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Dental treatment costs here vs the North

  • 26-11-2009 7:14am
    #1
    Closed Accounts Posts: 83 ✭✭


    I have been advised by my dentist (after a filling that did not work) that I need a root canal/filling/crown. The cost of this runs to approximately eur1400. I phoned a few dentists in the Newry area and the average cost for the treatment is around 650 pounds. Would like to be patriotic and support my local dentist but can anybody explain why a Dublin dentist is twice the price of one in the North. There doesnt seem to be any recognition that the celtic tiger is dead.


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Comments

  • Registered Users, Registered Users 2 Posts: 3,834 ✭✭✭Welease


    Been covered a million times.. Market forces.. they will charge what people are willing to pay.

    FYI my wife's recent root canal and crown cost ~900 Euro in Kildare, so it might be worth checking outside Dublin also.


  • Registered Users, Registered Users 2 Posts: 33,518 ✭✭✭✭dudara


    Moved to Rip Off Ireland

    dudara


  • Registered Users, Registered Users 2 Posts: 466 ✭✭aquascrotum


    My gf saw a dentist in Armagh last week (she's moved here for a bit for work). She's been putting off getting root canal that her Dublin dentist has been reminding her is required for 2 years plus due to occasional and infrequent pain around a filling.

    The new dentist advised that her filling was fine and that he was sick of hearing of "root-canal happy Dublin dentists" and that in his opinion, the more expensive dental procedures in RoI were rapidly becoming a racket.

    Initial consult fee and a visit to the dental hygeinist for full clean up and polish set her back £55.

    So the lesson was 1) You might not even need root canal and 2) Price around if you do need it.


  • Registered Users, Registered Users 2 Posts: 10,846 ✭✭✭✭eth0_


    The new dentist advised that her filling was fine and that he was sick of hearing of "root-canal happy Dublin dentists" and that in his opinion, the more expensive dental procedures in RoI were rapidly becoming a racket.

    Exact same thing happened to me. Went to a Dublin dentist who had lot of flashy tech including a little camera that showed you on a screen above your head what she was doing. Cue much head shaking and sucking of air through teeth (like a dodgy mechanic) "Oh you're going to need a root canal and a crown" and then quoted me a HUGE price for this and packed me off with a prescription for painkillers.

    I was so upset at the price quoted to me I rang a dentist i'd been seeing for a bridge and crown and she told me to come up the next day, x-rayed it and showed me why a root canal was not necessary and a small filling was all that was required. Five years later and i've not had any further trouble with that tooth.

    You can find significantly cheaper prices outside Dublin. It's not just dentistry that's expensive in Dublin, after all!


  • Registered Users, Registered Users 2 Posts: 608 ✭✭✭Anthony16


    Anon47 wrote: »
    I have been advised by my dentist (after a filling that did not work) that I need a root canal/filling/crown. The cost of this runs to approximately eur1400. I phoned a few dentists in the Newry area and the average cost for the treatment is around 650 pounds. Would like to be patriotic and support my local dentist but can anybody explain why a Dublin dentist is twice the price of one in the North. There doesnt seem to be any recognition that the celtic tiger is dead.

    Just pay the money and be loyal to your dentist.He/she has to make a living too,so dont be a miser


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  • Registered Users, Registered Users 2 Posts: 1,998 ✭✭✭extra-ordinary_


    Anthony16 wrote: »
    Just pay the money and be loyal to your dentist.He/she has to make a living too,so dont be a miser



    Well said*















    *may contain lies.


  • Banned (with Prison Access) Posts: 63 ✭✭marinbike


    Anon47 wrote: »
    I have been advised by my dentist (after a filling that did not work) that I need a root canal/filling/crown. The cost of this runs to approximately eur1400. I phoned a few dentists in the Newry area and the average cost for the treatment is around 650 pounds. Would like to be patriotic and support my local dentist but can anybody explain why a Dublin dentist is twice the price of one in the North. There doesnt seem to be any recognition that the celtic tiger is dead.



    Irish Dentists are allowed charge whatever they like, thats why we are the most expensive in Europe for Dental treatment. Being 'patriotic' to support rip off dental rates sounds like a good catch phrase... I mean, why else would the Irish Dentists say that other than for their own corporate greed.

