Smiling through the pain

DENTAL HEALTH:With State support for dental care a thing of the past, the search for the right dentist is now as much about finances as it is about healthy teeth, writes CAROLINE MADDEN

AS A NATION, we may not be known for our pearly white smiles, but the general level of oral health in Ireland has improved in recent decades. However, with State support for dental care now severely curtailed, the danger is that dental health will begin to deteriorate again.

Though you may be loath to pick up the tab for services that were once free, neglecting your teeth is always a false economy. The longer you delay that trip to the dentist’s chair, the more likely it is that a niggling little problem will develop into a much bigger, and more expensive, one. So what can be done to lessen the financial pain of dental care?

From January 2010, the Government curtailed all support for treatments that used to be covered by the PRSI dental scheme, other than an annual examination. Subsidies for routine treatments such as fillings and extractions are no longer available.

However given that a dental check-up can, in some cases, cost more than €80, one free exam a year is not to be sniffed at. So before you visit your dentist, check whether or not you have satisfied the necessary PRSI conditions to qualify for the support by calling the treatment benefit section of the Department of Social and Family Affairs at 1890-400400.

Next, check whether you are entitled to tax relief on any dental procedures you require. While relief is not available for routine treatments such as scaling and fillings, it can be claimed on more expensive work such as crowns, root canal treatments and bridgework. Straightforward extractions are not covered, but the cost of the surgical extraction of impacted wisdom teeth is allowable.

Before 2009, relief was available on qualifying dental expenses at the higher rate of tax, but for 2009 onwards, relief can only be claimed at the standard rate of tax, which is currently 20 per cent. If you can make yourself understood with a numbed-up mouth, ask your dentist to complete a Form Med 2, and submit this to your local tax office. The Revenue allows a four-year window to apply for relief, so it’s still possible to claim relief for any qualifying procedures carried out since 2007.

Thirdly, if you have private health insurance, check whether dental treatments are covered by your policy, or whether discounts are available. For instance, Aviva offers its members discounts on certain procedures with the Smiles chain of dental clinics. Also, Vhi has developed a new standalone product called the Dental Starter Plan (which is cheaper but more restrictive than its existing Dental Plan product), but you should think carefully about whether the cost of this cover is likely to be justified. For someone aged between 18 and 39, the Dental Starter Plan will set them back €125.17 a year. This will cover them for half the cost of basic procedures such as fillings, extractions and treatment of gum disease, up to certain limits.

There are a number of conditions that may give potential customers pause for thought. For instance, an excess of €100 applies, and the plan will only cover 40 per cent of the cost of root canal treatments (net of tax relief) up to a maximum of €245 per tooth. However, a root canal procedure with a Dublin endontics specialist will set you back almost €800, or €640 after tax relief. Also, the policy does not cover the cost of crowns, which are generally required after root-canal treatment, and which can cost in excess of €700. Furthermore, a waiting period of up to 12 months may apply under the Dental Starter Plan for major treatment such as root canal.

Another option is to shop around, as prices can vary dramatically from one dental practice to another. For instance, research conducted by the National Consumer Agency last year found that the national average price for a simple extraction was €82, but within this, charges ranged from €40 to €150.

Despite the disparity in prices, a survey conducted by the Irish Dental Association found that most people select their dentist on the basis of the convenience of their location. Only 2 per cent said that value for money was the main factor. The difficulty with shopping around for dental care is that the customer very often has to pay for an initial examination in order to find out what further treatment is required.

However, some dentists are becoming more transparent when it comes to pricing, and are also cutting their fees. For instance, Phoenix Dental in Ashtown in Dublin 15 is running a deal during February and March, offering porcelain crowns for €480 instead of €700, a scale and polish for €40 and free check-ups.

For those willing to travel a little further, there are significant savings still to be had in Northern Ireland. It’s worth remembering that if you cross the Border for non-routine dental treatment, you may still be able to claim tax relief as long as the dentist is a qualified practitioner.

