The tooth, the whole tooth and...
Sinead Ryan outlines what you can and can't claim on dental procedures
Buying health insurance can be a difficult and bewildering experience due to the range and complexity of products on offer. So it's strange that there's almost a complete absence of any insurance at all for dental care.
"It's almost non-existent," says insurance expert Dermot Goode of Totalhealthcover.ie. "DeCare has around 15 plans, all with restrictions and caps. HSF offers some cash back on policies as do Laya, Irish Life and VHI but only on certain plans, and basically only for routine stuff, nothing complicated like orthodontics or braces which are specifically excluded."
You can pay thousands for 'train track' braces for children, and implants and dentures are equally expensive, yet you cannot get insurance to adequately cover it.
State help is limited. It provides a free check-up and contribution toward cleaning each year for PRSI and self employed people, but unlimited extractions and two fillings a year for those with medical cards (477,359 people applied in 2017 but in the first four months this year 298,718 have already done so, indicating an increase since the last budget extended the measure to the self-employed).
Fintan Hourihan of the Irish Dental Association says: "It is a matter of great concern to dentists that so few patients avail of their free dental examination when eight out of 10 Irish adults are entitled to an annual check-up under either the medical card (DTSS) or PRSI schemes but the take-up rate is only around 30pc.
"The main reasons are essentially lack of awareness or confusion around entitlements. It has been shown that every euro spent on prevention avoids up to €8 on treatment so from a political, economic, as well as from an oral health perspective, it is money wisely spent when the public is made aware of its entitlements to free dental examinations," adds Hourihan.
"Perhaps a dental voucher towards the cost of preventative treatments to be provided on a 'use it or lose it' basis should also be considered."
For complicated treatments such as crowns or root canal work, dentists can charge anything they wish, however they are required to display prices and many do so online, so at least you can shop around.
Revenue allows 'non-routine' dental expenses to be claimed back via the MED2 form, but only at the standard 20pc rate. Ordinary fillings etc cannot be claimed. If you get treatment within the EU, you can also claim this back as long as it is carried out in a registered dental surgery.
Many clinics abroad offer cheaper services for expensive work, but you do need to be careful you're getting it done properly. Dentists here complain all the time about the amount of repair work they end up doing after botched jobs elsewhere.
A porcelain crown can cost €500-€800 here, while some dentists in Budapest charge as little as €100. In Spain you'll pay around €300.
Many people go to Northern Ireland where dentists undergo the same training/registration as here. With sterling at a good rate, it's possible to get a far cheaper quote in Newry or Belfast, but make sure you are building in the cost of several visits, time off work and post-procedure check-ups.
Tips to cut dental costs
- Get several quotes. Your dentist may only recommend one orthodontist, but you can shop around as long as you know the procedure requirement.
- Many dentists will allow stage payments for complex procedures, so do ask.
- Check your health insurance policy to see what's covered, even if it's only ordinary visits.
- Claim tax relief on non-routine procedures each year.