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DENTAL TREATMENT FOR medical card holders is in complete chaos in Ireland, the profession’s industry body said.
Between 2017 and 2020, state spending on dental care for medical card patients nationwide decreased by 30%, from €5.5 million to €3.8 million.
Funding drops of up to 48% in certain areas have been recorded, while areas of Dublin account for six of the top 10 biggest drops in funding over three years.
The Irish Dental Association said an unprecedented number of dentists were withdrawing from the official treatment scheme.
Chief executive Fintan Hourihan said: “In 2020, almost one quarter of participating dentists nationwide left this scheme which is utterly unfit for purpose.
“Dentists simply cannot afford to participate, leading to complete chaos.”
He said dentists had sought to engage with the Department of Health to modify the Dental Treatment Services Scheme over many years to no avail.
“Increasingly, our members believe that the refusal to acknowledge this reality and the general approach of the Department of Health suggests a level of disrespect, if not contempt, for medical card patients and the dentists contracted to care for them.
“It also shows scant regard or understanding of the impact of this crisis on vulnerable patients who are unable to afford access to vital dental care.”
In 2019, then minister for health Simon Harris launched a new plan, “Smile agus Slainte”, aiming to transform the dental service from a “diagnose and treat” to one centred on prevention and available locally.
Under the government policy, all children up to 16 years would receive oral healthcare packages.
They would also be provided for medical card holders over 16 years.
The packages of care would be provided in a primary care setting by oral healthcare practitioners contracted by the HSE.
The Department of Health said the DTSS medical card scheme claims submitted by dentists had already returned to 90% of their pre-Covid level.
The numbers of dentists applying for new DTSS contracts is substantial and not reflected in IDA estimates, it said, adding that “they will contribute significantly to further services”.
A statement said it was supporting additional access to care for medical card holders under the DTSS scheme.
“The aim will be to improve access, reduce inequalities with other groups of patients and support preventive care.
“A fundamental and full DTSS review will take place in line with policy implementation but the department is cognisant of the need for interim measures before this full review to support practices and patients to help overcome Covid-19 impacts.
“The department appreciates the difficulties for the profession and medical card holders to provide and access care respectively throughout the Covid-19 pandemic.
“The department at all times is conscious of the impact of Covid-19 for vulnerable patients.
“The dedication of the profession is appreciated throughout this difficult time.”
The DTSS budget is annually determined by the take up of patients and this varies according to the numbers eligible for medical cards, as well as other factors such as the Covid-19 pandemic.
The statement said: “Throughout the Covid-19 pandemic the main group of medical card patients that have reduced their attendance and take up of all dental care including DTSS care have been older patients.
“This trend is similar across all non-Covid primary care services where older people have reduced take up of health care and are reluctant to access any but the most essential of care throughout the pandemic; the dental medical card figures reflect this phenomenon across the population and this is reflected in an overall reduction in take up of care.
“However, dental provision of care has been less affected than other health areas.”
State funding for dental care dropped by 30% while only this week the politicians are looking to increase their own wages.
And before anyone gets on the “dentists make too much money” bandwagon, the payment for medical card treatments doesn’t even pay enough to cover the time needed to throughly clean the surgery between patients and the new PPE needed to treat them so why work for free or at a loss ?
@David Jones: And dental materials are very expensive. Also in most cases people wouldn’t have to pay for lots of treatment if they look after their oral health properly, and go for regular free checkup and clean which detect issues early on and prevent major treatment being needed.
@David Jones: Sure they don’t David…1000 quid for a root canal on a molar with temporary crown. It took an 1 hour 30 mins. The tooth will need a permanent crown (about another 900 quid). I guess dentists make up for this ‘shortfall’ with private patients. You never wondered why people traveled to have dental work done elsewhere in Europe? As for ppe costs…give me a break. Gloves and smocks. Then additional bleach IPA cleaning. The disposables would already be changed patient to patient…the equipment would already be there to perform the cleaning. You’re basically wiping down the chair and patient contact surfaces. It’s taking ten minutes from what I see between patients. I’ve not known a dentist struggling to make ends meet at anytime in my life.
@David Jones, my dentist charges me an additional €12 for that service, are you telling me a dentist is getting less than €12?
@David Jones: I was quoted €850 for a root canal and a further €600 for the crown just a month ago. None of that is covered by the medical card, an implant (I would require 5) is €2000 per tooth. A denture is €1000.
Sure a dentist has a lot of overheads but my god can they charge.
@Rostyballs78: there is a reason crowns and implants cost a lot. For crowns the dental technician fee has to be considered. And for implants the implant itself is not cheap. You also need to fully scrub up with proper surgical PPE and equipment, alot of people are also sedated for the treatment so there’s the cost of the anaesthetist too.
