There's not a lot to smile about when it comes to dental costs. Laura Slattery reports on cutting those bills.
Numb dental patients spit out the last of the metal-flavoured saliva, slide off the grey leather chair and emerge into the softer light of reception, thinking the worst is over. Then they find out just how much their oral pain has cost.
The price of dental treatment has long been a source of discomfort for those without super-strong, sugar-resistant teeth and gums, leaving us susceptible to the claims of insurance companies that promise to give us "something to smile about".
There is only one dental insurance product on sale in the Republic. Available from the State-owned health insurer VHI in partnership with an American company called DeCare, it is not, by any means, cheap.
The most basic plan, VHI DeCare Silver, costs from €144 to €166, depending on the policyholder's age, but has a maximum annual benefit of €750. That doesn't seem like a very high limit considering the frequent horror stories of €2,000-€3,000 dentists' bills. For example, getting a crown inserted can cost up to €1,000 per tooth.
The maximum annual benefit limits do not apply to any orthodontic treatment required for children, which is just as well as €750 would not get parents very far in the private orthodontic sector.
On the higher plans, the maximum annual benefits are a more comforting €1,000 and €2,000. But premiums here are even steeper, starting at €217 for a child on the Gold plan - the most popular plan, according to VHI - and €305 for a child on the Platinum plan and escalating up to a prohibitive €408 and €548 respectively for the over 70s.
VHI and DeCare make another claim about their dental insurance product - that it promotes oral health by covering the full cost of investigative and preventative treatment. Customers can make appointments for either one or two polishing and scaling sessions and either one or two routine examinations a year and recoup the full amount charged.
"Regular dental care means fewer serious problems, which can mean lower long-term dental costs and fewer overall health problems," according to the brochure.
Unfortunately for VHI and DeCare, the culture of preventative oral treatment in Ireland typically extends as far as twice-a-day teeth brushing and the odd gurgle of mouthwash.
"Irish people don't go to the dentist for check-ups twice a year, they go when they have a pain in their tooth," says Brighid Smyth, head of corporate communications at VHI Healthcare.
"Dental insurance is fairly new to the market, the whole concept is new. We hope to see more sales next year."
Despite recent reports of an increase in cosmetic treatments such as bleaching and straightening, it seems we are still a long way behind the Americans in our pursuit of the "celebrity smile". Often it is not the expense but our dental phobias that keep us away, Smyth says.
There has been another slight hiccup. VHI has had reports from a small number of policyholders whose dentists have refused to sign its claim forms, possibly on advice from the Irish Dental Association. The association has written to members advising that they are not obliged to carry out the administrative work of a commercial insurance company.
However, Smyth says customers who submit standard dentists' receipts will be able to make a successful claim once VHI DeCare have contacted the dentist directly to confirm that he or she carried out dental work eligible for a payout. This has already occurred in one or two cases, she says.
Dental patients shouldn't have any difficulty at all in getting their dentist to sign a MED 2 form, however. This form has absolutely nothing to do with VHI DeCare and everything to do with claiming tax relief on dental treatment.
Depending on the rate at which people pay tax, it is possible to recover either 20 per cent or 42 per cent of the cost of non-routine dental treatments by completing both the MED 1 and MED 2 Revenue forms.
The cost of scaling, extractions, fillings, artificial teeth and dentures is not eligible for relief, but crowns, veneers, gold inlays, root canal treatment, periodontal treatment, orthodontic treatment, bridgework and the surgical extraction of wisdom teeth are among the treatments for which relief can be claimed on behalf of yourself, certain relatives and qualifying dependants.
Under VHI DeCare, only 50 per cent of the cost of these treatments can be claimed back anyway - unless they qualify as dental emergencies - so the amount 42 per cent taxpayers can recover through MED 2 is only 8 per cent less.
The catch is that the first €125 of all annual medical expenses is not eligible for relief but, unlike the VHI DeCare plans, claiming tax relief costs nothing and there is no maximum limit on the amount you can get back.
Another way to numb the pain of dental costs is to visit a dentist on the Department of Social Welfare's panel (most of them are now on it) and claim under the Treatment Benefit Scheme. This will reduce the cost of treatment for people who have paid a certain number of PRSI contributions.
VHI DeCare's Gold and Platinum insurance plans could certainly prove cost-efficient for families where the parents know that their children are going to need orthodontic treatment.
But anyone who doesn't feel like handing over expensive premiums shouldn't feel they are taking too much of a risk by ignoring dental insurance. Ignoring the dentist is the real risk.