Dentists say the HSE is dismantling the medical card dental scheme and reducing it to as system that only provides emergency cover.

The Irish Dental Association (IDA) says the decision to restrict the scheme means that hundreds of thousands of medical card holders will be denied a range of routine free treatments, including fillings and extractions, as well as denture provision and treatment of gum disease.

In a circular sent to dentists, the HSE said it would only provide emergency dental care to eligible patients with a focus on relief of pain and infection.

The IDA says the HSE has ordered that additional care can only be considered in exceptional or high-risk cases.

It says the HSE move is unsafe, unworkable and unethical and will hit the most vulnerable in our society the hardest.

IDA Chief Executive Fintan Hourihan said his members did not accept the legitimacy of the circular which,he said, formalised the creation of a "two-tier"system between private and public patients.