Can a dentist issue a sick note (L4)? Sick leave from a dentist after a tooth or wisdom tooth extraction

Can a dentist issue a sick note?

Yes, a dentist can issue a sick note, known in Poland as L4. Article 54(1) of the Act of 25 June 1999 on cash benefits from social insurance in the event of sickness and maternity (the Sickness Benefits Act, consolidated text Dz.U. 2026 item 854) lists the doctor, the dentist, the feldsher and the senior feldsher among those whom ZUS (Poland’s Social Insurance Institution) authorises to issue certificates of temporary incapacity for work.

ZUS grants the authorisation by decision, after the doctor submits a declaration that they will follow the rules for certifying incapacity for work. The Act does not make this entitlement depend on whether the visit takes place under the NFZ (Poland’s National Health Fund) or privately. This description reflects the legal position as of 12 October 2026.

A sick note from a dentist is the same proof of incapacity for work as a sick note from a doctor of any other specialty: when entitlement to benefits is established, what counts is a certificate issued under Article 55 of the Act, not the specialty of the person who issued it (Article 53(1)).

What does an e-ZLA from a dentist look like?

A sick note from a dentist, like any other, is electronic: it is an e-ZLA issued in the ZUS system and signed electronically by the doctor (Article 55(1) and (2) of the Sickness Benefits Act). ZUS makes it available to the employer on the employer’s profile no later than the day after receiving it, without the disease code (Article 58(1)).

The content of the certificate is set out in Article 55(3), and the rules for the printout and the paper form in Article 55a of the Act. For the patient, these are the key elements:

• The period of incapacity for work, stated as a number of days.
• The medical instruction: “chory powinien leżeć” (the patient should stay in bed) or “chory może chodzić” (the patient may be up and about).
• The disease code under the International Statistical Classification of Diseases, which the employer cannot see.
• A printout signed by the doctor, issued at the patient’s request or when the employer has no ZUS profile.
• A paper form only when issuing it electronically is impossible, for example without internet access.

When does a dentist issue an L4 sick note?

A dentist issues an L4 sick note when, after an examination, they find that the patient’s health does not allow them to work. The decision is made only after a direct examination (Article 55(4) of the Act and § 6 of the Regulation of the Minister of Labour and Social Policy of 10 November 2015 on the procedure and method of certifying temporary incapacity for work) and is recorded in the medical records.

When certifying, the doctor takes into account all circumstances relevant to assessing the patient’s health, with particular regard to the type and conditions of work (§ 3 of the Regulation). That is why the same procedure may justify sick leave for someone in physical work but not for someone who works at a desk.

The regulations do not explicitly limit the dentist to dental diagnoses, but in practice a dentist certifies incapacity for work resulting from a condition they have examined and are treating themselves. Typical situations are a tooth extraction, especially a surgical one, wisdom tooth removal, implant surgery, an abscess and treatment under general anaesthesia.

L4 after a tooth extraction or wisdom tooth removal: how many days?

No regulation sets how many days of sick leave apply after a tooth or wisdom tooth extraction: the length of the L4 follows from the examination and from how long the patient should refrain from work (§ 8 of the Regulation). Sick leave is issued at most until the day on which the next examination is needed.

The UK’s National Health Service (NHS) states that after wisdom tooth removal most people return to their usual activities the next day, while after a difficult procedure or general anaesthesia they usually need 1 to 3 days off. Pain and swelling can last up to 2 weeks but usually ease after 1 to 2 days. After general anaesthesia, the NHS advises not driving, not operating machinery and not making important decisions for at least 24 hours.

The table describes typical practice, not an entitlement. Whether sick leave is needed, and for how many days, is decided by the doctor after an examination, so in a particular case it may be shorter, longer or unnecessary.

Can a dentist backdate an L4 or issue one on request?

A dentist can backdate an L4 by no more than 3 days before the examination, and only if the examination findings show that the patient was undoubtedly unable to work during that time (§ 7(3) of the Regulation). The regulations allow a longer backdated period only for a psychiatrist.

Sick leave usually starts on the day of the examination or the following day. It can start later, at the latest on the 4th day after the examination, when the visit is immediately followed by days off work, for example after a procedure on a Friday for someone who does not work at weekends (§ 7(1) and (2)).

There is no such thing as an L4 on request. Sick leave is a medical certification based on an examination, so a dentist may refuse to issue it if the patient’s health does not justify incapacity for work.

Can a dentist issue sick leave to look after a child?

Yes, the regulations also allow a dentist to issue sick leave for looking after a sick family member, for example a child after a procedure. Article 54(1) of the Sickness Benefits Act covers certificates of the need to personally care for a sick family member, and in that case the examination concerns the child (Article 55(4)).

Care allowance is payable, among other cases, for looking after a sick child up to the age of 14, for a total of up to 60 days per calendar year (Articles 32 and 33). It is not payable if there is another family member at home who can look after the child, except when caring for a sick child under 2 (Article 34).

What may and may not be done while on L4?

While on L4, you may not do paid work or anything inconsistent with the purpose of the sick leave; the penalty is losing sickness benefit for the entire period of the sick leave (Article 17(1) of the Sickness Benefits Act). The provision in its current wording explains that activities which hinder or prolong treatment or recovery are inconsistent with the purpose of sick leave.

Ordinary everyday activities are not inconsistent with the purpose of sick leave. Nor are occasional tasks that significant circumstances require regarded as paid work, although an instruction from the employer is not such a circumstance (Article 17(1a) and (1b)).

The instruction “chory może chodzić” (the patient may be up and about) does not mean permission to work or to exert yourself in a way that harms healing. After a tooth extraction or surgical procedure, the doctor’s advice on physical effort, smoking and driving also matters.

Certificate of attendance from a dentist versus L4: how do they differ?

A dentist’s certificate confirming a visit and an L4 are two different documents. Proof of incapacity for work when entitlement to benefits is established is a medical certificate issued under Article 55 of the Sickness Benefits Act, that is, the e-ZLA, or its printout (Article 53(1)).

A certificate of attendance only confirms that the patient was at the surgery on a given day. Whether and how it excuses an absence from work depends on employment law and on arrangements with the employer, so it is worth asking the HR department about it before the visit.

How it works at DentalBlue

At DentalBlue in Białystok, the procedures after which sick leave is most often discussed, namely tooth extraction including wisdom teeth, surgical procedures and implant surgery, are performed under local or general anaesthesia. Treatment under general anaesthesia is preceded by a combined dental and anaesthesiology consultation, and an anaesthesia nurse stays with the patient until they are fully awake. If you may need sick leave for yourself, or to look after a child, after a procedure, tell the doctor before the procedure; DentalBlue dentists issue e-ZLA, and the doctor decides on sick leave and its length after an examination. The clinic is open on weekdays from 8:00 to 20:00 and on Saturdays from 8:00 to 16:00.