Dr. Clodagh McAllister:

The difference when headed to an extraction is in whether the tooth is restorable. Sometimes it is not just a simple case of putting a filling in a tooth as opposed to taking a tooth out. Sometimes one might be faced with trying to save the tooth. I know people are interested in keeping their front teeth but they actually use all their back teeth for function. There is a cost involved and that is where the medical card fails because it is cheaper to take out a tooth than to do the correct procedure, which would be to maintain the tooth for health and provide a root canal treatment. That is the difference.

As regards the price difference between fillings and extractions done privately, they are all of a similar price but most people who could have a filling would opt for a filling as opposed to an extraction, whereas most people who are opting for an extraction in a private setting would be given the option of saving the tooth. The inequity of the medical card scheme is people cannot even do that. Young people are losing teeth very early on and it is a wholly unequal system. It goes against everything dentists are trained to do. We are trained to provide the best care and the best preventative care and the medical card does not allow us to do that. It allows dentists to be destructive and land people in situations where, while they may be relieved of pain, they are landed in difficulty because they have difficulty chewing, particularly if they have had multiple extractions which is, unfortunately, very common. Then the dentist cannot provide something to replace the teeth because people can only have dentures in an emergency situation. That is what it is about. There is no prevention, in my opinion, in the medical card system. It is wholly about getting the patient out of pain and the cost is the bottom line.