HSE makes a painful extraction from medical card-holders at the dentist

RECENTLY I received details of the latest cost-saving measure in the last budget – the restriction of dental services for adult medical card-holders to a service for relief of pain and infection.

On cursory examination, this draconian attack on basic health services for the most vulnerable in our society will not even provide appropriate treatment for some of the most common dental emergencies which present daily in dental practices. As an example, the proper treatment of one of the most common gum infections, acute necrotising ulcerative gingivitis (and it is as painful an unpleasant as it sounds), otherwise known as ANUG, is firstly gentle cleaning of the teeth, secondly oral hygiene instruction and, if necessary, the prescription of a course of an appropriate antibiotic medicine.

This medical card “emergency” scheme allows for only the prescription of medicine. The most basic dental healthcare need, cleaning of teeth and oral hygiene instruction, has been “suspended” for adult medical card-holders.

Another example of wanton disregard for patient suffering is the fact that as and from yesterday if medical card patients go to their dentist following an accident involving the fracture of two or more teeth, under the HSE “emergency scheme” the dentist is precluded from providing immediate pain relief for more than one of the teeth even if the nerves are exposed in additional teeth.

However, the HSE gives an assurance that it will endeavour to approve treatment for the other teeth within two weeks of application by the patient’s dentist. Relief of pain indeed!

In my view, these callous cutbacks clearly demonstrate the fact that the HSE is now satisfied to have medical card patients treated in a second-class fashion and is prepared to contract dental professionals to provide inappropriate and inadequate treatment for the relief of pain, that is, if the dental profession and the Dental Council are prepared to cooperate. It is clear that these cutbacks were planned and decided upon by management without reference to the dental profession; no dentist could recommend this emergency service as appropriate or ethical.

Pádraig O’Reachtagain

Dental Surgeon

Nationwide House

Castle Street


Co Tipperary

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