Dentists have called for the current medical card scheme for dental patients to be replaced with a credit or voucher system.
President-Elect of the Irish Dental Association, Dr Caroline Robins, said dentists want a new scheme "that reflects modern dental practice" and that allows vulnerable groups to access routine dental care in their community.
Speaking on RTÉ's Morning Ireland, she said the existing scheme was established over 28 years ago and dictates how dentists can provide treatment and care, what materials can be used and what procedures can be carried out.
Dr Robins said there are no referral pathways for patients and it is effectively a system that promotes extraction over preservation of teeth.
"We have no clinical autonomy to make decisions that we feel are in our patient's best interests. We can't use any modern based science for our clinical treatments. We really just feel like our hands are tied."
She said the current medical card scheme is "victorian" in its approach, adding, "I can effectively extract as many teeth that I wish from you, but I'm actually only allowed to place two fillings in your mouth in a year."
The Irish Dental Association commissioned a study to find a replacement scheme and said a voucher or credit scheme would allow dentists to treat patients on an individual basis.
The independently commissioned research paper was carried out by Professor of Health Economics at Queens University Belfast, Professor Ciaran O'Neill.
The research found that a 'Dental Credit Scheme' would bring reform to the current practices and fee structure, bringing them up to modern standards.
In his report, Pro O’Neill estimates that the annual cost of a voucher or credit scheme would be approximately €108 million.
The Irish Dental Association said there is now believed to be just 750 dentists treating medical card patients, which is less than half the number of DTSS contracts held by dentists up to two years ago.
In a statement, CEO of the Irish Dental Association Fintan Hourihan said that currently, there is one dentist per 2,000 medical card patients and that this cannot be allowed to continue.