Doctor Patrick O'Brien dentist Dunmanway Dental Practice Cork

This is a column that Dr Patrick O’Brien contributes to What’s On magazines.

My name is Patrick O’Brien and I run a dental surgery in Leinster Street, Athy.
In this new regular column I will attempt to bring a dentists perspective to some of the issues that are newsworthy and of interest to people in this area.

Topics for the future will include:
Futuristic dentistry provided by CAD CAM technology. Recently I attended a course in Germany on the subject of Computer – Aided Design and Computer – Aided Manufacturing in Dentistry.
Bleaching. Is it safe?
Cosmetic dentistry.
Silver fillings and mercury. Do they have a future?
Exactly how important is oral hygiene?

If there are any topics that you might like to see featured or queries you would like to have answered please email
This month I will address the topic that I am asked about most at present which relates to what the average person is entitled to from the state in relation to dental treatment.

What are the current entitlements for medical card holders and social welfare contributors on PAYE?

A year ago at least 65% of my practice was funded by government sponsored dental schemes. These schemes have now been slashed .

The first scheme to go was the PRSI scheme. All qualifying patients contributed towards this insurance scheme and the only payoff was a contribution towards dental and optical treatment . This was a very well run dental scheme.

The contributions towards PRSI entitled each patient to a yearly check up . Most dentists provided the second check up free of charge as a good will gesture. Twice yearly scale and polishes were free to the patient.

The PRSI scheme subsidised the cost of fillings, extractions, dentures etc . A patient who formerly attended twice in the year and who had two check ups, two scaling and a filling could expect to pay E40. Today the cost to the same patient would be E210.

The schemes demise was announced in November 2009 with a six week window to get your treatment started .

From Jan 1 any treatment started had to be completed by the end of March 2010. All that remains is a free check up once a year. This is despite the fact that patients still contribute the same high contributions to this insurance scheme.

If this was Quinn Insurance the financial regulator would be on the case.

The second scheme to go was the medical card scheme. This was announced by letter on the 24 April 2010.

Prior to this announcement a medical card patient was entitled to a large range of dental treatment completely free . This was and is a poorly run scheme which was bureaucratic and open to fraud.

From the April date a patient is entitled to a free exam ,an emergency extraction and up to two fillings per year if these are classed as an emergency. A patient is entitled to an emergency denture .

I had a patient who lost teeth in a sporting accident. I sent a photo of the patient with two missing front teeth to see if it constituted an emergency. The written reply came back on June 15 stating that they had as yet not received a reply from a higher authority as to what constituted an emergency .

This scheme is a mess and has all the hallmarks we expect these days from the HSE.

Two dentists have recently taken the HSE to court and won. A medical card holder has a constitutional right to dental care under the health act 1970. We wait in vain to see if the HSE act to do the right thing and reinstate the scheme.

What are the entitlements of children under the school dental scheme?

In the recent past a child in 2 nd and 6 th class would be entitled to have their teeth checked and any necessary treatment provided . Any other age group was only entitled to emergency care.

A second class student could typically expect to have a dental exam ,the first molars fissure sealed if not decayed and filled if they were decayed. Generally all decayed baby teeth were ignored. An orthodontic assessment was provided.

A 6 th class student had any necessary decayed adult teeth filled. Again a final orthodontic assessment was provided. These orthodontic assessments rarely led to treatment . Only the most severe had a remote chance of treatment.

There is a moratorium at present on any new posts being filled. The school dental scheme is a victim of this. Kildare to my knowledge is not too badly affected but by comparison our neighbours in Co Meath have only three dentists for the entire county.

What this means is that hard pressed taxpayers are having to pay to have dental treatment. This is a ludicrous situation as the principle of ‘stitch in time saves nine’ applies especially to dental treatment.
This unfortunately puts us in a situation where those who can afford to pay privately get modern up to date treatment. Those who cannot afford to pay will go back to the treatment of the 50・s with extractions and plastic dentures. Is this acceptable in the Ireland of 2010?