Dental practice in France: SELARL, equipment, prosthetics and VAT

Quick answer. Dental care and prosthetics custom-made for a patient are VAT-exempt in France (article 261, 4-1° of the tax code); orthodontic appliances, aligners and purely cosmetic procedures such as whitening are taxable at 20%. New clinical equipment is depreciated straight-line or, for eligible machinery, on a declining-balance basis (article 39 A). In a SELARL, corporate tax applies at 15% up to €42,500 of profit, and the manager's dividends above 10% of share capital are subject to self-employed social contributions. Fixed CARCDSF contributions come to €6,109 per practitioner in 2026, before the income-based portions.

Whether run as a sole practitioner (BNC regime) or through a professional company, a French dental practice concentrates three accounting challenges: VAT with a shifting boundary (exempt care, taxable cosmetic work), costly clinical equipment to depreciate intelligently, and a prosthetics purchase-and-rebilling cycle that is often poorly recorded. This article covers day-to-day operations; for the choice between sole practice, SELARL or SELAS and the SPFPL holding structure, see our complete guide to dentist accounting, of which this is the practical companion.

Recently, a three-practitioner practice consulted us during its conversion to a SELARL: orthodontic work was invoiced VAT-free as if it were care, the chair was depreciated over three years straight-line with no review of the declining-balance option, and dental laboratory invoices were recorded inconsistently from one month to the next. Three classic worksites, which we take up here point by point, with the support of a dental-sector accountant.

The rule: exemption for care with a therapeutic purpose#

Care provided to patients by dentists is VAT-exempt under article 261, 4-1° of the French tax code, as for all regulated medical professions — a framework shared across health professions, which we also cover for the VAT of health professionals. Diagnosis, scaling, treatment of caries, endodontics, periodontics: all procedures with a therapeutic purpose are covered.

The supply of dental prosthetics by dentists and dental technicians is exempt on the same basis, under three cumulative conditions:

• the prosthesis is manufactured for a specific patient;
• it answers the order of a prescribing practitioner;
• it is produced from a prior impression or technical specifications set by the practitioner.

The exceptions: orthodontics, aligners, cosmetic work#

A doctrinal clarification of 8 February 2023 (BOFiP, the French tax doctrine database) settled a long-debated point: orthodontic appliances and aligner trays are orthotics — they correct a position rather than replace an organ — and are therefore excluded from the exemption: standard 20% VAT applies. The same goes for procedures with no therapeutic purpose, such as cosmetic whitening.

The operational criterion: a procedure is exempt if it pursues a therapeutic purpose or is covered, even partially, by health insurance. A non-reimbursed procedure can remain exempt where its therapeutic value is established.

Base exemption: a threshold measured on taxable receipts only#

For ancillary taxable receipts (non-therapeutic orthodontics, whitening, product sales), the practice may use the VAT base exemption: €37,500 of taxable receipts in 2026. Decisive point: the threshold is measured on taxable transactions only — exempt care fees do not count. A practice with €400,000 of care and €20,000 of whitening stays within the exemption for its cosmetic work; in return, the related input VAT is not deductible.

Straight-line or declining balance#

Chair, treatment unit, rotary instruments, suction systems, intraoral or panoramic radiology: these tangible assets are depreciated over their useful life. Two regimes coexist:

1. Straight-line depreciation: a constant annual charge over the estimated useful life — commonly in the order of 5 to 10 years for a chair depending on intensity of use.
2. Declining-balance depreciation (tax code article 39 A), reserved for eligible new machinery and equipment: the straight-line rate is multiplied by a coefficient of 1.25 (life of 3 to 4 years), 1.75 (5 to 6 years) or 2.25 (over 6 years), switching back to straight-line at the end of the plan.

Worked example. Imaging equipment bought new for €120,000, useful life 8 years: declining balance (coefficient 2.25, rate 28.125%) yields a €33,750 charge in year one, against €15,000 straight-line. At a 25% marginal corporate tax rate, that is roughly €4,700 of tax deferred from the first year — a cash-flow lever, not a permanent saving. We detail the same mechanics for the depreciation of imaging equipment in a radiology practice.

Small instruments and low-value equipment can be expensed directly, under the usual tolerance for low unit values.

The accounting cycle for prosthetics is simple in principle, often muddled in practice:

1. The laboratory purchase is an operating expense: under the BNC regime, the purchases line of form 2035; in a company, a class 60 purchases account, per the chart of accounts adopted.
2. The fitting billed to the patient is a care fee, VAT-exempt: the exemption covers the whole — procedure plus prosthetic supply — with no VAT to collect.
3. The 100% Santé standard quote breaks the offer into three baskets — 100% Santé (no patient out-of-pocket), capped fees, free fees. This breakdown, comparable to the 100% Santé scheme at the optician, is a patient-information duty; in the accounts, the practice records the overall exempt fee.

Tracking the margin on prosthetics (prosthetic fees minus laboratory costs) nonetheless remains a valuable management indicator, built alongside the statutory accounts.

