Dental healthcare packages for children could cost up to €41.1m

The annual cost of preventive dental healthcare packages to all children under the age of 16 years could be as high as €41.1m according to the ESRI, while similar preventive dental healthcare packages for adults could cost even more.

The figures are among estimates by the Economic and Social Research Institute and provided to government, which has published its new National Oral Health Policy, Smile agus Sláinte.

Under the new policy, all children aged under 16 will receive eight oral healthcare packages including examinations, assessments, advice, prevention interventions, emergency care and referral as appropriate.

Similar packages will also be provided for medical card holders over 16 years, to be provided in a primary care setting by oral healthcare practitioners contracted by the HSE.

The ESRI estimated that the cost for the children packages would range between €26m and €41.1m a year, while those for adults would range between €6.9m and €42.8m.

According to the ESRI: "The range of estimates reflects differing assumptions about the scope of services available (e.g. allowance for extractions), eligible populations (eg relevant population for fluoride therapy) and usage frequency (e.g. annual vs. biennial oral examinations)."

According to the government, the new policy will have a particular focus on improved oral health services for vulnerable groups, including those in nursing and residential homes, with the local dentist the first point of contact.

It will also include a full review of education and training in the dental profession, oral health promotion programmes for the entire population and the maintenance of the programme of water fluoridation.

It comes as the HSE said an audit of medical files of 7,500 children is nearing completion amid concerns that their teeth were permanently damaged due to a lack of follow-up orthodontic care in previous decades.

RTE's PrimeTime programme revealed this week that children at the end of the 1990s and into the following decade had compromised dental care after a reduction in staff in regional orthodontic teams at that time.

Speaking on RTE's Morning Ireland programme Ted McNamara, who was the first consult orthodontist to be appointed in the country and who worked on the scheme, said: "The children were just left, there was no follow-up."

That lack of follow-up treatment was revealed in a still-unpublished HSE report from 2015 into the issue, and the HSE said following completion of the audit a serious incident management team will consider if patients need to be recalled.

UPDATE April 4: President of the Irish Dental Association, Kieran O’Connor said that the Association welcomed the publication of the policy (25 years since the last policy was published) and its greater focus on prevention. However, he pointed out that the IDA's members had not been consulted "in any meaningful way" or involved in its formulation.

Dr. O’Connor, whose practice is based in Youghal, said the IDA would need to study the plan carefully to see how it compared with its vision for oral health services. He said nothing short of a complete reversal of Government policy would be required if the policy was to be rolled out successfully.

“Over the last decade the Government has slashed spending on oral health programmes, taking close to €1bn out of the system. The proposed reforms – which are linked to the cross-party Sláintecare programme - will necessitate huge investment and resources by the state, so it’s essential that sufficient, ringfenced funding is set aside for them,” he said.

“The new policy will also provide the first real test for the Government of its commitment to Sláintecare. It’s all very well to promise free dental care to the under sixes and to say you are then going to extend it to all children under 16. Delivering on that promise is another matter entirely.”