Crowns falling out and disputes over pricing were among the 763 cases handled by the Dental Complaints Resolution Service (DCRS) in the last two years.
The DCRS managed 398 cases in 2024 and 365 in 2025, according to its annual report published on Tuesday.
The service does not investigate malpractice or award compensation, but facilitates mediation between patients and dentists when complaints arise.
The report noted that, since it was established in 2012, the DCRS “has prevented countless disputes from driving towards litigation or public conflict”.
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Most complaints stemmed from “miscommunications or misperceptions relating to pricing”, issues such as fillings or crowns falling out, or “a potential lack of care continuity” when a dentist leaves a practice.
“The vast majority of complaints relating to clinical care involve fillings and crowns falling out, and the colour of crowns and composite bonding,” according to the report.
“When a filling falls out a short time after treatment, this is usually resolved by the dentist and an explanation, an apology, and no charge for replacing the filling always works.”
The report noted that a crown falling out, “particularly at the front of a patient’s mouth, is usually more distressing”.
Most complaints are “dealt with by the dentist immediately” but, in some cases, “patients don’t get a response” and contact the DCRS.
Some issues “become particularly entrenched when the patient has been looking forward to an event like a wedding or other family occasion, and had hoped that they would have their longed-for beautiful smile for the event”, the document said.
“If the dentist does not meet the patient’s disappointment with some empathy, there is always a stand-off. Of course, the patient is not always right, but as we always say, they deserve to be heard and understood.”
In relation to complaints about pricing, the report said: “It is very important that cost is agreed prior to commencing treatment, and consent given. We have heard stories of patients embarrassed at the reception area when they don’t have enough money to pay.”
The DCRS said, when there is a change in price mid-treatment, “the patients should be informed of the change and the reason for it”.
“Most patients to whom we spoke understood that complexities can arise but were very annoyed when it was not explained to them. Some patients who hold a medical card and cannot access public treatment are now paying for treatment, and it is really important to ensure that prices are clear.”
While most issues are resolved once the DCRS becomes involved, the organisation said “poor communication often leads to patients feeling that they have not been heard or understood, and dentists believing they are under siege”.
The DCRS said it aimed to prevent “prolonged conflict or litigation” as this “harms not only reputations and careers, but emotional wellbeing”.
“Dentistry sits at the intersection of technical expertise and human vulnerability,” the report said.
“Patients arrive with fear, expectation and hope; dentists carry responsibility, judgement and the weight of care. When outcomes disappoint – whether through complications, miscommunication or unmet expectations – emotions can escalate quickly, and the psychological strain can be profound on both sides.”
Launching the report, High Court president Justice David Barniville said the DCRS had done “very valuable work”. He said it was “very significant that there appears to be a growing willingness on the part of dentists to refer patients to the service or to seek guidance themselves from the service”.
Dr Will Rymer, president of the Irish Dental Association, welcomed the fact more dentists and patients are engaging with the service.
“Patients know there is a pathway to resolution, and dentists increasingly recognise the value of engaging constructively before positions harden,” he said.
