Availability of Dental Care in Slovakia: A Regional Analysis of the Outpatient Care Network, Preventive Care, and Workforce Capacity

Availability of Dental Care in Slovakia: A Regional Analysis of the Outpatient Care Network, Preventive Care, and Workforce Capacity

The aim of the study was to analyse the availability of dental care in Slovakia with a focus on the regional distribution of dental practices, the availability of emergency dental services, population participation in preventive oral examinations, the dental workforce, and trends in the number of dental students.

The study was conducted as a descriptive retrospective analysis of secondary data. Statistical data from the National Health Information Center, the Ministry of Health of the Slovak Republic, and other publicly available sources for the period 2015–2024 were analysed. The obtained data were processed using descriptive statistics and presented in tables and figures.

The analysis confirmed the existence of regional differences in the availability of dental care. The highest number of dental practices was recorded in the Bratislava Region (n = 431), the lowest in the Trnava Region (n = 215). Emergency dental services were provided by only 24 practices in the territory of the Slovak Republic, with an uneven distribution among the regions. In 2024, 2,747,545 individuals underwent a preventive oral examination. The highest participation was recorded among children aged 10–14 years, the lowest among children aged 0–4 years. The number of dentists increased from 2,647 to 2,966 in the period 2015–2024. The most numerous age group was dentists aged 30–39 years (33%), while dentists aged 65 years and over also represented a significant proportion (19.8%). The number of dental students showed a slightly increasing trend.

The results point to persistent regional differences in the availability of dental care in Slovakia, especially in the distribution of practices and the provision of emergency services. Despite a slight increase in the number of dentists, their even regional distribution and generational renewal remain a challenge. Improving the availability of dental care requires systematic planning of the practice network, support for preventive programmes, and the adoption of measures aimed at stabilising workforce capacity. The aim of this study was to analyse the availability of dental care in Slovakia with a focus on the regional distribution of dental practices, the availability of emergency dental services, participation in preventive oral examinations, the dental workforce, and trends in the number of dental students.

A descriptive retrospective analysis of secondary data was conducted. Statistical data from the National Health Information Center of the Slovak Republic, the Ministry of Health of the Slovak Republic, and other publicly available sources covering the period from 2015 to 2024 were analysed. The data were processed using descriptive statistical methods and presented in tables and figures.

The analysis confirmed regional disparities in the availability of dental care across Slovakia. The highest number of dental practices was recorded in the Bratislava Region (n = 431), while the lowest was found in the Trnava Region (n = 215). Emergency dental care was provided by only 24 dental practices nationwide, with an uneven regional distribution. In 2024, a total of 2,747,545 individuals underwent preventive oral examinations. The highest participation rate was observed among children aged 10–14 years, whereas the lowest was recorded among children aged 0–4 years. Between 2015 and 2024, the number of dentists increased from 2,647 to 2,966. Dentists aged 30–39 years constituted the largest age group (33%), while those aged 65 years and older represented a substantial proportion (19.8%). The number of dental students showed a slight upward trend during the study period.

The findings indicate persistent regional disparities in the availability of dental care in Slovakia, particularly regarding the distribution of dental practices and the provision of emergency dental services. Despite a gradual increase in the number of dentists, equitable regional distribution and generational renewal of the dental workforce remain major challenges. Improving the availability of dental care requires systematic planning of the dental service network, strengthening preventive programmes, and implementing measures to ensure a stable and sustainable dental workforce. Key words: healthcare availability, preventive dental examination, regional disparities, Slovakia, emergency dental service, dental care, dentists.

Dental care is an integral part of comprehensive patient healthcare. In addition to basic preventive and therapeutic procedures, specialised dental care also plays a significant role, focusing on the diagnosis and treatment of complicated diseases of the teeth, periodontium, and other structures of the oral cavity (Hupp, Ellis & Tucker, 2019; Glick et al., 2024).

Specialised dental care includes several fields focused on specific areas of diagnosis and treatment:

• Periodontology – prevention, diagnosis, and treatment of periodontal diseases, primarily gingivitis and periodontitis (Newman et al., 2023).

• Endodontics – treatment of diseases of the dental pulp and root canal system with the aim of preserving the natural tooth in the oral cavity (Torabinejad & Walton, 2020).

• Orthodontics – diagnosis and treatment of dental irregularities and malocclusions using fixed and removable appliances (Proffit et al., 2019).

• Prosthodontics – replacement of missing teeth using crowns, bridges, removable dentures, and implants (Rosenstiel, Land & Fujimoto, 2022).

