Parents whose children have misaligned teeth find themselves in a hopeless situation when trying to schedule an orthodontist appointment. In more severe cases, the service should be covered by the Health Insurance Fund, but waiting times can stretch into years. Paying out of pocket allows for faster access to treatment, according to "Aktuaalne kaamera."

"It's more challenging with those treatment facilities that have contracts, where the Health Insurance Fund requires them to maintain queues. All patients are in the queue on an equal basis, and we take them in order. In these treatment facilities, if I remember correctly, the wait times ranged from nine to 24 months, depending on the facility," said Liis-Eleen Kalmer, a board member of the Orthodontists' Society.

Heli Paluste, head of the healthcare network at the Ministry of Social Affairs, mentioned that the Health Insurance Fund acknowledges that waiting times can indeed be unreasonably long in some areas.

The Competition Authority initiated a market analysis based on media reports to understand the reasons behind the situation.

"Issues with queues may have arisen between 2018 and 2020. The main issue is that demand is high, and supply unfortunately can't keep up. We are trying to understand where the supply problems are or what affects the supply. When demand is high and supply is not, prices climb very high," said Kadri Lepikult, head of administrative proceedings at the Competition Authority.

This is also illustrated by the fact that orthodontists' salaries are the highest in the medical sector, averaging €10,000 per month, which is 2.5 times the average doctor's salary.

Orthodontists believe there is no shortage of them in the market, but the Ministry of Social Affairs is ready to review both the orthodontists' training quotas and additional training for dentists, enabling them to perform simpler orthodontic procedures.

"This year, four residents were admitted to the training program; this was the university's proposal. We suggested increasing this number, but it remained at four. However, we are ready to reconsider this next year to see if the number could be increased," said Heli Paluste.

According to orthodontists, dentists sometimes refer patients to them unnecessarily. They see a solution in implementing e-consultations.

Liis-Eleen Kalmer explained that e-consultations would allow dentists to quickly consult an orthodontist on urgent questions that arise during visits, without needing a direct orthodontist appointment. "If it's a short question, a quick short answer can be given. Today, for example, several patients came to my appointment too early because their parents were overly worried and felt they couldn't wait any longer," Kalmer said.

Another potential solution could be allowing patients to be placed on a waiting list for only one treatment facility per referral. Currently, a single child might be on the waiting list at multiple clinics simultaneously, which artificially extends the queues, orthodontists believe.

The Competition Authority hopes to complete the analysis by the end of June. "We hope that the analysis will not reveal any indicators that would necessitate us to start proceedings," said Kadri Lepikult.

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