Dental services for people with medical cards in 'a state of almost permanent collapse'

An appointment to clean and polish teeth can cost from €80 privately. Workers who pay PRSI are entitled to this once a year for €15. File photo

Only 25 dentists in Kerry and 13 in Clare take medical card patients, while just a quarter of the 200 who do it in Cork are outside the city, new HSE figures show.

Around the country, dental services for over 1.5 million people with medical cards are in “a state of almost permanent collapse”, the Irish Dental Association (IDA) warned.

Private patients are also affected by dentist shortages, as the IDA found last year that 25% of practices did not take on new patients.

A national dental policy published in 2019 has still not been put into action despite ongoing work to launch an implementation plan.

More people are now eligible for medical cards than ever before since the Government lowered the income thresholds. However, IDA chief executive Fintan Hourihan pointed out that the workforce is not there to offer them appointments.

Waiting lists get attention, but he said the “bigger problem” is an unknown number of people getting no care at all. 

What's your view on this issue?

You can tell us here

“They are now becoming increasingly aware of the consequences in terms of their oral health, which is in decline,” he said.

“What’s very striking is that oral health is one area where there is a real difference in standards of good health between those who are better off and those who are less well off.

“Those who are less well-off suffer the most when the public service is in a state of almost permanent collapse.” 

An appointment to clean and polish teeth can cost from €80 privately. Workers who pay PRSI are entitled to this once a year for €15.

The HSE pays private dentists to treat adult medical card patients under a dental scheme.

Until the pandemic, about 1,400 dentists were in this every year, with numbers changing by around 100 up or down annually. In 2021, this dropped to 1,151 and hit 810 by 2024, the most recent year available.

The north Tipperary, east Limerick region had just 20 dentists in the scheme and Mayo only 25. Mr Hourihan expects the decline to have continued in 2025.

He said:
Morale is at rock bottom, we are seeing signs of stress in the numbers of dentists on sick leave.

“They feel the scheme is not workable from an ethical or clinical point of view, because of the bureaucracy and because the costs aren’t covered by what they’re paid.

"It’s no longer viable, and they can’t afford to risk their dental practices to make losses.” 

Private sector demand is also extremely high, meaning dentists have an alternative to HSE work. Some also opt to offer cosmetic care such as Botox or fillers.

He called for “an entirely new system” for medical card patients.

However, he raised concerns about long delays rolling out a national plan, saying: “This may be the last chance to fix our dental crisis.”

Fine Gael TD Colm Burke raised concerns this week about gaps in care for children and adults. “Access to dental care should not depend on the ability to pay,” he said.

He supported the IDA’s call for reform and also urged more recruitment for Cork and Kerry.

“Children deserve timely, preventative care, not years on a waiting list. I will continue to raise this issue at national level until Cork receives the dental capacity it urgently needs,” he said.