Loophole allows rogue providers of dentures put patients at risk

A legal loophole is allowing illegal providers of dentures, some operating from garden sheds or kitchen tables, to continue in business despite risks to patients’ health.

Regulatory authorities, who have been alerted to allegations of patients being treated in unhygienic conditions by unqualified operators, are powerless to intervene because of gaps in Irish law and EU regulations.

Homespun denture businesses are treating patients in dirty conditions and failing to adhere to basic hygiene precautions, according to one professional group. The Clinical Dental Technicians Association claims "rogue providers" are free to continue in business due to inaction by regulatory bodies.

The group is this week sending “cease and desist” letters to more than 20 operators it claims are illegally providing dentures. It has vowed to seek injunctions against firms that do not comply.

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Under law, the only people allowed to provide dentures directly to the public are dentists or trained clinical dental technicians. Anyone found illegally providing dentures can be fined up to €1,500 and jailed for up to a year.

The Dental Council says it has taken action in the past but admits it has no powers to stop illegal practice or to investigate suspicions that arise. The revised Dental Bill being prepared by the Department of Health should address many of the issues concerning the regulation of dental practices, it says.

The clinical dental technicians say they have made representations to the council as well as politicians, the Health Products Regulatory Authority (HPRA) and consumer and advertising watchdogs but all say they are hamstrung by inadequate legislation or claim the issue is beyond their remit.

Carpentry training

Association chairman Philip McGrath says it has received reports of patients being treated by unqualified denture providers in “dirty, unhygienic” conditions. One operator’s training is as a carpenter, it claims.

“One patient detailed how a provider attempted to put an ungloved hand in her mouth, despite an open wound on his finger.”

Mr McGrath believes the use of illegal providers is putting people off regular check-ups where abnormalities, including oral cancers, could be detected.

The association has hired private investigators to obtain evidence on those providing dentures directly to the public. It has also gathered evidence by logging complaints from patients and gathering evidence from websites.

The HPRA says it has investigated the association’s complaints but is not aware of the illegal fitting of dentures “under current legislation”.

Under current rules, a prescription for a dental device such as dentures must be written by a medical practitioner “or other authorised person”.

The loophole arises because there is no legal definition of an “authorised person”.

Forthcoming EU regulations on medical devices may help resolve the issue, a HPRA spokeswoman says.