• Oral and Maxillofacial Surgery – surgical procedures in the oral cavity, such as extractions of complicated teeth, apicoectomies, implant procedures, and surgical treatment of cysts and tumours (Hupp, Ellis & Tucker, 2019).

These fields require specialised education, practice, and the use of modern diagnostic and therapeutic procedures, including digital technologies and microscopically assisted procedures (Sanz et al., 2020; Glick et al., 2024).

The aim of the article is to highlight the importance of individual specialised fields of dentistry and to emphasise the irreplaceable role of prevention in the long-term maintenance of oral health.

Material and Methods

For the purposes of processing and analyzing the available information, data published in the Health Yearbook of the Slovak Republic for 2024 were used, which represents an official statistical source on the state and development of healthcare. This document provides comprehensive data concerning demographic indicators, the network of healthcare facilities, staffing, as well as the performance and consumption of healthcare, including the dental field. Due to its methodological accuracy and regular updates, it serves as a relevant basis for expert analysis, trend comparison, and formulation of conclusions in the field of specialized dental care and prevention (NCZI, 2024).

Results

The available data indicate that the highest concentration of dental clinics is in the Bratislava Region (n = 431), which is an expected result given the population density, urbanization, and higher concentration of healthcare facilities in the capital city. In second place is the Košice Region (n = 372), followed by the Prešov Region (n = 335) and the Žilina Region (n = 307). Lower numbers of dental clinics are recorded in the Nitra Region (n = 250), the Trenčín Region (n = 249), and the Banská Bystrica Region (n = 232). The lowest number of clinics is recorded in the Trnava Region (n = 215) (Tab. 1).

Tab. 1 Specialized outpatient dental healthcare (NCZI, 2024) [

](/files/c5ad3544865939452bdd9f07419d715f) 1) units with professional focus on stomatology, dentistry, and pediatric dentistry 2) for the calculation of the indicator "number of visits per medical post", only those professional units that reported both the number of medical posts and the number of visits within the NCZI statistical surveys were included

Within the Slovak Republic, the provision of dental emergency services is limited by a relatively low number of facilities. It is provided by only 24 clinics in total, which represents a relatively limited availability of this form of care at the national level. The highest number of emergency clinics is concentrated in the Žilina Region (6 clinics), which may be related to the geographical size of the region, as well as the need to provide care for a dispersed population. In other regions of the Slovak Republic, the number of workplaces providing dental emergency services is even lower, pointing to an uneven regional distribution of these healthcare services. This situation can negatively affect the temporal and geographical availability of urgent dental care, especially in larger or more sparsely populated regions, where patients in acute cases are often forced to travel greater distances for treatment. The Bratislava Region has four emergency clinics, the Trnava, Trenčín, and Košice Regions each have three clinics, the Banská Bystrica and Prešov Regions each have two clinics, and the Nitra Region has only one dental emergency clinic available (Tab. 2).

Tab. 2 Specialized outpatient healthcare – dental emergency service (NCZI, 2024) [

](/files/3be5ee70db88fa9535fe24ba58b83901)

In 2024, a total of 2,747,545 persons underwent a preventive oral cavity examination. The largest share was made up by the age category 18 years and older (n = 2,053,617), which points to a higher participation rate of the adult population in preventive procedures (Tab. 3). The participation of younger age groups, especially children and adolescents, was lower, which may be related to differing motivation for prevention, the availability of dental services, or the degree of parental involvement in the child's oral health care.

Tab. 3 Preventive oral cavity examinations (NCZI, 2024) [

](/files/5bef604e41de71daa32fb886fc54b926)

Fig. 1 shows the development of participation in preventive oral cavity examinations by age categories in the period 2021 – 2024. The analysis of the time trend allows for assessing changes in the participation of individual age groups in preventive examinations, identifying trends in their development, and evaluating the effectiveness of preventive programs in the monitored period. The highest rate of completed preventive examinations, expressed as a percentage of the respective age population, was long-term achieved by children aged 10 – 14 years, with values ranging from 72.2% to 84.7%. They were followed by children aged 5 – 9 years with participation of 66.9 – 80.4%, adolescents aged 15 – 17 years (67.7 – 77.2%), and the adult population aged 18 years and older (43.0 – 46.7%). The lowest participation in preventive examinations was recorded in the age group of children aged 0 – 4 years, in which the proportion of completed examinations ranged from 18.5% to 29.0%.