    A simple solution that would force them to lower their Dental Rates should come in next weeks budget (increase the tax rates on Dentists/Doctors/Lawyers). These are the very ones who are still charging extremely high rates.


  • Registered Users, Registered Users 2 Posts: 609 ✭✭✭mossfort


    Anthony16 wrote: »
    Just pay the money and be loyal to your dentist.He/she has to make a living too,so dont be a miser

    they are not being a miser.
    im sure the irish dentist is making a very good living.
    the attitude here in ireland is that you should just pay up no matter how high the charges are.
    i had the same experience with a local dentist who turned a simple filling into 750 euros worth of work.
    he took numerous x rays at 40 euros each , did a few fillings then refered me to a consultant who charged 150 euros for a 5 minute consultation.
    i eventually ended up having two of my teeth extracted in hospital and thank god i had health insurance.


  • Closed Accounts Posts: 1,493 ✭✭✭mcaul


    If you were a dentist in the UK, your public liabilty insurance would be mnostly paid by the state as would the salary of your dental nurse as would a portion of your other costs.

    In Ireland there is no state aid for dentists.

    But then, we have lower direct taxes, a FAR superior free education system, better general heathcare (NHS is worse, I can assure you!), no £3000 a year council tax, no private water rates.

    Give me Ireland anyday - as before I speak from experience of both UK (6 year) and Ireland.


  • Registered Users, Registered Users 2 Posts: 608 ✭✭✭Anthony16


    mossfort wrote: »
    they are not being a miser.
    im sure the irish dentist is making a very good living.
    the attitude here in ireland is that you should just pay up no matter how high the charges are.
    i had the same experience with a local dentist who turned a simple filling into 750 euros worth of work.
    he took numerous x rays at 40 euros each , did a few fillings then refered me to a consultant who charged 150 euros for a 5 minute consultation.
    i eventually ended up having two of my teeth extracted in hospital and thank god i had health insurance.

    That dentist put years of hard work into becoming the dentist he/she is today.If he/she deemed the x ray was needed then it was needed.Dentists deserve a good salary because they provide a great service.I hate the way people always undermine the decision of health professionals.and no, i dont have any friends or relations who are dentists,i just dont like the jealousy people have towards healthcare professionals who have big salaries.They try their best and shouldnt be down graded


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  • Registered Users, Registered Users 2 Posts: 12,741 ✭✭✭✭Ally Dick


    I paid €1400 for root canal about four years ago. I was able to claim a lot of it back on the MED2 form via the revenue though. I don't think you can claim a refund back on the higher rate any more though.


  • Moderators Posts: 1,589 ✭✭✭Big_G


    marinbike wrote: »
    Irish Dentists are allowed charge whatever they like, thats why we are the most expensive in Europe for Dental treatment. Being 'patriotic' to support rip off dental rates sounds like a good catch phrase... I mean, why else would the Irish Dentists say that other than for their own corporate greed.

    A simple solution that would force them to lower their Dental Rates should come in next weeks budget (increase the tax rates on Dentists/Doctors/Lawyers). These are the very ones who are still charging extremely high rates.


    As soon as taxes are raised, prices will go up. So that seems like a very well thought out solution.

    Compare a dentist to a GP. The GP gets secretarial and waste allowances as well as other government subsidies and a pension for being part of the public health system. The dentist gets nothing. Your GP will still charge you 50 + euro for a visit, with a fraction of the overhead that a dentist would have including staff costs, materials costs, indemnity insurance, equipment costs, etc, etc, etc.

    As for the comment from the dentist in the North, I've repaired enough shoddy NHS style dentistry that patients have paid private fees for from the North to know that there is plenty of a racket going on up there. Dentists in the North can incorporate and so pay UK corporate tax instead of income tax, thus keeping their costs down. Lab fees are generally less up there also.


  • Registered Users, Registered Users 2 Posts: 466 ✭✭aquascrotum


    mcaul wrote: »
    But then, we have lower direct taxes, a FAR superior free education system, better general heathcare (NHS is worse, I can assure you!), no £3000 a year council tax, no private water rates.

    In fairness, the thread title is comparing NI dentist costs with those of the RoI - none of the bold text applies to NI. We do have "domestic rates" which are nowhere near £3k per year. A decent Belfast suburb would be £5-600/yr.

