Ireland’s public dental service is failing to consistently meet the needs of all children, according to a new report.

Since the publication of the National Oral Health Policy Smile agus Sláinte in 2019, the Health Service Executive (HSE) public dental service has been in a state of decline amid increasing pressures on the healthcare system.

There are more than 11,000 children on waiting lists for dental or orthodontic care across the country, with 8,000 of those waiting longer than two years. More than 105,000 (50%) of primary-school children have not received targeted dental screening despite the State’s statutory obligation to provide it.

Ireland’s Ombudsman for Children has published a report which addresses those issues and which makes 10 recommendations to the Irish Government which it hopes will be incorporated into its action plan due to be released shortly.

“Complaints to the Ombudsman for Children’s Office (OCO) over the years from families affected by delays in accessing public dental services highlight the impact this is having on their children first hand,” said a spokesperson.

“Our work on the issue reveals recurring problems: excessive waits for treatment, uncertainty about prioritisation, inconsistent communication and a significant variation in access to treatment between regions.

“This impact is not only clinical. Our Office has seen complaints where dental and orthodontic delays have affected children’s health and psychosocial wellbeing.”

The report makes 10 recommendations:

• A time-bound reform plan: Prioritise dental screening for children in DEIS Plus, DEIS Band 1 and 2 schools and special education settings, aiming to complete 6th Class screening by June 2027.
• Target the greatest gaps: Identify children who have aged out of primary school without screening and address this backlog alongside current 6th Class children.
• Clear the screening backlog: Move towards delivering two of the three recommended targeted school-age screening appointments, with clear funding pathways and delivery milestones.
• Separate specialist waiting lists: Maintain child-specific regional waiting list data for children with special care needs and those requiring care under general anaesthetic.
• Oversight and Monitoring: Develop a time-bound action plan to ensure that children with additional or special care needs get access to their required dental treatment as priority issue across all HSE regions and regularly monitored by the governance and oversight committees within the HSE and Department of Health.
• Address orthodontic delay: Provide additional ring-fenced funding for eligible Grade 4 and 5 patients waiting more than two years for orthodontic treatment, including through contracted care where appropriate.
• Reassess children over time: Review orthodontic waiting list management so that deterioration, developmental timing and the impact of prolonged delay can affect prioritisation.
• Improve communication: Develop a communications pathway with children and their families that includes information on what the child’s treatment needs are, if there is a necessity to prioritise them for treatment and why, the indicative waiting time, when reassessment should be sought and what alternatives or interim supports exist. Children and families require transparent and reliable information to be available to them so they can make informed choices about their healthcare.
• Strengthen early years pathways: Explore preventative screening pathways for children aged 3–5 years in Early Start, ECCE and other early years settings.
• Build capacity: Use public-private collaboration and robust contracted care arrangement where necessary in the short to medium term to ensure children are getting access to equitable and timely dental services while developing sustainable HSE dental and allied health workforce and service capacity.

“We will follow up with the Department of Health and HSE and their relevant oversight and governance committees in 12 months to determine if the [Government’s] proposed plan adequately addresses children’s right to timely access to dental and oral healthcare,” said the spokesperson

Tags: children, crisis, Dental, HSE, Smile agus Sláinte