Fig. 1 Development of the number of preventive oral cavity examinations by age groups (NCZI, 2024) [

](/files/e3a9092e3af1e3d7086f8456d9857396) The number of dentists in the period 2015 – 2024 shows a slightly increasing trend. While in 2015 there were 2,647 dentists registered, in 2024 their number increased to 2,966 (Fig. 2).

Fig. 2 Trend in the number of dentists from 2015 to 2024 (NCZI, 2024) [

](/files/3398bc26b16386d0d7a14c8690f33f2e)

From the perspective of the age structure of dentists in Slovakia in 2024, the most numerous group was the category 30 – 39 years (33%). In second place was the age group 65 years and older (19.8%), which points to a significant proportion of the older generation in dental practice. Other significant age categories include:

• 40 – 49 years (16.7%), representing a stabilized generation of doctors with many years of experience,

• 50 – 59 years (14.2%), who are still actively practicing but are approaching retirement age,

• younger than 30 years (11.2%), where the proportion is significantly lower, which may indicate an insufficient influx of graduates into practice or a slower entry of young doctors into independent professional practice (Fig. 3).

Fig. 3 Development of the age structure of dentists (NCZI, 2024) [

](/files/b78e1b56ab77a6f84da91cf3147282c3)

The number of dental students for the years 2015 – 2024 is slightly increasing compared to 2015 with the number of graduates of Slovak state citizenship (n=80) versus 2024 with the number of Slovak students (n=110). However, the highest number of students was recorded in 2019 (n=118) and 2021 (n=117) (Fig. 4).

Fig. 4 Development of the number of graduates in the field of dentistry (NCZI, 2024) Note: university graduates as of December 31 of the given year [

](/files/1929a1bbe0b1a973b4e84cb0ac4af25a)

Discussion

The results of this work point to significant regional differences in the availability of dental care in Slovakia. The highest number of dental practices was recorded in the Bratislava Region, while the lowest was in the Trnava Region. Such a distribution is to some extent expected, as the Bratislava Region is the most densely populated region with the highest concentration of healthcare facilities, specialized workplaces, and economic opportunities. Similar regional differences in the distribution of healthcare workers are also described by Peres et al. (2019), Watt et al. (2019), WHO (2022), and OECD (2023), according to whom healthcare workers tend to concentrate in larger cities and economically more developed areas.

However, the identified regional differences cannot be explained solely by population size. The attractiveness of individual regions for practicing the medical profession, the level of infrastructure, the economic situation, opportunities for further professional growth, as well as the presence of university workplaces and dental clinics, also play a significant role. These factors influence the decision-making of young dentists when choosing a place of practice and can contribute to the persistence of regional inequalities in the availability of healthcare (Watt et al., 2019; WHO, 2016; OECD, 2023). From a health policy perspective, therefore, supporting the balanced development of the network of practices in all regions of the Slovak Republic remains an important task.

A significant finding is also the low number of facilities providing dental emergency services. In the territory of the Slovak Republic, this service is currently provided by only 24 practices, which, given the population of over 5.4 million, can be considered insufficient capacity. In the other regions, except for the Žilina Region, the number of emergency practices is even lower, pointing to their uneven regional distribution. Such a situation can lead to reduced temporal and geographical accessibility of urgent dental care, especially in larger or more sparsely populated regions, where patients are forced to travel greater distances for treatment. Similar problems were identified by the WHO (2022), which considers the geographical accessibility of healthcare to be one of the basic indicators of health system performance.

The limited capacity of dental emergency services also represents a significant systemic problem. Acute odontogenic pain, inflammation, and injuries are among the most common reasons for seeking urgent dental treatment (FDI World Dental Federation, 2021). The low number of facilities leads to their higher workload, longer waiting times, and can negatively affect the quality of provided healthcare. This problem is most pronounced in peripheral regions, where patients often travel tens of kilometers to obtain urgent treatment.

From the perspective of health system organization, it would be appropriate to consider optimizing the network of dental emergency services. One option is to establish a minimum standard of availability based on population size or catchment areas. Equally important is to create a stable funding model that will motivate dentists to participate in emergency services. A promising solution may also be more intensive cooperation between the public and private sectors through contractual mechanisms and rotation services of multiple practices. Several European countries also use electronic information systems that allow patients to find the nearest open emergency practice or consult their health condition via telephone or telemedicine services (OECD, 2023).

