The Dental Treatment Services Scheme (DTSS) provides access to dental treatment for adult medical card holders. As funding has been capped at the 2008 level of €63 million, the HSE prioritises for treatment patients with special needs, high risk patients and those who have greater clinical needs. A free oral examination every calendar year and free emergency dental treatment with a focus on relief of pain and sepsis are available to all eligible patients, regardless of their medical condition. This includes 2 fillings, all extractions and a number of complex treatments. The National Oral Health Office of the HSE issued Standard Operating Procedures to dental contractors in November 2011 to support equitable and priority funding and provide clearer guidance to dentists on the application of DTSS prior approval requests. The HSE monitors monthly DTSS expenditure and has confirmed that the funding of €63 million will be spent by year end. Given the growing demands and current budgetary constraints, it is not possible to expand the service at present. The HSE will continue to monitor the operation of the DTSS to ensure the most beneficial, effective and efficient use of available resources.