"We'll become a nation of the toothless": Czechs clash over dental costs after filling reform

Since January 2026, the rules for paying for dental fillings in Czechia have changed: insurance companies now fully cover the basic single-layer white filling, whereas previously patients who opted for white composite over amalgam had to pay for it entirely out of pocket. The news has sparked a lively debate among readers, many of whom are raising concerns about the real cost of dental treatment and the fairness of the health insurance system as a whole.

According to dentist Bára Malíková, in more complex cases of tooth decay it can make sense to pay extra and, combined with the insurer's contribution, get a higher-quality multi-layer filling. However, the doctor stresses, the best way to avoid pain and costly procedures is regular preventive care.

What has actually changed

As readers point out in the comments, full coverage doesn't apply equally to every case. For children and teenagers under 18, white photocomposite fillings are covered in full — both on baby teeth and permanent ones. For adults, only the basic single-layer filling remains free, provided it's suitable for the specific case of decay. If the damage is larger or deeper and requires a higher-quality multi-layer filling, in 2026 the insurer contributes 900 crowns, with the patient covering the rest according to the clinic's price list.

Full coverage only applies at dentists who have a contract with the patient's insurance company. For adults, a free filling on the same tooth is generally available no more than once every two years — the specific type of filling is determined by the dentist based on the size and depth of the damage.

Readers on prices and fairness

Many participants in the discussion point out that the real cost of a dental visit — not just fillings — runs into the thousands of crowns, which is simply not affordable for everyone. One reader, Radana Broučková, notes: "Root canal treatment on back teeth isn't covered by insurance at all, even though that's exactly where it's needed most. You leave the dentist having spent at least 15,000 crowns — not everyone can afford that. We'll end up as a nation of the toothless, even though everyone is required to pay health insurance."

Other readers complain that, in practice, nothing has really changed since the New Year: clinics' price lists have stayed the same, with only the 900-crown insurance contribution added on top — meaning, in their view, patients are paying just as much for fillings as before. There's also an opposing view: some commenters argue that the cost of treating teeth ruined by poor hygiene shouldn't fall on the state and on working taxpayers.

Another point of contention is the comparison between amalgam and white fillings. Some readers lament that amalgam lasted for decades and was free, whereas white fillings, in their experience, often need replacing after just 2-3 years, and repeated drilling eventually leads to the tooth being extracted. Others in the discussion explain that the move away from amalgam isn't due to an EU decision, but to scientific evidence that the mercury it contains does leach into the body — drawing a parallel with the history of the DDT pesticide ban.

Some commenters also raise a broader question: why dentistry and treatments such as root canals remain among the few areas of medicine where patients pay so much out of pocket, while treatment for other conditions — from cancer to surgery — is covered by insurance almost entirely.

Read also: Giving birth in Czechia as a foreigner: insurance and maternity hospitals 2026

Around Prague, based on reporting by seznamzpravy.cz