Currently, there is no internationally accepted standard or recommendation from the WHO or OECD that would determine the minimum number of dental emergency facilities per population. Despite the absence of an internationally defined standard, the need to expand the network of dental emergency services in Slovakia can be justified from the perspective of real healthcare availability. In many regions, patients must travel tens of kilometers for treatment during weekends and holidays, which represents a significant barrier, especially for children, the elderly, persons with disabilities, or patients with acute pain or infection. Insufficient regional availability can lead to the postponement of necessary treatment, deterioration of health status, and increased use of hospital emergency departments, which are not primarily intended for addressing acute dental problems. Therefore, the planning of the dental emergency service network should not be based solely on the total population, but primarily on regional needs, geographical accessibility, demographic structure of the population, transport accessibility, and the real demand for urgent dental treatment. Such an approach is in line with the principles of ensuring accessible and equitable healthcare and can contribute to reducing regional inequalities in access to dental services. The organization of the dental emergency service in Slovakia is regulated by national legislation, particularly Decree No. 115/2018 Coll., which establishes the method of financing and reimbursement for the provision of dental emergency services, but does not determine the minimum number of emergency facilities in relation to the population.

The results concerning preventive check-ups point to high participation among school-age children, with the highest proportion of preventive check-ups recorded in the 10–14 age group. This result likely reflects the positive influence of parental care, regular preventive programs, and the health insurance reimbursement system. Conversely, the lowest participation was found in children aged 0–4 years. This is a significant finding because early childhood is a crucial period for establishing proper hygiene habits and preventing early childhood caries. Kassebaum et al. (2017), the FDI World Dental Federation (2021), and the WHO (2022) emphasize that preventive care should begin soon after the eruption of the first teeth, and that parental education significantly reduces the risk of developing oral diseases.

Although the absolute number of preventive check-ups was highest in the adult population, when calculated per size of individual age groups, adults have long shown a lower participation rate than children. This trend is also observed in several OECD countries and is often associated with lower motivation among adults to undergo preventive examinations, time constraints, or visiting the dentist only when pain occurs (OECD, 2023). From a public health perspective, therefore, strengthening preventive programs and increasing health literacy among the adult population remains a priority.

A positive finding of this work is a slight increase in the number of dentists in the period 2015 – 2024. Nevertheless, the increase in the number of professionals alone does not automatically guarantee better accessibility of dental care. Decisive is their regional distribution, which may continue to deepen existing differences between individual regions. A similar problem is described by the OECD (2023), which warns that the number of healthcare workers alone cannot be considered the sole indicator of healthcare accessibility.

From the perspective of the age structure, a significant finding is the high proportion of doctors aged 65 and over, who constitute almost one-fifth of all dentists. This figure points to the continuing process of ageing of the healthcare workforce. Although the most numerous group remains doctors aged 30 – 39, the relatively low proportion of doctors under 30 may lead to problems with generational renewal in the future. The WHO (2016) and the OECD (2023) warn that the ageing of healthcare workers represents one of the main challenges for European health systems.

The development in the number of dentistry students indicates a slight increase in the number of graduates, which can be assessed positively. Nevertheless, the increase in the number of students alone may not be sufficient to compensate for the expected departure of a large group of older doctors into retirement. Besides the number of graduates, their retention in the Slovak healthcare system and willingness to practice the profession outside the largest cities will also be decisive. Young doctors often prefer economically more attractive regions or go abroad, which can deepen regional differences in healthcare accessibility (WHO, 2016; OECD, 2023).

Conclusion

The work provides a comprehensive view of the current state of dental care accessibility in Slovakia and points to areas that require further attention in health policy planning. The acquired knowledge can serve as a basis for adopting measures aimed at improving the accessibility, quality, and efficiency of dental care provision.

Based on the results of this work, it is recommended to optimize the network of dental emergency clinics with an emphasis on more balanced regional coverage and improving their accessibility. At the same time, it is necessary to create a stable system for financing emergency services, support cooperation between the public and private sectors, and motivate dentists to participate in providing urgent dental care. A significant contribution would also be the use of modern information technologies to provide up-to-date information on the availability of emergency services and the development of telemedicine consultations. An inseparable part of improving dental care is also the support of preventive programs, dental hygiene, and health education, which can contribute to reducing the incidence of acute diseases and subsequently to reducing the burden on dental emergency services.

Authors: prof. Mgr. MUDr. Erik Dorko, PhD., MPH, MBA Institute of Public Health and Hygiene, UPJŠ LF in Košice Mgr. Andrea Houžvičková, PhD. Institute of Public Health and Hygiene, UPJŠ LF in Košice

Work supported by grant projects KEGA of the Ministry of Education, Research, Development and Youth of the Slovak Republic no. 001UPJŠ-4/2024 and no. 003UPJŠ-4/2024.

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