^ Federal Dental Association member statistics
- ↑ Reference to IAB research group on professional labor markets ulmato.de
- ^ Wolfgang Wegner: Ottingen (Ottinger). In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 1085.
- ↑ Bavarian Medical Professions Act
- ↑ Model training regulations. (PDF) German Dental Association, accessed on December 6, 2016 .
- ↑ a b Oral surgery pilot project. (No longer available online.) Hessian Chamber of Dentists, archived from the original on December 6, 2016 ; accessed on December 6, 2016 .
- ↑ moi.uni-frankfurt.de. Retrieved December 15, 2014 .
- ↑ Sample professional regulations, as of May 19, 2010. (PDF; 45 kB) Federal Dental Association
- ↑ Facts and Figures 2015 . (PDF) Leaflet with statistical information on contract dental care by KZBV and BZÄK
- ↑ Federal Statistical Office, Structure of Earnings Survey 2010
- ↑ D. Nies, K. Nies: How much “may” an employed dentist or assistant earn? (PDF) Retrieved December 15, 2014
- ↑ Employed dentists earn 4,323 euros gross , zm-online, April 8, 2019. Accessed April 9, 2019.
- ^ Salary dentist , APO bank
- ↑ Employed dentists work under these conditions in 2019 , Zahnärztliche Mitteilungen, July 8, 2019. Retrieved July 9, 2019.
- ↑ Cost structure of medical practices (PDF)
- ↑ Statistical Yearbook 2018 (PDF) KZBV. Retrieved May 12, 2019.
- ↑ Statistical Yearbook 2015. National Association of Statutory Health Insurance Dentists (KZBV), ISBN 978-3-944629-03-2
- ↑ Distribution of the income of the owners 2016 (PDF)
- ↑ Distribution of the income of the owners 2016 (PDF)
- ↑ Real value development of the dental surplus from 1976-2016 (PDF)
- ↑ Daniela Glocker, Johanna Storck: University, technical college or training, which subjects bring the highest wages? (PDF; 489 kB) DIW, weekly report 13/2012
- ↑ Decision of May 17, 2017 - Az .: 13 A 168/16 , Higher Administrative Court of North Rhine-Westphalia
- ↑ Voluntary insurance for dentists. (PDF; 561 kB) Professional Association for Health Services and Welfare, accessed on March 26, 2018 .