TRF1 decision annulling regulation on dental surgeons calls into question businesses and clinics structured under this regulation for years.

A ruling issued by the 8th Panel of the 1st Region Federal Regional Court (TRF1) declared, by a narrow majority of 3 votes to 2, the nullity of CFO Resolution No. 198/2019, a rule by the Federal Council of Dentistry that had regulated the practice of facial aesthetic procedures by dental surgeons, including oro-facial harmonization.

The decision rekindles a conflict of jurisdiction between professional categories and puts at risk business structures consolidated over years by clinics, specialized dentists, and investors in the sector.

What was at stake

The Public Civil Action that gave rise to the appellate decision was filed by the Federal Council of Medicine (CFM), the Brazilian Medical Association (AMB), the Brazilian Society of Dermatology (SBD), and the Brazilian Society of Plastic Surgery against the Federal Council of Dentistry (CFO).

The central argument of the plaintiff entities: there is no federal law authorizing dental surgeons to perform invasive procedures on the face, neck, and head for aesthetic purposes, which would make CFO Resolution No. 198/2019 an infralegal act without legislative backing.

Following the first-instance judgment dismissing the lawsuit, the TRF1, upon appeal, reversed the outcome and declared the resolution null and void, reopening the debate on the limits of self-regulation by federal councils.

The economic weight of the decision

The economic dimension of the conflict is significant. Data from the CFO himself¹ indicate that more than 6,500 professionals have a specialization in orofacial harmonization, a segment included in a market that moves approximately R$ 48 billion per year².

Throughout the validity of CFO Resolution No. 198/2019, these professionals invested in:

• Training and specialization courses recognized by the CFO;
• Equipment, supplies, and adaptation of offices and clinics;
• Business models structured based on the legality of the norm.

Therefore, the eventual consolidation of the nullity does not only affect the corporate dispute between boards. It directly affects the operational viability of thousands of professionals and countless clinics that operated in good faith under this regulatory framework.

The regulatory issue that goes beyond the category

The ruling raises a question that transcends the limits of dentistry: to what extent can a professional council, through its own resolution, define the scope of practice of its registrants?

On the one hand, there is the argument that the expansion of professional competencies requires support in formal law, and that infralegal acts of councils cannot create new fields of practice not provided for by the legislator.

On the other hand, there is the argument that the practice of health professions evolves continuously. New techniques, devices, and protocols emerge at a rapid pace, and the infralegal regulation by the councils would precisely fulfill the role of keeping pace with this evolution, provided it is compatible with the competencies already recognized by current legislation.

This regulatory tension is not exclusive to dentistry. Other professional health councils face similar questioning, and the outcome of this case could establish relevant precedents for the scope of the normative competence of these entities.

The current scenario and next steps

The TRF1 ruling does not end the controversy. The Federal Council of Dentistry has already signaled that it will adopt all appropriate legal measures and maintains that the decision, at this time, does not prevent the performance of aesthetic procedures by dental surgeons, at least until a definitive judicial ruling is issued.

While awaiting this definitive pronouncement, the sector operates in a zone of regulatory uncertainty, with two central aspects remaining open:

• The definition of the scope of competence of dental surgeons for facial aesthetic procedures;
• The limits of the normative competence of federal councils to expand, by their own resolution, the scope of activity of their categories.

For clinics, investors, and industry professionals, closely monitoring upcoming procedural developments with technical and strategic attention is an immediate necessity.

Orofacial Harmonization and Council Regulation: Points under Debate