Patients with toothache could be faced with an agonising three-month wait for treatment under proposals to slash millions from the NHS dental budget.
Government initiatives to address oral health in Northern Ireland - the worst in the UK - look set to be left in tatters with proposals to remove £6m from the NHS dental budget this year.
Cost-cutting measures include reducing the number of treatments automatically available in order to save £2m.
Under the proposals, prior approval from the Business Services Organisation will be required before dentists can carry out a range of NHS treatments such as root canals on molar teeth.
But dentists have been told the process could take between two and three months to complete.
This would mean a patient who requires root canal treatment for a painful infection at the back of their mouth will have to decide whether to wait three months for treatment, have the tooth taken out on the NHS, or pay for the root canal treatment themselves at a cost of several hundred pounds.
It is widely believed within the dental profession the proposal is designed to make it harder for patients to access NHS treatments so they are forced to take private treatment instead.
Health bosses are also planning to stop incentive payments that encourage dentists to treat NHS patients and change the criteria for practice allowance payments - used to cover the cost of training and meeting the stringent regulations of dental practices.
Surgeries will be expected to have a larger proportion of patients who pay fees for NHS treatment in order to receive the payment, meaning those in deprived areas where most people are on benefits and entitled to free treatment will be hardest hit.
Richard Graham, who owns two dental practices in Clogher and Fivemiletown, said: "Prior approval will not work.
"If someone comes to me in pain they are not going to wait three months for treatment. The people behind these changes are claiming there has been an overspend in the budget, but that isn't the case. This is simply what it costs to provide a dental service on the NHS."
Claudette Christie, director of the British Dental Association in Northern Ireland, said the proposals are "wholly unacceptable".
"The demand for dental care provided by the health service is at an unprecedented level with 1.1 million people in Northern Ireland now registered by the health service with a dentist," she said.
"This is an increase of 18% over a 12-month period. Patient care is the priority of dentists, with dentists working really hard to meet the oral health needs of such a number of patients.
"This commitment to patients from their dentists must be matched by the same commitment from Government to the health service and how it delivers dental care."
Dental work which could require prior approval:
- Root canal treatment on molars - cleaning out root canal system of the tooth.
- The fitting of metal dentures will be substituted for plastic dentures, which can break easily and can exacerbate gum problems.
- Any work of solely cosmetic benefit, such as veneers.