One thing that unites us all is the need for dental treatment and the concern about what it may cost. There are no controls over prices for dental care in the Republic and as a result dentists can charge whatever patients are prepared to pay. Dentists are, however, subject to market forces and private treatment costs vary significantly from region to region and within the Dublin area.
Before making an appointment or beginning to shop around, PRSI contributors or their spouses should check their eligibility for Dental Benefit with the Department of Social, Community and Family Affairs. Eligibility can be established in one quick telephone call to the Treatment Benefit Section of the Department, based in Letterkenny (074 25566), or your local Social Welfare Office.
Certain PRSI conditions must be satisfied to qualify for benefit and the conditions vary according to the age of the claimant. PRSI classes A, E, H and P count.
For those under 21, the requirement is 39 weeks PRSI paid since first starting work. Add to that a further 39 weeks PRSI paid or credited in the tax year on which the claim is based for those aged 21 to 24. The next age band is 25 to 65 and the requirement is also 39 weeks in the relevant tax year plus 260 weeks PRSI paid since first starting work.
Dental Benefit gives cover for a number of different types of dental treatment, including a free yearly examination, free diagnosis and free scaling and polishing twice a year. The majority of dentists are participants in the scheme and the Treatment Benefit Section in Letterkenny can supply callers with a list of participating dentists in their area.
Under the scheme, the claimant must pay part of the cost of other types of treatment, such as fillings, extractions, dentures and root canal therapy. The proportion paid by the patient increases with the cost of the treatment, starting at 30 per cent of the cost of fillings.
Claiming the benefit is very straightforward. The forms to apply to the Department are available in dentists' surgeries. Some dentists may double-check the claimant's eligibility themselves and will go ahead with treatment before approval comes through from the Department. The wait for approval is up to three weeks and others may opt to hold off on treatment until after the claim is approved.
If you open the Golden Pages under dental practitioners, you may be surprised to see prominent advertising by dental surgeries in Northern Ireland. Dentists in the Republic are ethically debarred from advertising by the Irish Dental Council.
Dr David McCauley, secretary of the Northern Ireland branch of the British Dental Association explains the phenomenon. "In recent years, the numbers of people coming over the Border for treatment has increased. Some dentists, especially in Border counties, are making a business of it and targeting the Southern market."
Some treatments, such as the more expensive crown and bridgework can be significantly cheaper in the North. Unlike in the Republic, there is a recommended scale of fees for private work issued by the British Dental Association and the General Dental Practitioners' Association. Historically, fees in Northern Ireland have been held down by the relatively low National Health Service rates.
Dr Bernard Murphy, chairman of the General Practitioners Group of the Irish Dental Association, points out that although the treatment may be cheaper for a variety of reasons, there are possible disadvantages for the patient.
"I would seriously question the wisdom of travelling North for specialised treatment as one has to take into account the service cost for follow-on treatment. It may work out an expensive inconvenience if a patient has to travel for attention to a minor matter following the initial visit."
The real saving is difficult to calculate, mainly because of the lack of information on this side of the Border. All dentists or representatives of dentists in the Republic contacted for the purposes of this report were unable or unwilling to provide estimates of average dental treatment costs. It was explained that quotes could only be given on a case by case basis.
Although dentists in Northern Ireland are free to charge what they like for treatment, the scale of fees guidelines issued by their representative bodies offer a fairly accurate reflection of the going rates.
Regardless of where the dental treatment is carried out, those registered for income tax can claim tax relief on money spent on certain costly treatments, including crown and bridgework. The dentist and the patient both have to fill out a Med 1 form, obtainable from the Revenue Commissioners.
When it comes to dentures, prices vary according to the quality of the finished product and the choice is up to the consumer. An average set would cost £500-£600 through a dentist or £250-£300 from a dental laboratory.
Getting fitted with dentures through a dentist is more expensive than going directly to a dental laboratory although the type and extent of service is different. Many Irish dentists avail of the competitive prices of British-based laboratories when purchasing dentures for their patients.
All children up to the age of 14 are entitled to free dental care. Primary school children are usually screened in second, fourth and sixth class and for follow-on treatment they will be referred to their local health board clinic. Orthodontic treatment is also free once the problem has been noted in primary school. The child should be seen by a consultant around the age of 12 and will then join a waiting list. The treatment may not begin until after the age of 14, but it will still be free if the child was diagnosed in primary school.
The dental hospitals in Cork and Dublin provide general practice treatment at a fraction of the going rate. While you might pay £40£60 pounds for a filling in a private practice, the hospital will do the job for around a third of the price. The catch? The treatment is carried out by students - under supervision, of course.
At the end of the day it is not all about the money. A visit to the dentist can be a stressful affair for many people and no price can be placed on the security of being seen in comfortable surroundings by someone you know and trust who has an excellent technique and chair-side manner.
