DENTISTS treating medical card patients have been told they have permission to carry out only one emergency treatment a year. Any further visits from people with bad toothaches must be passed by the health board.
Under instructions from the Department of Health, the health boards contacted dentists, telling them a revised protocol for emergency treatment had been agreed.
The letter from the Eastern Health Board to dentists stated that the incidence of emergency treatment for any one person is "infrequent and would rarely recur within the same 12-month period".
The emergency element of the dental treatment services scheme for adults, it said, "is designed only for the provisions of urgent emergency treatment for the relief of pain".
A Dublin dentist yesterday criticised the regulation, saying it was "ridiculous" that dentists treating a second emergency had to send a separate claim form with an explanatory covering note seeking health board permission.
Dr David Neligan said he believed it was an effort to reduce demand, since dentists would have to wait and see if the payment had been approved.
"This is not dentistry. How can you possibly make rules about people having a second emergency? It is a piece of senseless bureaucracy and is probably only saving buttons," he said.
According to the letter, surgical extractions will also require health board certification. Once it is passed payment is made by the GMS.
Dr Neligan said the fee for treating a second emergency had been reduced. The fee for tooth extraction dropped from £28 to £18.
In the letter, dentists were told that the new protocol for emergencies had been agreed by the Department of Health and the Irish Dental Association. However, it is believed agreement had not been reached when dentists were informed of the change.
The Irish Dental Association has advised dentists not to operate the new system. A spokesman for the association said there were ongoing discussions with the Department of Health. "There have been indications to us that sufficient funds will be made available for the proper running of the emergency and routine scheme," he said.
There was no evidence, he said, that any dentist that did apply for payment for a second emergency procedure was refused payment by a health board.
Last night a spokeswoman for the Eastern Health Board said their letter had been issued in September on the instruction of the Department of Health who said agreement had been reached with the dentists.
Two months later the Department told the Board that the system was no longer in operation. However they were not instructed to write to the dentists informing them of this, she said.
The spokeswoman pointed out that the service was not disrupted at any time because of the new protocol.