    I (and my now NI resident gf) would take issue with your statement on the NHS going on personal experience, and also the NI education system is widely acknowledged to be superior to mainland UK.

    Slightly off topic but felt compelled to flag that up.


  • Registered Users, Registered Users 2 Posts: 1,834 ✭✭✭Captain Flaps


    Big_G wrote: »
    As for the comment from the dentist in the North, I've repaired enough shoddy NHS style dentistry that patients have paid private fees for from the North to know that there is plenty of a racket going on up there.

    I've heard that too. My mate's Dad is a dentist and he'll send people up North for Root canals because he says he can't price to compete with NI prices for those procedures. However, he warned us that you have to be very careful about where you go, because he makes plenty repairing botched jobs. Apparently the worst offender is fillings in an improperly cleaned tooth that's rotting from the bottom up, he gets at least 2 of thse a week.


  • Closed Accounts Posts: 83 ✭✭Anon47


    Went to Gentle Dental in Warrenpoint (couldnt get an appointment any time soon with a Newry dentist) The dentist removed the original filling and replaced it. He suggested that the original filling done by my dentist in Dublin failed because of micro cracks in the tooth which were not sealed. Have had the new filling for two months now pain free. All steps in the procedure were carefully explained and I have to give them 10/10 for customer service. Total cost £50 +€20 for petrol.


  • Registered Users, Registered Users 2 Posts: 2,074 ✭✭✭skibum


    My wife needs to get two crowns, her dentist quoted her euro 1800, her friend recommended a dentist in newry. We went up last week and she has been quoted 800 sterling for the two crowns. So even allowing for the exchange rate, time, cost of diesel, tolls etc, she is very happy with the savings.

    It has been mentioned about difference in cost of doing buisness here and the north, I got a timing belt and service on my passat done in Belfast last September, it cost me euro 330. At the time I was getting quotes ranging from 1750 (crowd in pottery road) to 650 by a local mechanic.....
    I have recently noticed that a lot of garages have considerably reduced the cost for the same job. We will probably get the timing belt on my wifes car done here as the difference between the north is reducing all the time.


  • Registered Users, Registered Users 2 Posts: 22 mudbingo


    Having checked some Dublin prices e.g <snip>-and prices in Newry-I found that prices in Budapest are 30% of Newry charges and a lot cheaper than Dublin.Madenta dentists have a clinic in Dublin to do X Rays-give a costed treatment plan and do pre treatment work in Dublin-before you go to Budapest,they give all the details and arrange everything-their web site show prices at-root canal at 99 euro-implants at 449 euro-porcelain fused crowns at 250 euro etc etc.So even if we have lost our tax allowences -and Dublin dentists charge so much-Going to Krakow or Budapest-as a Dental Tourist,- could be an Irish persons solution to help our shrinking financial circemstances.


  • Registered Users, Registered Users 2 Posts: 1,834 ✭✭✭Captain Flaps


    mudbingo wrote: »
    Having checked some Dublin prices e.g <snip>-and prices in Newry-I found that prices in Budapest are 30% of Newry charges and a lot cheaper than Dublin.Madenta dentists have a clinic in Dublin to do X Rays-give a costed treatment plan and do pre treatment work in Dublin-before you go to Budapest,they give all the details and arrange everything-their web site show prices at-root canal at 99 euro-implants at 449 euro-porcelain fused crowns at 250 euro etc etc.So even if we have lost our tax allowences -and Dublin dentists charge so much-Going to Krakow or Budapest-as a Dental Tourist,- could be an Irish persons solution to help our shrinking financial circemstances.

    Lower cost-of-living country in cheaper dental-care shocker!


  • Closed Accounts Posts: 283 ✭✭escobar


    mudbingo wrote: »
    Having checked some Dublin prices e.g <snip>-and prices in Newry-I found that prices in Budapest are 30% of Newry charges and a lot cheaper than Dublin.Madenta dentists have a clinic in Dublin to do X Rays-give a costed treatment plan and do pre treatment work in Dublin-before you go to Budapest,they give all the details and arrange everything-their web site show prices at-root canal at 99 euro-implants at 449 euro-porcelain fused crowns at 250 euro etc etc.So even if we have lost our tax allowences -and Dublin dentists charge so much-Going to Krakow or Budapest-as a Dental Tourist,- could be an Irish persons solution to help our shrinking financial circemstances.

    yeah I know someone who got some dental work done in Budapest recently to an Irish registered company.... She even gets checkups and treatment in Ireland afterwards if necessary........ already been for a check up.

