Time for action : Ireland's Dental Magazine

Time for action

Strategic planning and increased funding are needed urgently to address the dental services crisis

A motion before the Dáil Éireann in July highlighted the severe crisis in Ireland’s public dental health services, brought about by a lack of prioritisation, planning and provision of resources by successive governments. The motion outlined several critical problems within the public dental system.

The school dental programme is failing to provide timely screenings and treatment. Many primary and secondary school pupils are not being seen for their first check-up until they are in their teens. The number of pupils screened and treated has dropped significantly. The Dental Treatment Services Scheme (DTSS), which provides dental care to adults with medical cards, is effectively non-existent in many areas.

The Treatment Benefit Scheme, based on Pay Related Social Insurance (PRSI), is also limited, only covering examinations and cleaning. This leaves low- and middle-income families at a disadvantage, as they have to pay out-of-pocket for necessary treatments such as fillings or extractions. Others, particularly children and adults with special needs who require general anaesthesia for dental treatment, face a two-year waiting list due to a lack of hospital staff and capacity.

There is a recruitment and workforce crisis. The number of dentists in public service has dropped by 23% in the last 15 years, with less than 10% of dentists now working in the public system. This is exacerbated by a lack of new dentists entering the workforce, not helped by significant delays, often up to six months, in the Health Service Executive’s (HSE) recruitment process.

The Irish Government needs to take immediate and comprehensive action. This should involve strategic planning and increased funding. It should publish its long-promised implementation plan for Smile agus Slainte, the national oral healthcare policy, provide a significant increase in the upcoming budget for dental care and ensure clear tracking of how this budget is being used to improve services and outcomes.

The workforce crisis must be addressed with an increase in the number of dental school places at University College Cork (UCC) and Trinity College Dublin (TCD), with additional funding and the reinstatement of a structured mentorship programme to help new graduates gain experience. The HSE should be authorised to accelerate recruitment for public dental services and there should be implementation of a campaign by the DTSS to attract more practices.

In addition, the range of services available under the PRSI-based Treatment Benefit Scheme needs to be expanded and there should be an improvement and expansion of hospital services and capacity for special needs patients who require treatment under general anaesthesia.

The Irish Dental Association (IDA) welcomed the contributions made during the debate. It has consistently highlighted the urgent need for reform, investment and workforce planning across public dental services. A properly funded and resourced public dental system is vital to delivering timely, preventative and equitable oral healthcare. Today, it is in a state of crisis. While the motion before the Dáil Éireann was a welcome step in highlighting the serious issues facing the dental sector, the time for action from the Government is now.