Dental Council says refusal to remove braces is unethical

The refusal of any orthodontist to remove braces from a child on the basis that they had not been paid is unethical, a spokesman for the Dental Council of Ireland has said. The regulatory body for dentists commented following a report in The Irish Times yesterday on the case of a girl in the care of the Child and Family Agency who had not had her braces removed because the orthodontist treating her had not been paid.

The teenager should have had her braces taken off three months ago, Judge Colin Daly, at the Dublin District Family Court, was told. The orthodontic work had been arranged for the teenager by her foster mother, but that placement had subsequently broken down and the girl no longer lived with her.

The girl had been moved to a residential unit and the foster mother had not settled the orthodontist’s bill, the agency told the court. The solicitor for the agency also said it had now received approval from management to pay the bill and was anxious to resolve matters, but he did not know how quickly the braces could be removed.

Judge Daly ordered that the case should be brought back before the court if the teenager’s braces were not removed by the end of the month. He said it was “an unnecessary trespass on her person that should be remedied”.

A spokesman for the Dental Council said it could not comment on individual cases, but it was unethical for dentists to withhold dental treatment on the basis of non-payment of bills. “If there is a problem with a patient continuing treatment or if a person can’t afford to pay, there is an obligation to leave a patient dentally fit. “In the context of orthodontic work,” he added, “this would mean the removal of the dental appliance. Not doing anything, pending payment, would not be ethical.”

Robert Troy TD, Fianna Fáil spokesman on children, said the teenager’s case demonstrated the basic dysfunction of the intervention and family support services in the Republic. “It’s a disgrace that despite the establishment of the Child and Family Agency, cracks still remain, and this case is a prime example of the gaps which still exist within the system.”

He said the case raised questions about staffing and support practices, including whether the girl had a dedicated social worker and whether the agency had attempted to make arrangements to have her orthodontic treatment completed. “The establishment of the Child and Family Agency was meant to herald a new era in our child support and protection services, but funding and resources issues are already hampering any progress,” he added.

Mr Troy said the agency had already overrun its funding by €25 million this year, and chief executive Gordon Jeyes had claimed an additional €45 million was needed for next year, as well as a further €60 million to fill vacant posts and to finance essential new developments.

There was no one available from the Child and Family Agency to comment last night.