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What is the oral care trajectory?
The oral care trajectory is a rule in the royal decree of 28 June 2016 on patients’ personal share for dental care, in force since 1 July 2016. It does not change what the dentist charges, only what the patient pays: a patient who did not come the previous year is reimbursed less. For patients with increased reimbursement it has applied since 1 January 2017, with a smaller difference.
The aim, according to RIZIV-INAMI: about one person in five says they do not see a dentist every year, and a yearly check-up matters for oral and general health. The trajectory is meant to bring more people to the dentist every year.
Who is in the oral care trajectory?
Every patient from their 19th birthday, automatically. The sickness fund checks its own records for at least one reimbursed dental act in the previous calendar year, and works out the reimbursement straight away.
- Any reimbursed act counts, including a consultation or the annual oral exam, at any dentist.
- Care abroad or after an accident at work counts too.
- Only the previous calendar year counts: a patient who did not come in 2025 is outside the trajectory in 2026, even after a check-up in January.
- One reimbursed act in 2026 puts the patient back in the trajectory for the whole of 2027.
- The COVID exception, which counted two years, ended on 1 January 2025.
- Under 19 a patient is outside it: ordinary dental care is then fully reimbursed.
Which care costs more outside the trajectory?
Fillings and build-ups, root canals, extractions, sutures, X-rays, urgent-care flat fees, removable dentures and implants. For that care the personal share roughly doubles; for X-rays it rises by about half; for removable dentures by €53 to €56; for implants by €40.50. With increased reimbursement it rises by €2 at most.
Consultations, preventive care such as the annual oral exam and scaling, periodontics and orthodontics do not depend on it. Nor does specific dental care for cancer patients or in anodontia.
| Act, age 19 and over | Fee | Patient share inside | Outside | Increased reimbursement, inside or outside |
|---|---|---|---|---|
| Filling, two surfaces | €59.58 | €9.50 | €18.50 | €0 or €1 |
| Root canal, two canals | €134.05 | €13.00 | €25.50 | €0 or €1 |
| Extraction, from age 50 | €68.82 | €7.50 | €14.50 | €0 or €1 |
| First intra-oral X-ray | €15.92 | €3.50 | €5.00 | €0 |
| Complete removable denture | €919.34 | €189.50 | €242.50 | €25 or €27 |
What changed in 2026?
On 1 June 2026 the continuity rule that halved the reimbursement of scaling for patients who had not seen a dentist the year before was dropped. The dentists and health insurers agreement brought it in line with the oral care trajectory, which leaves preventive care alone: scaling no longer depends on the previous year.
On the same day the annual oral exam went up to €82, with the DPSI periodontal screening included from age 18. As preventive care it is not reimbursed less outside the trajectory, and as a reimbursed act it keeps the patient in the trajectory for the next year. The rest of the agreement is in the Belgian dental fee agreement 2026-2027.
How does a practice know whether a patient is in the trajectory?
Through the tariff lookup in MyCareNet, which according to the Christian sickness fund (CM-MC) takes the patient’s trajectory into account from the fund’s own data. Your own records tell you too if you treated the patient last year; care at another dentist does not show there.
If you are unsure when billing in third-party payment, CM-MC advises billing as if the patient were outside the trajectory; the fund then pays the patient the difference. The official waiting-room poster shows the amounts outside the trajectory in a separate column.
SourceCM, mondzorgtraject for dentists (in Dutch); RIZIV-INAMI, MyCareNet for dentists
What does it mean for a practice’s recall?
A six-month recall looks at the mouth; the oral care trajectory looks at the calendar year. For next year’s reimbursement, what counts is that a patient came at least once this year, so the time to remind those who have not come yet is the autumn, not January.
Tilcao, an AI dental receptionist, sends that reminder to the patients you select, in your own words, and books the check-up into your diary where the practice software allows it. It quotes no amount you did not give it and gives no advice on an individual patient’s reimbursement. Texts to send yourself are in dental appointment reminder templates.
What do the sickness funds say?
CM and Helan explain the trajectory to their members, with the amounts inside and outside it. Solidaris argued in 2018 for scrapping it: by its study, three in ten ordinary insured patients paid €27 more on average. Note that some sickness fund pages still say 18, or two calendar years. Under the current rules it applies from the 19th birthday and only the previous calendar year counts.
SourceHelan, oral care program; Le Spécialiste on the Solidaris study, 15 November 2018 (in French)
Questions practices ask
From what age does Belgium’s oral care trajectory apply?
From the 19th birthday. Before that, ordinary dental care is fully reimbursed and the trajectory plays no part. Some older pages say 18; that was the age limit before September 2023.
How often must a patient see the dentist to stay in the trajectory?
At least once per calendar year, for a reimbursed act, at any dentist. A check-up, a consultation or a treatment is enough. That one act keeps the patient in the trajectory for the next calendar year.
A patient did not come last year. Does a check-up now help for this year?
No. Only the previous calendar year counts, so this year the patient pays the higher personal share for care such as fillings or extractions. A reimbursed act this year does put them back in the trajectory for next year.
Does scaling cost more if the patient did not come last year?
Not since 1 June 2026. The continuity rule that halved the reimbursement was dropped, so scaling, like other preventive care, no longer depends on the previous year.
Does the trajectory apply to patients with increased reimbursement?
Yes, but the difference is small: outside the trajectory the personal share rises by €2 at most, and nothing changes for X-rays. For most care the personal share with increased reimbursement is nil inside the trajectory.