The Supreme Court has dismissed an appeal by dentists against a High Court decision to uphold changes to Health Service Executive funding of dental treatment for medical card holders.
The changes, introduced in 2010, confined funding to emergency treatments only.
The five-judge court unanimously ruled that a revised contract between the HSE and dentists gave the HSE "virtually untrammeled choice" in withdrawing funding from particular forms of dental treatments.
The court said it could not override the express terms of a contract.
Before the disputed changes were introduced, dentists were entitled to be reimbursed for all routine treatments provided to medical card holders. Under a 2010 circular, only emergency treatments qualified.
The Irish Dental Association (IDA) claimed the changes would lead to the break-up of its service to medical card holders.
Two dentists - Martin Reid of Moville, Co Donegal, and James Turner from Baltinglass, Co Wicklow - had appealed a 2011 High Court decision that there was no breach of contract by the HSE when it issued the circular in 2010.
Both dentists, members of the IDA, participated in the Dental Treatment Service Scheme (DTSS), introduced in 1994 for medical card holders.
In 1999, the IDA negotiated revised procedures over the DTSS which allowed health boards take whatever measures necessary to live within their budgets and statutory obligations, the High Court noted.
The 2010 Budget limited expenditure under the DTSS to €63m and, as a result, the HSE issued the circular.
The High Court found the circular, despite its limitations, was "patient oriented" because it meant emergency care related to pain and sepsis must be provided and also meant additional care could be considered in exceptional cases.
Giving the Supreme Court judgment upholding that decision, Mr Justice Peter Charleton rejected arguments by the dentists that nothing in the contracts between the HSE and dentists permitted such a "major unilateral change" as was introduced in 2010.
The relevant contract dates from 1994 and was revised in 1999, he said.
The IDA had, in a letter dated 17 September 1999 to the head of industrial relations in the Health Services Employers Agency, given a specific acknowledgement of budgetary constraints, the judge said.
Dentists then worked under the 1999 contract for another decade until this dispute arose in the wake of the economic crisis manifest from 2008.
By 2009, the national costs of this scheme had risen to €80m, he said. A decision was taken to limit the expenditure for 2010, and for all subsequent years, to €63m and the circular essentially told dentists only emergency treatments would be funded from then.
The judge upheld arguments by the HSE that the 1999 revision of the 1994 contract entitled it to whatever measures were necessary to meet its budget constraints. He said the courts cannot override the express terms of a contract.
As the dentists had identified no error in the High Court judgment, the appeal must be dismissed, he said.
