Dental services - Oral health policy lacks direction

IT is hardly an exaggeration for the new president of the Irish Dental Association (IDA), Dr John Barry, to assert that a crisis looms in publicly funded dental services and schemes.

The facts, unfortunately, speak for themselves and illustrate how negligent the Government has been in failing to provide those services, especially for children and those with special needs.

Because of the failure to appoint anybody to the post of Chief Dental Officer since the previous incumbent retired two and a half years ago, the country’s publicly funded dental services are in serious disarray.

That inexcusable oversight, as well as the absence of a senior dental advisor to the Health Service Executive (HSE), effectively means that the Department of Health is without anybody to plan future oral health strategy.

Consequently, the situation is becoming critical and for people with special needs whose treatment involves general anaesthetic services, particularly children, that crisis may have already arrived.

Four years ago the National Oral Health Survey of Children with Special Needs showed that as many as 42% of five year-olds; 19% of 12 year-olds, and 15% of 15 year-olds, required general anaesthesia for dental care. Yet, according to Dr. Barry, there are currently no general anaesthetic services in the majority of areas through the country, which he correctly describes as “intolerable”.

The problem is intensified because of the closure of two oral surgery units near Dublin, and now there is nowhere for the HSE to refer children who require oral/dental surgery. The absence of this service impacts very seriously on those people within the community who have a disability because it has been found they experienced more oral health problems than others.

Very often they are confronted with complex and difficult dental needs.The survey taken four years ago, showed that 30% more dental decay was untreated in children with a disability than in those without.

Similarly, adults with disabilities need more dental treatment and both young and old can have their health affected by an inability to have nutritious food, as well as impairing their confidence and lifestyle.

Last year a subcommittee of the joint Oireachtas Committee on Health and Children reported that there were over 10,000 children awaiting assessment in the public orthodontic service at the end of 2004, and it was more than likely that there were thousands more on other lists awaiting treatment, having been assessed.

Dr Barry and the IDA is calling for the urgent appointment by Health Minister Mary Harney of a Chief Dental Officer. Doing so emphasises how critical such an appointment is, to the extent he intends to make it a key objective for his term of office.

Hopefully, this is a deplorable aberration that will be corrected long before another 12 months, at least, is over. It is ludicrous that later this month the department is expected to announce the results of the Adult and Children’s Oral Health Survey and yet the country’s future oral health policy would appear to be without direction.