The Dental Treatment Services Scheme (DTSS) provides dental treatments to medical card holders. Services currently available annually include an examination, two fillings and emergency extractions. Other more complex care is also provided, some of which requires prior approval by a Principal Dental Surgeon. Patients with special needs and high risk patients can avail of a broader range of treatments. These services are provided by independent dental practitioners who have a contract with the HSE. There is no provision in the DTSS contract for the charging of additional fees for this dental care. Any patient who is charged such a fee should report the matter to the HSE.