    You have some come back with the regulator ,small claims etc just in case...and you can claim back your tax allowance as well because it's Irish registered...pretty sweet really!!

    Was incredibly cheap ......the north couldn't compete with it .... even got a holiday thrown in..... Budapest is lovely by all accounts..

    you're prob looking at any any dental work from 300 euros being worth getting a free holiday for depending on flight price ......accomodation is really cheap and meals etc are for nothing in Budapest.


  • Registered Users, Registered Users 2 Posts: 7,065 ✭✭✭Fighting Irish


    Welease wrote: »
    Been covered a million times.. Market forces.. they will charge what people are willing to pay.

    FYI my wife's recent root canal and crown cost ~900 Euro in Kildare, so it might be worth checking outside Dublin also.

    :werd: Dublin is going to be most expensive part of the country


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  • Registered Users, Registered Users 2 Posts: 2,100 ✭✭✭eightyfish


    I went up north for my root canal. Service was brilliant, and it was about 1/3 the price here. However, I had to go up a total of 4 times on the train in the end to get it done, so it's cheaper but not really an option if you've a busy life.


  • Registered Users, Registered Users 2 Posts: 22 mudbingo


    While Hungary is Noted for its Dentistry-the quality is good and while only checked one such clinic in Seapoint -Dublin regarding such remedial type dental work -Dublin is so expensive v.s.Budapest -which can be 30% of the Dublin cost.Fed up of being ripped off?-Take a Dental holiday!


  • Closed Accounts Posts: 283 ✭✭escobar


    mudbingo wrote: »
    While Hungary is Noted for its Dentistry-the quality is good and while only checked one such clinic in Seapoint -Dublin regarding such remedial type dental work -Dublin is so expensive v.s.Budapest -which can be 30% of the Dublin cost.Fed up of being ripped off?-Take a Dental holiday!

    My friend saved a fortune......would have cost a a few grand here and is even getting her tax back ....... there's no justification at all for the prices here.


  • Registered Users, Registered Users 2 Posts: 1,834 ✭✭✭Captain Flaps


    escobar wrote: »
    My friend saved a fortune......would have cost a a few grand here and is even getting her tax back ....... there's no justification at all for the prices here.

    Obviously higher cost of living and higher level of business tax don't come into it at all.


  • Closed Accounts Posts: 283 ✭✭escobar


    Obviously higher cost of living and higher level of business tax don't come into it at all.

    thanks captain ,you're ever vigilant....:D

    though I was talking about the money you can claim back on your own personal tax on your wages....

    because the budapest dentist was an irish registered company you can claim back your tax unlike n. Ireland..

    making it even cheaper again

    link and quote below...


    http://www.citizensinformation.ie/categories/health/dental-aural-and-optical-services/dental_services

    ''If you do not have a medical card and have to pay for dental services from a private practitioner, you may claim tax relief for certain specialised dental treatments. ''


  • Closed Accounts Posts: 83 ✭✭Anon47


    escobar wrote: »
    thanks captain ,you're ever vigilant....:D

    though I was talking about the money you can claim back on your own personal tax on your wages....

    because the budapest dentist was an irish registered company you can claim back your tax unlike n. Ireland..

    making it even cheaper again

    link and quote below...


    http://www.citizensinformation.ie/categories/health/dental-aural-and-optical-services/dental_services

    ''If you do not have a medical card and have to pay for dental services from a private practitioner, you may claim tax relief for certain specialised dental treatments. ''


    You can claim tax relief for Dental work done in Northern Ireland. Just bring a MED2 with you for work that qualifies for relief.


  • Closed Accounts Posts: 83 ✭✭Anon47


    Went back up to Warrenpoint, no need for root canal (hooray), temporary filling replaced, two more visits to size and fit crown. Total bill for visit £40!!.
    Quoted £250-£400 for crown depending on type, compares with €500 - €750 euro quote in Dublin. Total bill (including petrol and tolls) likely to be <€700 vs €1500 original quote here.


