Dentists told not to fill children’s teeth
HSE CUTBACKS are forcing dentists not to perform fillings on children’s decaying teeth other than in “exceptional” circumstances where the procedure is considered a clinical emergency.
The Irish Examiner has learned that despite the Irish Dental Association (IDA) stating that suspect teeth should be treated to prevent infections and future orthodontic work, dentists have been told to drastically reduce the service on offer.
A HSE policy statement sent to all dentists in the Sligo-Leitrim community care area has warned “deciduous” fillings – the clinical term for children’s baby teeth – can no longer be provided on a routine basis.
The letter, which has led to claims of discrimination among dentists in the area as the restrictions have not been imposed in any other part of the country, does not explicitly prohibit the measure.
However, it states child fillings should only take place in non-defined “exceptional” circumstances – and a parent who complains should not be advised to pursue the treatment privately.
“Routine filling of deciduous teeth is not indicated by the available published evidence and may cause more harm than good. Accordingly, dentists are instructed not to provide routine deciduous fillings,” the correspondence read.
“On occasion, a dentist may decide to fill a deciduous tooth... Such fillings should be exceptional and prompted by an obvious health gain for the patient. At no time should it be suggested to parents that deciduous teeth need to be filled privately. A parent may want the teeth filled, but they should never be directed to do so,” it added.
Irish Dental Association (IDA) president Dr Billy Davis has heavily criticised the policy change, warning that such a move and other recent oral health cutbacks risk “undermining the substantial progress made in the last 50 years”.
Similar claims have been made by dentists who spoke to this newspaper who believe the policy will increase the possibility of children suffering painful oral infections and other consequences of decaying teeth.
While the current national approach to public service dentistry is based on the Department of Health’s 1994 dental action plan, since 2003 there has been no chief dental officer in place, with principal dental surgeons making varied decisions in each area.
As a result, the IDA said existing national dental policies have not been updated to meet changing needs.
These issues were raised with Health Minister Mary Harney by the IDA in March, but have yet to receive a response – causing “a lack of clarity as regards the provision of services to children”.
A HSE spokesman said emergency dental care for medical card holders, children and those in special needs groups are being safeguarded, but said cutbacks are still taking place.
“Against a background that the overall Dental Treatment Services Scheme activity outturn for 2009 was 25% higher than planned, with corresponding expenditure being 35% ahead of budget, the Government decided to cap expenditure at 2008 levels.
“The HSE must stay within expenditure limits. Fewer treatments will be available and limits have been placed on certain treatments,” the spokesman said.
He added a review of the public dentists services is nearing completion.
The child fillings cutbacks emerged after an April HSE circular to dentists said medical card patients could no longer receive state-paid care or have more than two fillings unless it was considered a clinical emergency.
