"In a situation where the number of orthodontists has remained at the same level over the last decade and the number of patients has multiplied, this has led to long waiting lists and market failure, which undermines the well-being of the society," said Kadri Lepikult, head of the Estonian Competition Authority.

"Long waiting times for treatment limit effective competition and prevent patients from making alternative choices that would be best suited to them," Lepikult said.

In its analysis, the Competition Authority found that the state would be able to influence the level of supply for orthodontic services via strategic management of the sector. It could regulate the orthodontic sector by increasing the number of orthodontic providers and commissioning more teaching and residency places at universities.

The Competition Authority believes that the state needs to ensure a sufficient number of providers in order to improve the competitive situation. This would in turn influence companies to adjust prices according to market conditions as a result of the increased competition. Patients have to be guaranteed the possibility of assessing competing offers and making reasoned choices about which services to choose,  though that is not possible in the current situation.

To improve the competitive situation, the Competion Authority recommended the establishment of a national strategic vision along with an agreement to address the market failure caused by undersupply.

It is also deemed necessary to strike a balance between experts and stakeholders to ensure that policies are transparent and geared towards consumer welfare and reducing market failure.

The analysis also suggests a need to increase the supply of services by expanding the scope of orthodontic services and/or increasing the number of dental training and orthodontic residency positions at the University of Tartu.

Long waiting lists for orthodontic treatment mostly affect children, for whom waiting for several months or even years to correct the position of their teeth is particularly problematic

Orthodontists themselves consider the long lines for their services to be an artificial problem. However, the Ministry of Social Affairs is prepared to discuss extending the training of dentists so that they too can carry out simple orthodontic work.

Salaries for orthodontists are the highest in the medical sector, averaging €10,000 a month, which is 2.5 times higher than the average for doctors.

On June 13,  the Competition Authority organized a round table with representatives of the Estonian Orthodontic Association, the Estonian Dental Association, the University of Tartu, the Health Board, the Health Insurance Fund and the Ministry of Social Affairs. During the meeting discussed the preliminary findings of the Competition Authority's findings were discussed. Feedback was collected and used as the basis for completing the short analysis.

This June, the Competition Authority carried out a short review to assess the competitiveness of orthodontic services in Estonia. The aim of the analysis was to identify any issues and make recommendations to improve the situation where necessary.

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