Dental cuts causing chaos and hardship, meeting told


THERE HAS been an “unprecedented assault” on the State’s dental services because of cutbacks to the dental care scheme for medical card holders, the Joint Committee on Health has heard.

It also heard a claim that the scheme was about to collapse because funds were running out.

The cutbacks announced in April restrict treatment for medical card holders to emergency care. They followed other changes made in the budget that reduced the benefits available to taxpayers under the PRSI dental treatment benefits scheme.

The committee heard about one case where a teenage girl needed five fillings before beginning orthodontic treatment but approval was refused because of cutbacks to the medical card scheme.

A patient who regularly had panic attacks in the dentist’s chair was refused sedation before having major dental work done because of the changes to the scheme.

Another case involved a 73- year-old woman with Parkinson’s disease. The medical card holder tended to fracture her fillings and needed three fillings replaced but approval was refused.

Another dentist was refused approval for gum treatment for a young woman with a major psychiatric illness. Her teeth were fine before admission to hospital but six months later she needed six fillings and gum treatment. Under the reduced scheme, she was only entitled to two fillings and no provision was made for treatment for her swollen, bleeding gums.

The cutbacks were announced in a circular issued by the Health Service Executive in April to dentists participating in the Dental Treatment Services Scheme.

The circular said additional care must only be considered “in exceptional or high-risk cases”.

Dentists must seek approval from the principal dental surgeon before undertaking treatment.

Irish Dental Association chief executive Fintan Hourihan said the cutbacks had caused “chaos, confusion and hardship” to vulnerable people. He said the content of the circular was “as ludicrous as it is vague”, and no clarity had been provided to dentists or their patients since then.

He said dentists were encountering hardship cases every day as a result of the cutbacks. “In our worst year, we have never seen the chaos that is currently out there,” he said.

Dr Jane Renehan, a principal dental surgeon, said €63 million had been allocated for the Dental Treatment Services Scheme this year and some €59.3 million was already spent. “This system is about to collapse,” she said.

Mr Hourihan said some dentists would be forced to close their practices because of the collapse in patient numbers due to the cuts to the medical card and PRSI schemes.

At a later meeting of the committee yesterday, Minister for Health Mary Harney defended the cuts in dental service provisions and told committee members they needed to be more “challenging” and to use their “critical faculties” when groups came before them.

Ms Harney said funds for the scheme had been capped at 2008 levels and this was not unreasonable in the current environment.

Patrick Burke of the HSE said he had engaged in “wide consultation” with principal dental surgeons about the changes to the scheme.