Leading dental expert calls for introduction of a ‘Use it or lose it voucher’ for first dental visit

Leading dental expert calls for introduction of a ‘Use it or lose it voucher’ for first dental visit

(11 May 2017)

A leading dental expert has called on the Government to introduce a ‘use it or lose it’ voucher scheme for parents, to cover cost of their child’s first dental visit.

The call follows the publication of a recent Irish study which recommended that the ‘first tooth, first visit’ model of care has the potential to ensure ‘zero cavities’ in later childhood.

The Irish Dental Association estimates the cost of establishing such a scheme would be between €2 to €3m but believes the savings would far outweigh the initial cost.

Such visits enable dentists to identify potential problems early, to convey suitable preventive advice to their parents and to place children at high risk of decay on an appropriate preventive programme.

Speaking in advance of the IDA’s annual conference in Kilkenny this weekend, Dr Eleanor McGovern, said such a voucher scheme would encourage parents to bring their young children to see the dentist and could kick start a new approach to children’s oral healthcare.

She said there is significant international evidence* that children should have their first dental visit by their first birthday and that they should be seen on a regular basis thereafter.

“Dental decay (tooth cavities) is the most common chronic disease of childhood and is associated with a reduction in quality of life of the child. Approximately  50% of children in Ireland have tooth decay by the time they are 5 years old*, yet children are not normally seen through the public HSE dental system until approximately 7 years of age, and even later for some.”

Dr McGovern, who is a Consultant Paediatric Dental Surgeon at Temple Street Children’s University Hospital, says this is far too late.   

“As a result children may suffer from associated dental pain (toothache) and infection. Dental decay can also interfere with the child’s sleep, nutrition, behavior, growth and development.  Children will then require numerous dental visits, days of school and/or extractions under general anaesthesia.” 

The Irish Dental Association believes over 10,000 Irish children are having teeth extracted under general anaesthetic every year. The Association has described the figure as a disgrace.

The IDA points out that there is currently no dental care for pre-school children in Ireland and says we have fallen a long way behind Scotland and England in this regard.


The Scottish Experience

International studies show that dental decay is already well established by the time a child reaches three years of age. When Scottish 3 year olds were examined in 2007/08 the prevalence of dental decay was 25%, with a higher rate of 32% in children living in deprived areas.

In response Scotland introduced the Childsmile programme which provides a comprehensive pathway of dental care for all Scottish children from when they are born to when they are 17. The programme has reduced the rates of dental decay by half since it was set up.


Time to bin the treat culture

Dr McGovern says we need a similar publically funded programme here to improve the oral health of our child population and reduce health inequalities. But she added that, parents, teachers, sports coaches and healthcare workers also need to start taking child oral health seriously.

“The anti-smoking campaign has been highly effective in Ireland. We need to apply the same approach on a consistent basis to sugar consumption. For example how often do we see schools and sports clubs distributing sugar containing drinks and snacks during or after certain school and sports events.”

“If they were handing out cigarettes there would be an outcry but the regular distribution of soft drinks, sugar laden fruit juices, buns, bars and crisps has become common place. It’s time to call a halt. All influential adults in the life of a child need to encourage children to eat and drink healthily. Water and milk are the only safe drinks for children’s teeth. We also need to bin the current unrelenting treat culture”

“Scotland and England have provided templates and shown what can be achieved. It’s time for our politicians, the HSE and the Chief Dental Officer to provide leadership. By using revenue from the impending sugar tax we could finance our own Childsmile programme and save our children a great deal of pain and heartache. We’d also save the state money in the process! ‘Prevention is the best and most cost effective cure. What’s stopping us?” 


* Numerous international dental organisations such as the American Academy of Paediatric Dentistry, British Society of Paediatric Dentistry, and the European Academy of Paediatric Dentistry recommend that children see their dentist by the child’s first birthday.

*This figure dates from 2002 which is the last time the HSE carried out a study which measured tooth decay amongst children in Ireland.