1. Recognition and registration come first
In Italy you can practise dentistry only once you are registered with the Albo degli Odontoiatri of the provincial Ordine dei Medici Chirurghi e degli Odontoiatri (OMCeO). With a degree obtained abroad, the first step is an application to the Ministry of Health for recognition of the qualification. Once it is recognised, you apply to the Ordine of the province where you will work.
- EU qualifications: dentistry is one of the professions with automatic recognition under Directive 2005/36/EC, implemented in Italy by Legislative Decree 206/2007. The Ministry checks the application and forwards it to the Ordine.
- Non-EU qualifications: the Ministry assesses the training and may require compensation measures. You will also need a residence permit that allows self-employed or employed work.
- Italian language: knowledge of Italian is checked as part of the process. Ask the Ministry or your Ordine which certificate or test applies to you.
Typical documents include a certified copy of the degree with a sworn translation, a certificate of the course length and, if you have practised abroad, a certificate of good standing. Allow time for this phase: the lease, the premises works and the hiring of staff should be planned around it.
Once registered, you are also enrolled with ENPAM, the pension and welfare fund for doctors and dentists.
2. Choose the legal form
- Sole or associated practice: you practise in your own name, possibly with colleagues.
- Professional company (STP): a company whose partners are professionals, under the rules of the Ordine.
- Company in the dental sector: allowed by Law 124/2017 (art. 1, para. 153), provided it has a dental director registered with the Albo degli Odontoiatri and that treatments are performed only by qualified professionals.
The choice affects liability, taxes, pension contributions and authorisations. Decide it with an Italian accountant (commercialista) and, when needed, a lawyer.
3. Premises and authorisation
Nationally, art. 8-ter of Legislative Decree 502/1992 requires an authorisation for dental practices equipped for outpatient surgery or for procedures that carry a risk for the patient. Each region sets the structural, technical and organisational requirements and the procedure. Applications go through the SUAP (the municipality's one-stop shop for businesses), with checks by the local health authority (ASL). In Tuscany, for example, the rules are Regional Law 51/2009 and Regulation 79/R/2016.
Before signing a lease, have a technician check the permitted use of the property, accessibility, floor areas, ventilation and systems, and talk to the SUAP and the ASL. Adapting premises afterwards costs far more.
4. Compliance you need from day one
| Area | Main reference | What you need, in short |
|---|---|---|
| Radiation protection | Legislative Decree 101/2020 | A radiation protection expert, periodic checks of X-ray equipment, training of exposed staff |
| Workplace safety | Legislative Decree 81/2008 | Risk assessment document (DVR), safety officer (RSPP), occupational doctor and health checks, staff training |
| Healthcare waste | Presidential Decree 254/2003 | Contract with an authorised waste company, correct temporary storage, registers and forms |
| Privacy | Regulation (EU) 2016/679 | Privacy notices and consents, records of processing, data processing agreements with suppliers, security for health data |
| Insurance | Law 24/2017 | Professional liability cover for the practice and for each clinician |
| Estimates and consent | Law 124/2017, Law 219/2017 | Written or digital treatment estimate, informed consent of the patient |
| Advertising | Law 145/2018, art. 1, para. 525 | Healthcare advertising must be informative only, without promotional or suggestive content |
5. Staff
Chairside assistants must hold the ASO (assistente di studio odontoiatrico) qualification, or an exemption, and attend at least 10 hours of training every year (Prime Ministerial Decrees of 9 February 2018 and 9 March 2022). Employment contracts follow the national collective agreement that applies to your practice. Ask a payroll consultant (consulente del lavoro) before you make an offer.
6. Invoicing and the Sistema Tessera Sanitaria
- Medical expenses data: dentists send the data on patients' medical expenses to the Sistema Tessera Sanitaria. The Revenue Agency uses this data to prepare patients' pre-filled tax returns.
- Invoices to patients: for services to individual patients, the e-invoice must not be sent through the national e-invoicing system (SdI). Since Legislative Decree 81/2025 this ban is permanent. Invoices to companies and other entities follow the ordinary e-invoicing rules.
- Tax regime and VAT: these depend on the legal form and on your income. This is your accountant's job.
Your checklist
- Recognition of the qualification and registration with the Ordine, plus a residence permit if needed.
- Business plan, break-even point and financing for the first months.
- Legal form, chosen with an accountant.
- Premises checked before signing, then the authorisation through the SUAP.
- Radiation protection, workplace safety, waste, privacy and insurance.
- Staff with the ASO qualification, contracts, job descriptions and protocols.
- Practice management software, X-ray imaging, network and backups.
- Invoicing and the Sistema Tessera Sanitaria.
- Website and Google profile, compliant with the healthcare advertising rules.
A longer checklist on the same topic is available in Italian.
Legal references checked in November 2026. This guide is general information. It does not replace the checks with the Ministry of Health, the Ordine, the SUAP, the ASL and your advisers.