  • Closed Accounts Posts: 11 Aviva_Lasvagas


    A good freind of mine got two root canal fillings and Crowns fitted in the North for about 1100 Euro last year - he was quoted more than that for one in the South.:o


  • Closed Accounts Posts: 6,123 ✭✭✭stepbar


    Well I've had the full works done in my mouth. So far I've had....

    3 root canals
    2 gold crowns
    1 cap
    1 porcelain tooth and removal of bone (associated with same)

    All done thank god. I guesstimate that I've spend no more than c2k to get this all done. Where did it get it all done you may ask?

    The Dublin Dental Hospital. Now granted it took ages but it really didn't matter to me at the time as I was a student. If you have lots of time on your hands I would highly recommend the Dublin Dental Hospital.


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  • Closed Accounts Posts: 83 ✭✭Anon47


    Thats interesting Stepbar how long did u have to wait?

    Were you a Dental Student?


  • Registered Users, Registered Users 2 Posts: 7,939 ✭✭✭ballsymchugh


    the waiting lists in DDH are closed for a year unless you're in serious pain. even at that, you'll just be sorted and sent back to your own dentist.


  • Closed Accounts Posts: 59 ✭✭Cato78


    From an American perspective, it seems so strange that you'd have to drive to the UK for anything. I live in Florida and can't imagine having to drive to Georgia to buy something or get medical care. Are there many demonstrations there over things like this? I can't imagine most people are happy with the government.


  • Registered Users, Registered Users 2 Posts: 751 ✭✭✭greenie


    stepbar wrote: »
    Well I've had the full works done in my mouth. So far I've had....

    3 root canals
    2 gold crowns
    1 cap
    1 porcelain tooth and removal of bone (associated with same)

    All done thank god. I guesstimate that I've spend no more than c2k to get this all done.

    I am really really really shocked that you only paid 2k for all that work here in Dublin. Considering finding someone to do a crown alone for under 1k is near impossible. Wow!


  • Registered Users, Registered Users 2 Posts: 751 ✭✭✭greenie


    Anthony16 wrote: »
    That dentist put years of hard work into becoming the dentist he/she is today.If he/she deemed the x ray was needed then it was needed.Dentists deserve a good salary because they provide a great service.I hate the way people always undermine the decision of health professionals.and no, i dont have any friends or relations who are dentists,i just dont like the jealousy people have towards healthcare professionals who have big salaries.They try their best and shouldnt be down graded

    I don't think the question is whether Dentists deserve a good salary..people aren't refusing to stay in Dublin for dentist work simply because they're misers, that's very unfair. A lot of people are struggling these days and simply cannot afford some of these outrageous prices. Granted Dentists here claim to use better quality materials (which I don't refute in any way) leading to increased prices however when it comes down to less extensive/non cosmetic work then of course people are going to get the work done for half the price whether it be outside Dublin or in the North. I think you'll find that people who can afford treatment here will stay here and others who just can't afford it will shop around.


  • Registered Users, Registered Users 2 Posts: 544 ✭✭✭Cerocco


    Last year I had a tooth that needed looking at. It had gone blackish in colour after a previous root canal done here in Dublin. That set me back €500. A friend recommended a dentist in Downpatrick. She had a look and recommended a plan of action. I had my teeth whitened, new crown, had to have another root canal ( just bad luck) 2 veneers numerous x-rays. The total cost was £1200. Priced the work down here and it would have set me back over 2 and a half grand. Have a perfect smile now and found a really nice dentist aswell. If only I could get a GP up there as well I would be sorted:D


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  • Closed Accounts Posts: 6,123 ✭✭✭stepbar


    Anon47 wrote: »
    Thats interesting Stepbar how long did u have to wait?

    Were you a Dental Student?

    Had to wait about a year and yes I was a dental student. Realistically, it's not for the faint hearted. Each root canals took 3 sessions and each session was 3 hours long!


  • Closed Accounts Posts: 18,056 ✭✭✭✭BostonB


    I assume that an ordinary punter wouldn't get those prices


  • Closed Accounts Posts: 6,123 ✭✭✭stepbar


    BostonB wrote: »
    I assume that an ordinary punter wouldn't get those prices

    And why do you assume that? :confused:

    I waited in line like everyone else.


