Fixing Ireland's dental crisis will take 10 years given scale of problem, Dáil committee told

The public Dental Treatment Services Scheme currently treats just 970,000 patients annually out of an eligible cohort of 1.6 million adults, largely due to a lack of eligible dentists signing up to the scheme, as it is considered to be severely underfunded.

Fixing Ireland’s dental crisis will take at least 10 years given the sheer scale of the problem, particularly in schools, the Oireachtas Health Committee has heard.

The committee on Wednesday morning heard from representatives of the Irish Dental Association, who, while relating harrowing case studies, said Ireland’s public dental schemes had not been fit for purpose for more than 10 years.

The public Dental Treatment Services Scheme currently treats just 970,000 patients annually out of an eligible cohort of 1.6 million adults, largely due to a lack of eligible dentists signing up to the scheme, as it is considered to be severely underfunded.

Chief executive of the Irish Dental Association (IDA) Fintan Hourihan told the committee any intervention by the State to fix the crisis “would take a full decade to see any genuine improvement given the level of unmet need”. 

“Oral health is not given any priority at all,” he said.

His colleague, president of the IDA Dr Will Rymer said he had taken the decision to leave the medical card scheme due to fact it was not providing for his patients adequately.

The same scheme only offers extractions or emergency dental care, as opposed to more complex treatments.

Dr Rymer spoke of a young woman who had come to him after years of oral health neglect seeking to “turn the situation around”. 

“She came in to me and what can I offer her? Very, very minimal intervention and we sort of cast them back into the world and the problem hasn’t really been addressed. She’s a very young patient, she’s going to lose a lot of her teeth due to gum disease.”

The IDA president further told of a second patient, a 35-year-old man, who had gone abroad to get dental work done before consulting the doctor’s practice.

“He came back wondering why it was loose, and over two years I have converted him... to two very ill-fitting dentures. I have sent him out into the world knowing that the work I am able to provide under the medical card scheme is woefully inadequate for his function, for his ability to eat and talk,” he said.

Dr Rymer questioned why the State was willing to provide hip and knee replacements but the same attention was not given to teeth.

He said even if the Government put “a huge amount of money in to fix” the situation, it would be pointless as they also “have to fix the school’s screening crisis”.

The committee was told the HSE school screening programme, which is supposed to assess children three times across their primary school years, is currently seeing barely half of the 200,000 eligible children each year, with many students being seen only once or not at all.

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Assistant secretary at the Department of Health Niall Redmond later acknowledged to the committee the problems in the public dental service, noting the State currently has “a capacity challenge”.

Asked why, despite a national oral health policy, Smile agus Sláinte, being published in 2019, seven years later, an implementation plan for that policy has yet to be delivered, Mr Redmond said the timing of its publication had been unfortunate as it had been “just before the pandemic”.