For applicants
Self-employed or salaried in dental care?
Earning more is usually the reason to make the switch. This is the honest calculation — plus the rules, insurance and registrations that come with it.
The choice in brief.
Salaried employment
- Advantage: A steady income, pension, paid holiday and continuing education usually taken care of.
- Disadvantage: You give up control over your schedule and part of your earning potential.
Self-employment and locum work
- Advantage: Your own rate and your own choices.
- Disadvantage: All the risks are yours: an empty schedule, illness, pension and insurance.
- Disadvantage: The rules are getting stricter — see the rules.
Secondment
The third path almost nobody knows: employed by a secondment agency.
- Advantage: Working in a variety of practices.
- Advantage: Variety without the business risk.
What does it pay? The honest calculation.
Self-employed hourly rates look substantial next to a monthly salary. An honest comparison starts with everything an employer pays for — and everything you therefore arrange yourself as a contractor.
| Role | Salaried | Self-employed or locum |
|---|---|---|
| Dental hygienist | € 3.000 – 4.500gross per month, for a full week | € 50 – 70per hour, roughly |
| Dentist | € 4.000 – 6.500gross per month, or a revenue share | around 40%usually as a percentage of turnover; by the hour, an experienced locum charges roughly € 120 – 150 |
| Dental assistant | € 2.500 – 3.300gross per month, full-time | Rarethe gains lie in progression, for example towards prevention work |
There is no collective labour agreement (cao) in dental care, and the KNMT has not issued a pay guideline since 2022. All the figures above are market observations — what we see practices pay — not standard amounts. For specific specialisms or more seniority, we also see higher salaries. The full underpinning is in What does dental care pay in 2026.
What comes off the hourly rate before you put it next to a salary
- Your disability insurance (AOV)
- Your pension contributions
- Paid holiday and public holidays
- Your continuing education
- Your admin
- The days when the schedule isn’t full
Deduct all of that and what remains is often less than the rate suggests. Not always: a sought-after locum with a full schedule can genuinely come out well ahead.
Honestly: which form pays more differs per person, per region and per year. Want to know how it works out in your case? Create your anonymous profile — and we will put your figures next to what practices are paying right now.
The rules: false self-employment and what is coming.
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In force
1 January 2025
The Dutch tax authority is fully enforcing the rules on false self-employment again.
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In force
Since 2026
Penalties for culpable conduct are possible for anyone who knowingly continues an arrangement that doesn’t hold up.
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Coming
31 December 2026
A statutory presumption of an employment contract, tied to the hourly rate.
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Coming
2028
For 2028 the government is working on the Self-Employment Act.
The core: anyone who is a fixed part of the rota, gets the practice rate and carries no business risk of their own looks like an employee with an invoice — whatever the heading on the contract.
- The question “are you genuinely self-employed?” will only grow in importance over the coming years.
- The five questions for testing your own arrangement: Can your locum still work as a self-employed contractor?
- Every piece of legislation, with dates and sources: the self-employment and flexible-work rules topic page
KVK, VAT and admin.
Registering with the KVK (the Dutch Chamber of Commerce), a business account, sending invoices: practically manageable. What often catches people out in dental care:
- VAT exemption
- Dental care is as a rule exempt from VAT. Sounds like an advantage, but it also means you usually don’t reclaim the VAT on your own purchases. Get a bookkeeper who knows healthcare.
- The all-in rate
- Rates in dental care are usually all-in: travel time, admin and no-shows are included. Set your rate as if every hour were billable and you are fooling yourself.
- Wkkgz
- As an independent care provider you must have a complaints scheme and be affiliated with a recognised disputes body. Not a formality to postpone — it is a legal requirement.
Pension and buffers.
- Pension
- Self-employed, you arrange it entirely yourself, for example through an annuity (lijfrente) using your annual pension allowance (jaarruimte). In salaried employment you usually build it up automatically. Do nothing, and you build up nothing from day one.
- Buffer
- Set money aside for quiet months and for the tax bill that always arrives later than you expect in your first year.
- In short
- This is not a side issue next to your rate; it belongs in your rate.
Get the basics in place.
Four subjects are big enough for a page of their own. Read them before you sign — in whatever form.
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Insurance for the self-employed
Disability insurance (AOV), professional liability, legal expenses insurance and the Wkkgz complaints scheme: what you arrange yourself and what salaried employment covers automatically.
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Continuing education in dental care
KRT, KRM and PE points: how to keep your registration up to date, and who pays for the training — you or the practice.
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Everything about BIG registration
Getting it, keeping it and re-registering — and the route for anyone trained abroad.
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Working as a self-employed dental hygienist
Where the assignments come from, what you charge and what to arrange before your first invoice. In Dutch.
Locum, secondment or permanent.
- Locum work
- Can be a phase: after graduating, between two permanent positions, or as a deliberate choice to run your own business.
- Secondment
- The variety of locum work with the security of employment.
- A permanent position
- In a tight market, a moment to negotiate: security, a training budget and hours are terms just as much as the salary is.
The choice is not a fork in the road. We place people in permanent, interim and secondment roles, so we have no stake in pushing you towards one form — we simply do the sums with you.
Frequently asked questions.
Do I earn more self-employed in dental care than in salaried employment?
Often on paper, not always in practice. Out of your hourly rate you pay for your own disability insurance, pension, holiday, continuing education and the days the schedule is empty. The comparison is only honest once you deduct all of that — and how it works out differs per situation.
Which insurance do I need when I start out on my own?
At the very least professional liability insurance and a complaints scheme under the Wkkgz. Disability insurance is not compulsory but it is the biggest financial risk you run. Legal expenses insurance is worth considering. All the details are on the insurance page.
Do I have to charge VAT on my work in dental care?
Dental care is as a rule exempt from VAT. That also means you usually cannot reclaim the VAT on your own purchases. Put your situation to a bookkeeper who knows healthcare before you send your first invoice.
Can I still do locum work as a self-employed professional in 2026?
Yes, provided the arrangement is genuine self-employment. The Dutch tax authority has been enforcing the rules on false self-employment again since 2025, and since 2026 penalties for culpable conduct are possible for anyone who knowingly carries on. Separate assignments, your own rate and several clients count in your favour; a fixed rota among salaried colleagues is the strongest signal against. Test your own situation against the five questions.
What does the statutory presumption from 31 December 2026 mean for me?
From that date a statutory presumption of an employment contract applies, tied to the hourly rate. Work at a low rate and employment may be presumed sooner — whatever the heading on your contract. Exactly how it will work follows from the text of the act; get advice. The current state of all the legislation is on the topic page.
What about pension when self-employed?
You arrange that entirely yourself, for example through an annuity (lijfrente) using your annual pension allowance (jaarruimte). In salaried employment you usually build it up automatically through your employer. Switch to self-employment and arrange nothing, and you build up nothing from day one — price that into your rate.
What is an anonymous profile and what happens to my details?
You leave your details with us — nothing is public. We test what you earn against what practices are paying right now, and get in touch when something comes along that fits better. Your name and CV only go to a practice once you know exactly which practice it is and have said yes to it.
Create your anonymous profile.
Get paid better in your next job or assignment. Tell us what you do and what you want; we put it next to what practices are paying now and get in touch as soon as something comes along that fits better. Your name stays with us until you say yes.