  • Closed Accounts Posts: 18,056 ✭✭✭✭BostonB


    I was under the impression that Dental Students get a discount at Dublin Dental Hospital. Perhaps even all Trinity students. I was told that before by a student who got some work done there. Maybe thats not the case anymore? Or maybe your not aware of it?


  • Closed Accounts Posts: 6,123 ✭✭✭stepbar


    BostonB wrote: »
    I was under the impression that Dental Students get a discount at Dublin Dental Hospital. Perhaps even all Trinity students. I was told that before by a student who got some work done there. Maybe thats not the case anymore? Or maybe your not aware of it?

    I'm not a dental student; I misread the post a few up. I'm an ordinary punter.


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  • Registered Users, Registered Users 2 Posts: 491 ✭✭buswankers


    Had a similar experience last year as some of the other posters..... Tooth giving me gib visited dentist in Dublin who took an x-ray put in a temporary filling & told me to come back couple of weeks later. Went back, was told i needed root canal & a crown...tidy sum of €1,500.

    Am from Galway so next time i was down home visited a dentist who priced the treatment at €1,300 - he also took an x-ray.

    No way i could afford that at the time so I decided to price the treatment up North...found a dentist in Newry that would do both for £550. Took a trip up for an intial consultation, she took an x-ray, had a look at the tooth & said we should be able to get away with a filling no bother.....Total cost: £50. That's nearly a year ago now & the tooth hasnt given me any trouble since!

    My advice: unless u know the dentist very well I would always go for a 2n opinion (in my case i needed a third!)


  • Closed Accounts Posts: 18,056 ✭✭✭✭BostonB


    Getting away with it fine. The temp fix might last your lifetime, or not. But it isn't fixing the underlying problem. So its not directly comparable in terms of price. The 500 vs 1500 is comparable. I'd like to understand why theres such a big disparity.


  • Closed Accounts Posts: 83 ✭✭Anon47


    BostonB wrote: »
    Getting away with it fine. The temp fix might last your lifetime, or not. But it isn't fixing the underlying problem. So its not directly comparable in terms of price. The 500 vs 1500 is comparable. I'd like to understand why theres such a big disparity.

    I would accept up to a 25% uplift in costs here compared with the North given the tax and business cost regime, but 200-300% smacks of getting away with it during the Celtic Tiger and not adjusting to reality now that the Tiger is a rug on the floor!


  • Closed Accounts Posts: 6,926 ✭✭✭davo10


    Guys, I don't really want to delve too much into this discussion but I'll give you a little backround.

    a)In general things cost more in Dublin compared to the rest of Ireland, just as things cost more in Belfast compared to small towns in the North and in London etc. The cost of buildings/rent/rates/wages/living/homes/insurance/water etc is higher, so there is no great surprise that virtually everything costs more in Dublin than in Newry.
    b) The exchange rate is excellent at tha moment for purchasing anything in the North be it wine or dental treatment. Consider this, if a filling costs €100 today in Dublin and €70 (£63)in Newry, 2 years ago when the exchange rate was 66p to the Euro, the cost of the filling would have been almost the same north and south, in other words currency changes have effected the price difference between all consumer items. This used to work to our favour a few years ago when Northerners used to come down here for cheaper shopping/hotel breaks etc.
    c) Dentists in the north get large grants from NHS for practice building/refurbishments etc and for years got "capitation" and "continuing care" payments from NHS for every patient registered at their clinic, this used to range from £1-£3 per month per patient depending on age and was not dependent on the patient having treatment, just registering at the clinic, now the clinic I worked at in the North had approx 10,000 NHS patients so about £20,000.00 came into the clinic each month even if the dentists there never saw a patient. This scheme I believe has changed in recent years so I'm not sure what payments the clinics in the North now recieve from the NHS.
    d) Why do people think that the most of the fees they pay is profit for the dentist and why do people think dental treatment should be cheap. The cost of running a clinic is enormous. In particular root treatments and crowns are at the top end of fees. Root treatments are difficult to do, time consuming and if the dentist is up to date the rotary machines and instruments are very costly. A set of titanium rotary files costs about €70 and are recommended to be single use, for a molar rct I book off about 2 1/2 hours which costs me €300 in clinical running costs (total monthly expenditure devided by number of appointments), for the price I charge patients for RCT, I would be better off doing 10 scale and polishes in the same time. Crowns are a little more emotive, a good lava/procera ceramic crown will cost €300-€350 in lab costs, they look incredible right down to the finest detail and come with a 5 year gaurantee, an NHS PJC crown costs about €70 but they do not reflect/refract light well and are brittle. But they can look nice.
    e) if profits are so great why do Northern/Hungarian/Bulgarian dentists not open clinics here to do all their treatments (I know some to exams/pre treatment here), the reason is that if they charged their fees here they would go out of business very quickly.
    f) Lastly consider this, virtually every profession is paid less in the North than here, the difference is exaggerated due to the exchange rate but right now public sector workers are up in arms over an 8% wage reduction which still leaves them considerably better off than their Northern counterparts. In the South we want everything to be as cheap as in the North but at the same time keep the wages we have been used to.

