Dental scheme for medical card patients in ‘complete chaos’

Dental treatment for people with medical cards is in “complete chaos”, dentists have claimed.

The Irish Dental Association said "unprecedented numbers of dentists" were withdrawing from the State's dental treatment service scheme, with serious repercussions for patients.

It said the number of dentists with contracts with the Health Service Executive (HSE) to provide services to adult medical card patients under the dental treatment service scheme had fallen by about 31 per cent in the last five years.

The dental treatment service scheme covers basic dental treatment for adults with medical cards including examinations, extractions and two fillings per year. Other forms of treatment can be provided with prior approval from the HSE.

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Association chief executive Fintan Hourihan said 250 dentists had left the scheme in the last year. He said there were now towns across the country which had few if any dentists providing treatment to adult medical card patients. He said fees cut under financial emergency legisation following the crash a decade ago had not been restored.

He said dentists could not afford to continue to participate. He said the last straw for many had been the failure to deliver on a promise by government to support financially the provision of personal protective equipment.

Funding fall-off

The dental association said that a fall-off in State funding and in the number of dentists participating in the scheme had resulted in medical card patients now facing: delays while seeking treatment; increased travel times while seeking that treatment; and possible reliance on the already-underfunded public dental service to provide care in areas where dental treatment service scheme contracts are not in place.

The association said that between 2017 and 2020, State spending on the scheme providing dental care for medical card patients decreased by 30 per cent from €5.5 million to €3.8 million.

It said that “according to HSE figures, the number of dental treatment service scheme contracts held by dentists nationwide has fallen by 31 per cent between 2015 and 2020, from 1,847 to 1,279”.

Mr Hourihan said that the fall in funding and participating dentists was “hugely damaging” for patients nationwide.

“This is an unprecedented crisis in dentistry. 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.”

Disillusioned dentists

He said that the nature of the medical card crisis in dentistry was unprecedented in scale and dentists were disillusioned with the Government’s lack of action on the matter.

"We have sought to engage with the Department of Health to modify this 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."

Mr Hourihan said that significant extra costs being incurred by general dental practices during the Covid-19 pandemic were making the existing dental treatment service scheme completely unviable.

“Dentists want to be able to provide care for medical card patients, but the Government is leaving them with little choice but to minimise their involvement or withdraw.”