Dental Protection’s Dental Director, Dr Raj Rattan has written to the Chief Dental Officer to express concerns over the current Dental Treatment Service Scheme (DTSS), following continuing reports of the declining number of dentists participating in this scheme.

In the letter, Dental Protection acknowledged the importance of providing access to care for patients who may not otherwise be in a position to afford this. Such access is only possible however if there are sufficient resources to support this and there is a risk that the falling number of dentists participating in the scheme seriously limits provision of this service.

There have been concerns for some time within the profession that because the DTSS limits care to a narrow range of treatment options using approaches which do not always reflect current thinking in clinical practice. The patients’ best interests are therefore not always served.

The contract does not promote a conservative and preventive-based approach for patients treated under the scheme. Dental research underpins the modern approach to improving the oral health of patients because it provides an evidence base for clinical interventions. Dentists have a moral and ethical obligation to adhere to clinical guidelines and apply the principles of evidence based care but are prevented from discharging this duty because of systemic factors associated with outdated approaches to clinical care.

The importance of a preventive approach is of course recognised as a key element in improving oral health by Smile agus Sláinte. We believe a root and branch review of the system is now long overdue for this cohort of patients both in terms of improving the level and type of clinical care available and how it is provided.

In our view, an approach that reflects current philosophies in clinical practice and at the same time encourages ethical care would be a positive step forward for  patients, for the professional and for all stakeholders – all of whom believe in the ethos of patient-centred care.