Concerns dentures to be rationed for medical card holders
Irish Dental Association (IDA) chief executive, Fintan Hourihan, said dentures are the most expensive discretionary item provided for under the general medical card scheme.
“Because of that we are getting strong indications they will be the first thing to go,” he said.
Currently, dentists can perform routine dental work, such as examinations, fillings and extractions on medical card patients without receiving authorisation from a HSE principal dental surgeon. More expensive treatment items, such as advanced gum treatment, large x-rays and dentures, must be authorised by the HSE.
Dentures are estimated to account for 80% of the treatments approved by HSE principal dental surgeons.
IDA spokeswoman Dr Jane Renehan, who is also a HSE principal dental surgeon, said: “Dentures are the main budgetary element of which the HSE has control over concerning dentists, so that is where the squeeze is going to come.”
She added: “A lot of people lose dentures in hospital. It is a huge issue, they go to nursing homes or hospitals and may have some problems because they are on medication. They leave their dentures out and they get lost. We are not going to be allowed to replace those — it’s very sad.”
Last year 270,000 patients were seen by dentists under the medical card scheme. This was a major increase on the 2007 figure and is expected to rise again this year as more people become eligible. Dental treatment for medical card patients cost €63 million in 2008.
The HSE pays a dentist €450 for a full set of dentures, a fraction of the cost of the treatment privately.
Dr Helen Walsh, a dentist at the Portobello Dental Clinic, said: “What the HSE pays in many incidents does not even cover the lab fee of making the dentures, and already many dentists have withdrawn from the service for that reason.”
A HSE spokeswoman said: “We have not engaged in any discussions or decisions on restrictions to do with people’s dental treatment on the medical card.”
Mr Hourihan told the Oireachtas health committee that there was a “crisis” in dental community care.
Only 700 dentists were treating more than 10 medical card patients a month, with 34% of dentists not participating at all in the HSE’s Dental Service Treatment Scheme (DTSS).
In many parts of the country, “blackspots” exist where very few dentists are participating in the DTSS scheme and patients are left to travel great distances to be seen for treatment.
Participating dentists are also seeing growing waiting lists.
The IDA pointed out there had been an effective freeze on bringing new dentists into the DTSS.
However, dentist Maurice Quirke warned against so-call “dental tourism”, where patients go to countries, mainly in Eastern Europe, for dental treatment.
Dr Quirke said he had personal experience of one patient suffering from chronic gum disease travelling abroad to receive 22 crowns. “It was like building houses in a bog,” he added.