This article does not address the choice of structure — that is the purpose of the guide cited in the introduction and of our page on the dentist SELARL. Once the SELARL (or the SELAS, its share-based variant) exists, three mechanisms apply:

• Corporate income tax: 15% up to €42,500 of profit (tax code article 219, I-b), 25% beyond. The company can smooth the practitioner's remuneration and retain earnings to self-finance equipment.
• Social regime: the majority manager of a SELARL remains a self-employed worker (TNS), affiliated to the CARCDSF — see our comparison of the TNS manager social regime.
• Dividends: the portion of dividends exceeding 10% of share capital, issue premiums and shareholder current accounts is subject to TNS social contributions (not merely to the flat-tax social levies). Example: €10,000 capital, €2,000 dividend — the fraction above €1,000 (10% of capital) enters the social base. For tax, dividends fall under the 31.4% flat tax in 2026 (12.8% income tax + 18.6% social levies), unless the progressive scale is elected.

Every self-employed dentist — including a SELARL manager — contributes to the CARCDSF pension fund. 2026 schedule (annual social security ceiling, PASS = €48,060):

Order of magnitude. For a practitioner under agreement declaring €200,000 of income, total 2026 CARCDSF contributions come to roughly €34,600: €4,196 of base pension on bracket 1 (€48,060 × 8.73%), €3,740 on bracket 2 (€200,000 × 1.87%), €3,210.60 + €19,154 of supplementary pension (11.35% of €168,761), €1,663.60 + €1,450 of PCV and €1,235 of disability-death cover. Urssaf contributions (health, family allowances, CSG-CRDS) come on top, under a separate schedule covered in the complete guide cited in the introduction. For practitioners under agreement, health insurance contributes €3,327.20 toward the fixed portion of the PCV in 2026 — two thirds of that scheme's funding.

• DAS2: fees, commissions and retrocessions paid to third parties (associates, locum dentists) must be declared once they exceed €2,400 per year and per recipient (tax code article 240). The declaration is filed with the tax administration, within the same deadlines as the income declaration.
• Electronic invoicing: under the national timetable, every practice — sole practitioner or SELARL — must be able to receive electronic invoices from 1 September 2026 (laboratories, equipment suppliers); the issuing obligation for small businesses follows on 1 September 2027. A tool such as Pennylane absorbs this inbound flow and automates the matching of laboratory invoices.
• VAT: if taxable receipts exceed the exemption threshold, the practice declares VAT on its taxable procedures only, under the applicable regime.

Early-career practitioner: micro-BNC#

A self-employed dentist falls under the BNC regime. Below €83,600 of receipts, the micro-BNC applies: a 34% flat allowance, income reported on form 2042-C-PRO. Beyond that, or by election, the standard regime (form 2035) deducts actual expenses — almost always preferable once the practice carries rent, a chair and laboratory costs. The 25% surcharge for not joining an approved management body was abolished from 2023 income onwards. The same reasoning applies to other health professions, from the physiotherapist choosing between SEL and BNC to the self-employed nurse.

Group practice#

In a multi-practitioner SELARL, fees are collected by the company, which bears the costs and remunerates each associate per the bylaws; cost accounting by chair becomes the allocation tool. In a grouped sole practice (SCM), each practitioner keeps their own receipts and shares the resources.

Associate and locum dentists#

Retrocessions paid to a self-employed associate follow the fees regime: DAS2 declaration above €2,400 per recipient. The collaboration agreement itself (royalties, status) is covered in the complete guide cited in the introduction.

• Orthodontics and aligners invoiced without VAT: the most expensive error — these procedures carry 20% VAT since the 2023 doctrinal clarification.
• Whitening and purely cosmetic work: taxable at 20%; isolate these receipts in a dedicated account from collection.
• Misread exemption threshold: €37,500 is measured on taxable receipts only, not on exempt care fees.
• Declining balance overlooked: on new clinical equipment, the first-year tax cash difference runs to thousands of euros.
• SELARL dividends: the fraction above 10% of capital, premiums and current accounts bears TNS contributions — build it into the remuneration forecast.
• DAS2: failing to declare retrocessions exposes the practice to penalties; list every recipient from €2,400 a year.
• VAT recodification: from 1 September 2026, the VAT provisions of the French tax code are recodified into the goods and services taxation code (CIBS); the articles cited here keep their substance under new references.

Three pitfalls recur in dental practice accounts. VAT first: the exemption on care is so habitual that taxable receipts — non-therapeutic orthodontics, whitening — stay under the radar until an audit. Depreciation next: defaulting to straight-line without reviewing the declining-balance option leaves tax cash on the table at every renewal of a chair or imaging unit. Dividends finally: since the social base was extended, yesterday's "optimised" distribution creates today's contribution reassessments.

Recently, we supported the conversion of a three-practitioner practice into a SELARL. The decisive project was not tax-driven but patrimonial: self-financing €120,000 of imaging equipment. Electing declining-balance depreciation (a €33,750 first-year charge instead of €15,000) and smoothing remuneration secured the financing plan without additional debt. Our bookkeeping and tax advisory services equip these quantified decisions — in liaison with the professional bodies and respecting medical confidentiality over patient files.

Hayot Expertise advice. Structure your chart of accounts around the VAT boundary: exempt care and prosthetics on one side, taxable non-therapeutic orthodontics and cosmetic work on the other, from the moment of collection. At every investment, compare straight-line and declining balance over the real useful life. In a SELARL, compute the dividend fraction subject to TNS contributions before deciding the distribution, not after. And make the margin on prosthetics (fees minus laboratory invoices) your monthly management indicator.