Dental services in 'Dark Ages' with some Laois teens never seen

The public dental scheme has collapsed to such an extent that some 17 year olds in Laois have never been to the dentist.  

That’s according to Laois Offaly TD Brian Stanley who raised the matter in the Dail last Wednesday. 

Deputy Stanley said: “In Laois-Offaly, we are in crisis. The Minister is standing in for the Taoiseach today. I want to get this addressed. The public scheme is not functioning properly.”

“Dentists have stopped taking patients for the dental treatment services scheme, DTSS, full stop. Services cannot be gotten and people cannot access them. Those are the facts,” Dep Stanley stated. 

“The school scheme has also collapsed. In Laois, there are 16-year-old and 17-year-old children - teenagers - who have not yet seen a dentist in their lifetime. Those are the facts of it. The services in Laois-Offaly are in the dark ages,” he said. 

Dep Stanley told the Dail “Services across CHO 8 are in severe difficulty. There is a budget and I am trying to find out how much it is. If the Minister could give me the figure, I would welcome it. I have been looking for it from the HSE. There is a budget and we have no service. Given that failure, will the Government now decide to train, recruit and employ public dentists through the HSE to provide a dental health service to the children and adults in Laois-Offaly?” 

In response, Minister for Public Expenditure and Reform, Deputy Michael McGrath  said: “I know this is an important issue and it is one we are committed to addressing. It is undoubtedly the case that a significant number of contracted dentists have chosen to opt out of the dental treatment scheme. It has caused a lot of problems and delays for medical card patients around the country.”

He said: “The Minister for Health has approved new measures to provide for both expanded dental healthcare for medical card holders in the dental treatment scheme and increased fees for dental contractors. Those came into effect on 1 May. In addition, further funding has been provided in the recent budget to assist the HSE in providing care to adult medical card holders who meet the HSE criteria for emergency care.”

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Meanwhile, dentists from around Ireland met in Portlaoise last week.  The Irish Dental Association says there is a backlog of almost ten years in some parts of the country in accessing the HSE School Dental Screening Service which is staffed by public only dentists.”

“Primary school children should be having check-ups in second, fourth and sixth class, however, the strain on the system is so much that some children aren’t receiving the first of these three important dental checks until they are in their fourth year of secondary school. This means that some children are not receiving an initial check-up until they are 16 years of age and are therefore missing out on vital early intervention, resulting in more drastic treatment or, in the worst cases, extractions being required during the formative teenage and early adult years,” The Irish Dental Association stated. 

Understaffing and a lack of resources in the public dental service is being blamed for the delays with the numbers of practising public-only dentists having dropped by almost one quarter (23%) in the past 15 years, decreasing from 330 in 2006 to 254 in 2022. This means the HSE will need to hire 76 dentists immediately to the bring the service back to the levels it was at 15 years ago.

The lack of HSE dentists is also impacting on the delivery of care to other vulnerable sections of society including those with special care needs and patients waiting on essential public orthodontic treatment.

There are currently two-year-long waiting lists for treatments requiring General Anaesthetic with dentists saying that they are being forced to choose which children they believe are suffering the most pain and treat them ahead of patients who may have already been waiting months or years.

This, the Irish Dental Association reports, is leading to high levels of stress and burnout among dentists hired by the HSE.

Chief Executive of the Irish Dental Association Fintan Hourihan said: “It is shameful that children, special care and other vulnerable patients are not receiving the dental care they are entitled to, with many suffering unnecessarily later in life as a result.”

“The simple solution is to adequately staff and resource our Public Dental Service. Too many children are slipping through the cracks, despite all the evidence showing that the younger a child is when they are first examined, the less likely the need for major treatment or extractions later. Dentists, however, are reporting seeing older children who are requiring three or four extractions and root canal treatment. This cannot be allowed to continue. We are urging the Government to address this as a critical priority to ensure children are receiving the care they are entitled to under our public dental system and at the earliest opportunity to save them from unnecessary and drastic treatments later,” Mr Hourihan remarked.