From next year, patients in Austria may have to pay more for dental fillings due to a funding dispute between the country’s Health Insurance Fund (ÖGK) and dentists.

The dispute comes as an EU-wide ban on amalgam fillings – the most affordable type, which is primarily composed of mercury, a heavy metal that is highly toxic and suspected of causing cancer – is set to take effect in 2025. As a result, dentists will need to switch to alternative materials.

Currently, the ÖGK fully covers the cost of amalgam fillings for back teeth and white plastic fillings for front teeth.

However, starting 1 January 2025, patients insured by the ÖGK will have to pay their dentists directly for fillings and then submit invoices for partial refunds.

The ÖGK has offered a 10% increase in fees to cover the new materials, but the Dental Association criticised the offer, calling it “economically unacceptable” for independent dentists and saying that further negotiations would be “pointless.”

“Accepting this proposal would have led to significant income cuts for independent dentists,” the association said in a statement, warning that the the reduced funding could result in fewer contracted dentists, thereby limiting services for the 7.4 million people insured by the ÖGK.

The most affordable replacement for amalgam is likely to be glass ionomer cement, which has already been used since 2018 for children and pregnant women. Other materials, such as composite, ceramic, and gold inlays, will also be available but at a higher cost.

The Dental Association also highlighted that many essential services – such as tooth extractions and denture repairs – already operate at a loss for contracted dentists. Basic consultations, vital to patient care, are not covered by the health insurance fund at all, adding further pressure to dentists’ earnings.