Today’s report from the CSO confirms the shocking impact of cuts in state funding for dental care and the dire need for an emergency plan to address our oral health crisis, says Irish Dental Association Chief Executive, Mr Fintan Hourihan.
In recent weeks the Irish Dental Association has written to the Taoiseach and other Government Ministers urging an urgent cross departmental approach to dealing with the real oral health crisis we face, evidence for which is now becoming apparent with greater regularity.
Today’s CSO report shows that the number of dental treatments provided to medical card patients fell by 16% between 2013 and 2016 even though the number of eligible patients increased by 17% between 2009 and the start of 2016*. Worryingly, the report shows also that curative treatments (such as extractions, fillings and dentures) significantly outnumber preventative treatments.
This worrying trend is also consistent with studies which show a 38 per cent increase in patients admitted to hospitals for severe infections caused by dental decay and CSO statistics which show that households have dramatically decreased their spending on dental treatment, from an average of €197 in 2010 to €84.53 in 2015.
State support for dental treatment, through PRSI and medical card schemes, has fallen from a high of almost €150 million in 2009 to less than €75 million last year.
Following the economic collapse in 2009, entitlements to treatment, under the PRSI Dental Treatment Benefit Scheme, were severely cut. Workers had been entitled to a free check-up and cleaning, as well as subsidised gum cleaning, fillings, extractions, root canal treatments, X-rays and denture work. After the 2009 budget, only the free examination was retained and workers were required to pay for the cost of all other treatments.
In 2010, the medical card Dental Treatment Services Scheme was also cut back. Entitlements to cleaning, gum cleaning and X-rays were suspended, root canal treatment could only be performed on an emergency basis and only on front teeth, denture work was only allowed on an emergency basis and people could only have two fillings per year. But extractions, the cheapest of dental pain remedies, could still be performed on an unlimited basis.
Separately, we know that while the under 16 population has increased by 20% over the past decade to 1.1m, the number of dentists in the Public Dental Service charged with looking after their oral health has dropped by 20% due to recruitment restrictions. Staff shortages, clinic closures and a lack of policy and direction by the HSE are putting an intolerable burden on the Public Dental Service and are undermining its ability to provide an effective service.
Figures from the UK show that dental extractions are the most common reason that children need Gas. Data from Ireland is harder to access. However, the National Clinical Programme for Paediatrics and Neonatology model of care for paediatric healthcare services in Ireland, states that in 2012 there were 8,601 inpatient dental procedures carried out on children under 15 years of age. The number of procedures carried out on children is second only to ENT surgery. However, the report states that the dental figures do not count minor surgical procedures under local anaesthetic, many GA dental procedures that are not recorded on HIPE (such as the 3,000 plus children treated each year in the St James’ Clinic prior to its closure) or about 1,000 children per year who are treated in the private sector.
* There has been a very significant increase in eligible medical card patients in recent years. As at 31st December 2009, the number of patients for dental care stood at 1,478,560, representing 34.87% of the population. As at 31st December 2015, the number of patients eligible for dental care stood at 1,734,853, representing 37.43% of the population. So between December 2009 and December 2015, we have seen an increase in eligible patients of 256,293 (17.33%).