    I expect a barage of insults for this post but I wanted to give you the broad strokes of what the differences are.


  • Closed Accounts Posts: 83 ✭✭Anon47


    Thanks Davo, that's the best informed explanation I have had since starting the thread. The differences in operating costs and other expenses you outlined suggest to me that costs in Dublin will be higher, but not perhaps by a factor of three for a root & crown. My experience up North to date has been excellent and inexpensive. I think that Dublin dentists may have to respond in time to market competition with the likes of Newry and Budapest but I dont intend to wait around paying a lot of money until they do so.
    Thanks again...:)


  • Closed Accounts Posts: 6,926 ✭✭✭davo10


    Anon, the problem is how to achieve the desired responce without closing your business. All the costs in my clinic are fixed bar the purchase of materiels which accounts for about €2000 per month of expenditure. I have no control over mortgage rates, leasing payments, bord gais elec, water, rates, indemnity insurance,etc. I could use cheaper labs but it has taken me 10 years to find the right combination for crown/implant/denture work labs that provide top quaility work. I agree abourt price disparity, fees in Dublin are higher than elsewhere, my fees would be closer to the North than to Dublin but I do not have the rent/rate/property price/living costs that a Dublin practice owner would have.

    Regarding Crowns: There are three tiers of crownwork in the North, NHS, Independent and Private. If comparing prices it should be private with private, the next time you have a crown fitted in the North, ask to see the Lab ticket just before cementation, the dentist ticks which type of crown they want lab to make so you will be able to see what you are getting. There is a difference in materials used and the ceramist who makes them. When i worked in North 12 years ago my boss made sure that every crown was NHS regardless if patient was NHS, independent or private.

    Anon, something very important happened last Thursday which is far more important to dental patients in Ireland. In December the government scrapped the PRSI dental scheme which allowed workers to get free/subsidized treatment, last Thursday the Medical card scheme was abolished. From last Friday med card holders can only get emergency dental treatment for pain and sepsis, this is limited to 2 fillings per year. The big kicker is that this applies not just to dentists on high street but ALSO to Health Board clinic dentists. Put simply if an elderly person falls and breaks front teeth, they cannot now obtain treatment even from the health board. Now thats a rip off.


  • Closed Accounts Posts: 83 ✭✭Anon47


    Thanks Davo, I have been offered a choice of two crowns - one with a metal frame costing £250 (fitted) and a poly-carbon/zirconium something (cant remember the actual name sorry) for £400 fitted. I will take your advice about the lab ticket thanks to ensure i'm getting the right one. By NHS I presume you mean the cheapest?
    On the issue of your costs I appreciate that any business has a combination of fixed and variable overheads but you dont mention what margin you are operating at. (For instance I recently got a prescription in a Chemist costing €7.80 and when I asked how much it cost them I was told €2.30 - there was a 100% markup followed by a dispensing cost). You need to make a profit but would it be fair to say that prices were excessive during the Celtic Tiger and they have not changed to reflect more straitened economic times. I was slagged in this thread for saying that I would prefer to support a local dentist if the price difference was less than 25%.
    As I write there is a discussion on Newstalk about Dental costs and it would appear that prices are not commonly displayed contrary to the guidelines.


