A person with a conviction for sexual assault who is not registered with the Dental Council of Ireland has been practising as a dentist here.
RTÉ Investigates understands the individual has been based at a clinic outside Dublin, and practising as a dentist in Ireland for a prolonged period. A second criminal investigation against them is also in progress.
The person has been the subject of a complaint to the Dental Council. Their case is one of several relating to people practising dentistry while unregistered which have been received in the last 12 months alone.
Operating as a dentist while unregistered with the Dental Council is a criminal offence.
Information on such complaints was released to RTÉ Investigates by the Dental Council ahead of a report which airs on Prime Time tonight.
Other complaints relate to someone purporting to be a registered dentist who repeatedly saw a child with a severe dental infection but did not treat the infection appropriately. The eight-year-old girl, who presented at the clinic with an abscess, was not x-rayed nor was she prescribed antibiotics, leading to the infection becoming progressively more serious.
The child's mother later discovered the individual had given her the name of another correctly registered and qualified dentist when they first introduced themselves to her. That correctly registered dentist had no links whatsoever to the practice being attended.
The identity of the person who treated the child remains unknown and the clinic continues to operate.
However, the Dental Council maintains it cannot pursue those involved as the dental practice itself is not run by a registered dentist.
In another case, a registered dentist was alerted to a referral letter purporting to be signed by him when a patient presented at a different clinic for an x-ray. The dentist had never worked in the practice named on the referral letter nor had he ever treated the patient.
It is not known who signed the referral letter in the dentist's name.
A number of allegations have also been made to the Dental Council in relation to a practice in Dublin where it is believed several unregistered dentists were working. The identities of many of the individuals are unclear to the Dental Council.
The extent of the complaints brings into focus problems with the regulation of dentistry in Ireland. The Dental Council says it has been unable to pursue any of the above concerns due to an absence of inspection powers.
"In all these cases, the appropriate regulatory reaction would be to inspect the practice and investigate the allegations further, but this is not possible under the Dentists Act 1985," a Dental Council spokesperson told RTÉ Investigates.
"An aggravating factor in some of these cases is that many of the patients being treated are non-Irish nationals," they added.
Under the Dentists Act 1985 only registered healthcare professionals are regulated. You do not have to be a dentist to own a dental practice, meaning it is not possible to sanction an unregistered person operating a dental practice unless they individually explicitly purport to be a dentist.
There are no restrictions on who can open or operate a dental clinic here and there is no code of practice governing the operation of dental practices, nor is there a register of dental practices.
"The lack of an inspection regime and relevant enforcement powers in respect of dental practices limits the [Dental] Council’s ability to investigate allegations of illegal practice and other potentially serious matters. This is a significant legislative weakness in terms of the protection of the public," the Dental Council spokesperson said.
Dentists in Ireland are obliged by law to display their certificates of registration where they practice. However, the Dental Council cannot inspect or enter a dental practice to monitor compliance.
"It’s limited in its ambit," said Senior Counsel Dr Ciarán Craven about the Dental Council.
"But there are models there which have been around since the Health Information and Quality Authority (HIQA) was established back in 2007, so there is a wealth of experience and a statutory framework now for over 16 years," Dr Craven SC told RTÉ Investigates.
"It is not as if a bespoke system has to be established, there are models there which can be adopted, which can be modified and which can be applied as well," he added.
In a statement, the Department of Health said five separate State and regulatory agencies can inspect dental practices. They include HIQA, the HSE, the Health & Safety Authority and the Environmental Protection Agency.
The department said that the Dental Council could rely on the Consumer Protection Act to prevent illegal practice but acknowledged the Dentists Act 1985 is awaiting review.
The department did not provide a timeframe for such a review but said "additional resources have been allocated to commence this work".
Over the last 12 months, RTÉ Investigates has separately reported on hundreds of patients who were left without services in Galway following the sudden closure last year of the Oranmore Orthodontics clinic.
The closure followed a decision by the Dental Council that it was in the public interest to apply to the High Court to suspend owner Dr Anne Hahessy. Dr Hahessy subsequently undertook not to practice dentistry. As a result, many patients did not get treatment they had paid in advance to receive and were left to source their own alternative care.
In 2015 the Hungarian dentist Koppany Kiss, who was not registered in Ireland, also left tens of patients stranded mid-treatment when his Dublin practice, Dental Magic, folded suddenly. Mr Kiss had previously been struck off from dentistry registers in two other countries.
In that case, the Dental Council could take no action as Mr Kiss and several other people suspected to be practising at his clinic had never applied for registration in Ireland.
According to Dr Craven SC, the cases and complaints uncovered are evidence of an ongoing and prolonged failure to address gaps in legislation governing the regulation of dentistry here, which leaves the public open to risk.
"That’s a large number of unregistered, non-regulated entities out there who are providing dental care which if not properly registered or controlled could potentially have quite significant and serious consequences."
Watch the RTÉ Investigates report on oversight of dentistry in Ireland on Prime Time, Thursday 9.35pm on RTÉ One and RTÉ Player.