@David Jones: dentists on €70ph !!
Meanwhile the taxpayers have hardly a tooth left.
@RogersRabbit: very true. Have worked every day of my working life and get pretty much nothing. Even the ‘free’ yearly check was nothing more than a cursory glance.
@RogersRabbit: A lot of us medical card holders have worked all our lives and paid our taxes just like you but had to retire at 65….no choice to stay on.
The scheme was rediculous anyway. Only 1 filling allowed a year, but extractions are free, what sort of “prevention” is that? Not surprised older people are not going to the dentist.
@Jane Alford: prevention means not needing the extraction or filling in the first place. Which most people wouldn’t if they went for regular checkups.
@Jane Alford: 2 fillings per year.
@Sam Harms: It really depends on your teeth. Regular checkups just mean at least one filling every visit…
@William Ryan: And if an existing filling falls out, as they do on a regular basis, refilling counts as a “filling”, there’s no warranty on fillings.
Doesn’t seem fair though people on medical cards could get free dental care while the rest of us pay for teeth cleaning etc. It was 120 euro the other day for my partner.
@Karen Doyle: I work full time and am a medical card holder. I had to pay €90 for a cleaning just after Xmas. It doesn’t cover cleaning, it covers the 2 mins the dentist looks into your mouth before deciding on what needs to be done. More of the the “they get everything for free” brigade. Don’t mind anyone’s actual circumstances
@Karen Doyle: you get one free checkup and a clean that you will have to pay a max of €12 towards each year through prsi.
@Karen Doyle: maybe you should change your dentist. There is a national scheme for one teeth cleaning per year to those with enough PSR contributions.
There is two dentist schemes for adults, card holders and everybody. The scheme for everybody depends of previous contribution via taxes deducted in the payslips. Cleaning teeth and removal of wisdom teeth is available free to everybody with enough PSR contributions. However medical card holders, adults, are excluded
@Nicola Monaghan: cleaning is free once per year with enough PSR contributions regardless of having or not medical card. Check the HSE site
@Karen Doyle: wtf dentists are hardly free for MC holders youd see a dentist cheaper on PRSI you tool
@Karen Doyle: Teeth cleaning on MC is not available.
@Karen Doyle: I paid 140 in smiles for small filling. Rip off.
Meanwhile, the state has UNLIMITED FUNDS to provide free legal aid for our criminals!
It doesn’t make any sense. I understand why dentists are leaving the scheme. The scheme is like only repair the broken and never program essential surgery, wait until the issue turns into emergency and then … will see …. how many PRS contributions have the patient? This is like the cancer screening schemes wouldn’t treat the cancer for not having enough PSR contributions
The government seems to see the dentists as a beauty and superfluous thing, maybe for them. However our health starts in our mouth as we are what we eat. Poverty has impact on the teeth and mouth. The quality of the drinking water supplies to our homes also impacts on the health of our mouths. Any policy investing the teeth and mouth health will reduce the cost of side effects saving money of the taxpayers at long term … Besides it is a temporary thanks to the children scheme
That never mentioned adults with special needs.They have no PRSI contributions only their medical cards.Dentists will not take them now
A lot of dentists on here by the comments.
@Peter Coen: true money, money, money. What’s new.
That never mentioned adults with special needs.They have no PRSI contributions only their medical cards.Dentists will not take them now.
“Dentists simply can’t afford to participate” oh my word, they can easily afford to reduce the cost of the treatments as it is and still make a massive profit
@Mickomacko: nah bruv
The link to Treatment Benefit Scheme available to those with enough social insurance contributions, the prsi on our payslips. The scheme is managed by the Department of Social Protection. Dentist can apply directly …. for the comments above it seems not the best practice … the bill must to disclose the Treatment Benefit discount
You can know if your dentist have applied and got it by making a Freedom of Information request to Social Welfare
https://www.gov.ie/en/service/1fb655-treatment-benefit-scheme/
My dentist now refuses to take the medical card. I’ve rung every dentist within 80km of where I live. Those still accepting the medical card are either only treating children or they are not accepting new patients. That includes so-called health centers.
There is zero chance of me being able to afford two fillings privately. Zero way to get €300. So, I’m in pain and will just have to suffer the medieval state of affairs in this country.
There has to be some alternative to this total fiasco. Surely they cannot expect to leave medical card holders in limbo like this forever ????
it made me think back in for a long time if you had a state medical card only pulling was free and because we had no money for fillings I have now 3 caps . I never understood why they where so backward cruel here . But I still live I wonder when this rule changed
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