  • Closed Accounts Posts: 6,926 ✭✭✭davo10


    Anon the best cosmetic crowns today are Procera and Lava provided your bite permits their use, £ 400 seems low for this type of crown with zirconium substructure, lab fees on these can be over €300 and when you take into account the other materials used and clinical time, something doesn't sound right. Make sure you are not getting a standard porcelain jacket crown and being charged for the more expensive one, again this info is on the lab ticket, a procera crown will always be marked private and comes with a gaurentee card from the manufacturer Nobel Biocare,the dentist is supposed to show the patient. A bonded or porcelain jacket crown can be NHS.

    NHS lab work is much cheaper and can look good initially, but they tend to fracture more easily, cosmetics deterioate over time and particularly with the bonded crowns (metal inside) the gum tends to receed. When I worked there we were paid £110 by NHS per crown so labs had to make them for £30-£40 at the time. They had to have the cheapest ceramics and metals so clinics could make a profit, also we were allowed to book off only 30 minutes for whole procedure, anaesthetic, impressions for temporary crown, bite registration, tooth preperation, temporary crown production and fit. Then a 15min appointment 2 weeks later for fit. I book off 90-120 mins now for crown preperations.

    You cannot really compare the cost and provision of dentistry with other retail markets but I'll have a go at it. The example you gave is in essence a retail transaction, the medication is counted out and dispenced (I am sure there is a lot more to pharmacy than this so forgive my ignorance), dentistry involves not just the dispencement of goods but also a clinical/surgical procedure that is required along with it, so where it may cost X to provide the treatment, the clinician must then put a price on their operatory skill, if there was no value to be assigned to the procedure, the dentist may as well just hand you the filling, show you to the chair and then say you have 20mins to put the filling in yourself. If I assign a value of €12.50 to the procedure of giving an injection in a way that is as comfortable as can be, excavating all decayed tissue from a tooth, preparing the cavity so that it provides suitiable retention for the filling, placing a calcium lining and then a quality filling, then the "markup" is of the order of 15%, hardly a ripoff. Now this is assuming that every patient turns up fo every appointment each month, if there is a reduction in clinical turnover because a number of patients fail to attend/cancel, I am absent due to illness etc or if interest rates/costs etc increase then the clinical costs per appointment go up and the percentage profit goes down.

    I would agree some prices are over the top but a dentist in Blackrock who charges €1000 for a crown is making far less profit than a dentist in Kells who charges €1000, the reasons should be obvious.

    Now to the price list, they are guidelines not requirements so dentists do not have to display them but in my opinion should. Mary Harney had a go at making this a requirement by law but stopped short, do you know why?, it's because prices would go up not down.

    Example of transparent price list for a silver filling:

    Local anaesthetic: €7.
    Single surface excavation: € 50.
    Each additional surface: €5 per surface.
    Lining: €5.
    Matrix band application: €5.
    Steel/titanium pin if necessary: €15.00.


    Total cost of a 3 surface silver filling with a pin: nearly €100 and the patient would have to pay every cent because it would all be there in the telephone sized book of prices it would take to have a transparent pricing index for every possible combination of treatment.

    Prices have come down considerably but cannot go below operatory costs, incidently I heard recently that 8 clinics have closed in Dublin due to downturn and a high profile chain is on the brink so we are no different to any other business.

    Anon, a new independent report by Prof Ciarin O'Neill NUI Galway on oral health of irish people found that each dentist in the North recieved an average of €37,000 per year in state grants from the NHS and that this gives dentists there a competitive edge.
    http://www.dentist.ie/resources/news/showarticle.jsp?id=962


  • Closed Accounts Posts: 83 ✭✭Anon47


    Headed back to Warrenpoint yesterday, tooth prepared and a temporary crown fitted. Final crown will be LAVA type. One hour in the chair, no charge for this visit. Total final charge for crown and fitting £400. The nice thing was having everything explained as we went along. One more visit on the 4/6 and i'm done.


  • Closed Accounts Posts: 6,926 ✭✭✭davo10


    £400 = €500, at least one half day off work for to go up for tooth prep and one half for fit (€700 weekly wage equates to €140 in lost earnings at a minimum or of one day from holiday allocation), 4 hour round trip on a Friday to warrenpoint each visit with travelling expenses plus a couple of pounds for something to eat. Total cost around €750.00?.


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