One savvy consumer tells us he was quoted a price of €1,800 for root-canal treatment on two teeth with a Dublin dentist, and decided to opt for a dental surgeon in Newry instead. In the end, he only required treatment on one tooth, which involved two visits costing a total of £350 (about €411) – plus about €40 in petrol – which he describes as an “absolute deal”.

“But to be honest, it was more than the cost,” he says, explaining that seven years ago he had a traumatic root canal experience with a Dublin dentist, although he says that “in fairness the technology has probably changed” in the meantime. He says his decision to head up North may be unpatriotic, “but tough times call for tough measures”.

For those who don’t wish to drive several hours every time a toothache strikes, the promise of Northern Ireland prices south of the Border is currently being offered by Smiles, which has 13 clinics throughout the country. Last year, the Smiles chain took the drastic step of dropping its prices by 30 per cent to match prices on offer in the North – and it has paid off. Within a short space of time they saw a 50 per cent increase in customer numbers. Founder Emmet O’Neill explains that because Smiles is bigger than most dental practices, they can buy in bulk and spread their overheads across a greater number of dentists.

Of course, your choice of dentist shouldn’t be based on price alone. For starters, just because a dentist’s prices are high, it doesn’t necessarily mean you are getting ripped off. You might well be receiving very high quality, specialised dental work. Also, other factors may be just as important as price. For instance, getting recommendations from friends and family can save you money by short-circuiting the search for a trustworthy, skilled dentist, whether they’re based north or south of the Border.

Teeth sorted for the rest of my days, a holiday in a remarkable city – and a clinic in Dublin for recommended six-monthly check-ups'

I'M AT AN age when it is time I did something about my teeth. Either that or lose them. I've recognised this for a long time but, not unusually, did nothing about it.

Then one of my beloved sisters – in whom I am well pleased – heard about this clinic in Dublin's Ranelagh called Access Smile which was operated by dentists from Hungary and who organised treatments for Irish patients in the country's capital Budapest for a fraction of the price in Ireland.

Said sister arranged an appointment, then told me about it. "Access Smile?", I said. "Forget it."

I thought it was some sort of cosmetic job, but it isn't. So I went along. They were very friendly, very professional and told me what needed to be done. It was up to me to decide what/or if I wanted to take it further.

Knowing myself, I decided it was either then or never, and so we agreed what should be done and when. They arranged appointments in Budapest and accommodation. I arranged my own flight at short notice and, hey presto, I was there. I could hardly be happier that I went.

I had six fillings, four crowns, an inlay and a bridge where I broke a tooth a few years ago. They also cleaned and polished my teeth, all in a state-of-the art clinic in suburban Budapest, where they take you by car for treatment and back again to your accommodation each time. (They also meet you at the airport and take you there again for departure after all is done).

As with most people, I hate going near a dentist, but it could not have been made easier. I felt no pain at all. And it is not all done all at once. You have days off in between. I was there for seven days in all, just three at the clinic. And what a stunning city Budapest is, with lovely helpful people, most of whom speak English, but with an appalling history! Thats the tourism bit.

The million dollar question – price? OK. Six fillings, four crowns, an inlay, a bridge, teeth cleaned, seven nights in a beautiful city- centre apartment with breakfast (if I wanted it, but mostly I'm not a breakfast person), and return flights to Budapest – what do you think?

It cost exactly €4,172. Teeth sorted for the rest of my days, a holiday in a remarkable city – and a dental clinic in Dublin for recommended six-monthly check-ups.

Am I complaining? Am I what? Just last week, I was talking to a friend who had work done in Dublin on three teeth. It has cost her €15,000. Are we mad?

I can fly out to Budapest, stay for a week, have three times as much dental work done and it still comes in at less than a third of what it cost her in Ireland to have work done on three teeth. If any of this is of use to you, contact access-smile.ie or ring them at 1850-493493 for further information. Clearly, I recommend them for dental care.

– Patsy McGarry