Madam, - Having returned recently from practising dentistry in France since 2003, I am saddened to see the impasse with which the Irish Dental Association finds itself with the HSE in regard to the provision of dental services to medical card holders (DTSS scheme).
The media often portray France as the Utopia of medical care. While it is true that access to medical care is prompt and usually of excellent quality, dentistry, sadly, is another story.
Dental services are provided under a universal government-funded scheme, grossly underfunded and out of touch with the needs of modern dentistry. Fees are state-controlled and, as with the DTSS scheme, bear no relation to the true cost of providing these treatments to patients in today's "hi-tech, high overheads" dental surgeries.
I worked in three very different practices during my time in France and have seen dentistry of all levels of complexity provided (or not) to every socio-economic group. Things are not as equal as they would have you believe. Sadly, my experience left me appalled at the disgraceful standards of care I witnessed across the board, from gross overtreatment (usually excessive crown and bridge work) to gross undertreatment, such as the failure by the vast majority of dentists to diagnose and treat periodontal disease, the primary cause of tooth loss in the developed world. Prevention, as we know it in Ireland, is non-existent in French surgeries.
French dentists - 50 per cent of whom work (struggle) without a dental assistant or receptionist - have allowed their successive governments to dictate how they will practice their profession and seem to have forgotten where their ethical responsibilities lie.
The only way to keep your surgery open and earn a living is to both overtreat and undertreat as necessary, depending on how the system and the various insurance schemes remunerate various items of treatment. Patients are the innocent and often "abused" losers - I witnessed mistreatment on a level I never dreamt I would see in a developed country.
Much as I would have dearly loved to stay in France for the fabulous lifestyle we enjoyed in the Alps, I could not practice my profession ethically, or to a standard I would wish to provide for my patients. I would like to commend the Irish Dental Association for yet again taking a strong stance in insisting that the Government recognises the true cost of providing quality dental care in this country.
It is in none of our interests, most especially not that of our patients, that we might be forced to practice in the manner of our colleagues in France.
Contrary to what you may be led to believe by the media, we are blessed in Ireland with dental professionals whose standards are second to none in the world, both highly qualified specialists and generalists. Sadly, our overheads - staff, equipment, materials, rents, insurance, utilities, laboratories, continuing education etc, are not cheap.
Modern dentistry is expensive, especially if you seek quality. It is vital that the HSE realises that trying to force professionals to do things "on the cheap" is a recipe for disaster. - Yours, etc ,
Dr NUALA CARNEY, Upper Dorset Street, Dublin 1.