As people struggle with cost-of-living pressures, access to dental care will only worsen without significant reform, warns Irish Dental Association in its submission to Government in advance of Budget 2023.

• Recommendations include the return of the Dental Tax Relief Scheme (Med 2) to 2009 levels to expand access to treatments and reliefs available for patients
• Commitment and roadmap to deliver a complete overhaul of failing medical card scheme (DTSS)
• Significant investment in the HSE public dental service to recruit and retain public dentists and adequately resource public dental schemes, including school screening programme
• Development of a national workforce strategy for oral healthcare and immediate reform of work permit rules for non-EEA citizens looking for work as dental nurses (currently on list of ineligible occupations) and dentists
• Investment and expansion of UCC and TCD dental schools to increase supply of dental graduates
• Fintan Hourihan, CEO of the Irish Dental Association: “We are calling on Government to invest in a root and branch reform of key areas of dentistry to mitigate the declining oral health of our nation and ensure access to care for all patients, at all income levels. Without investment, the decline of oral healthcare will only worsen, with those most badly affected already struggling with the cost of living.” 

The Irish Dental Association is calling on the Government to action six key recommendations as part of its upcoming Budget 2023. Click here to view the full submission.

In a submission to the Government, the Association, which represents 1,800 dentists in Ireland, sets out a series of interventions that address years of underinvestment and outdated policy in Irish oral healthcare.

These measures, it believes, can improve access to dental care in an equitable and sustainable manner for all people, across all income groups, as people struggle with cost of living and inflationary pressures.

Importantly, the recommendations can bring about the necessary and meaningful reform required to begin the process of adequately resourcing and future-proofing dental care in Ireland, while ensuring that those that require dental care can continue to access it.

Recommendation 1

The Association is calling for a reform of the Dental Tax Relief scheme (Med 2) to bring the tax relief to 40% (2009 level) up from 20% at present, expanding access to treatments and reliefs available. It also recommends the inclusion of dentures in the scheme to reduce to burden of costs on patients.

Recommendation 2

The Irish Dental Association is calling on the Government to deliver a meaningful commitment, in consultation with dentists, to completely overhaul the medical card (DTSS) scheme, where there are now less than 650 contracted dentists actively seeing patients. Earlier this year, the Association commissioned an independent report by Professor Ciaran O’Neill which puts forward proposals and recommendations for an entirely new scheme based on modern dental practice and with input from dental practitioners.

Recommendation 3

Critical to addressing the growing challenge of recruitment and resourcing in the dental profession is the development of a National Workforce Strategy which would examine the current and future needs of the supply of dentists, dental nurses, and dental hygienists. In a recent survey of Irish Dental Association members (September 2021), 80% said they had tried to recruit dental team members in the previous 12 months. However, one-third of dental practices that were actively recruiting staff have not made a hire due to the lack of suitable candidates. This staffing crisis is linked to a lack of training and education places and needs to be addressed urgently by Government.

Recommendation 4

The Irish Dental Association is calling on the reform of work permit rules for non-EEA citizens seeking work as dental nurses (currently prohibited) or as dentists (permitted only where dentist works as an employee with a single employer – most private dentists are self-employed and many work in more than one practice). The Association is also seeking an immediate reversal on the decision to place dental nursing on the ineligible occupations list as an urgent priority to help mitigate against the huge shortage of dental nurses that exists currently.

Recommendation 5

The Association calls on the Government to invest in the HSE public dental service to sufficiently recruit and retain 400 wholetime-equivalent dentist posts, and to improve the pay and conditions of these posts to boost the recruitment and retention of public service dentists. Current resourcing levels mean that early-stage issues in both children and patients with special needs are being missed, which could have major long-term health effects.

Recommendation 6

Finally, the Irish Dental Association calls for immediate and significant investment for the expansion of the UCC and TCD dental schools, to improve the capacity of those schools to produce dental graduates including dentists, dental nurses, and dental hygienists. The planned development of a new dental school in UCC has not seen any progress since it was due to begin development in 2019. As it stands, the dental schools are oversubscribed and do not produce sufficient dentists to meet patient demand.

Comment from Fintan Hourihan, CEO of the Irish Dental Association:

“At the heart of our submission to Government is an urgent call for a root and branch reform of key areas of dentistry to mitigate the declining oral health of our nation and ensure access to care for all patients, at all income levels. On its current trajectory and without investment, the decline of oral healthcare will only worsen, with those most badly affected already struggling with cost-of-living pressures and the current inflation crisis.

“We know that oral diseases and conditions disproportionally affect the poorer and more vulnerable members of society. Successive Governments have failed to adequately fund, and resource dentistry for decades leaving the most vulnerable patients without service and allowed the deterioration of oral healthcare to proliferate. As people become increasingly challenged by inflationary and cost-of-living pressures, we believe that the reform and expansion of the Med 2 scheme, alongside an entirely new medical card scheme (DTSS), can significantly alleviate the difficulties faced by patients in accessing dental care, regardless of their socioeconomic status.

“Earlier this year, the Irish Dental Association launched a reformed scheme for the DTSS, which was independently developed by Professor Ciaran O’Neill, Professor of Health Economics in Queens University Belfast. We have shared the proposed new scheme with the Minister Donnelly and his officials, and, despite multiple promises, we are still waiting for the Department of Health to meet with us to discuss a sustainable solution to this crisis including a workable scheme that meets the needs of both patients and dentists.

“We have also made known the labour supply crisis facing dentistry, including the neglect by Government in investing in our dental schools at UCC and TCD. Of the 200 dental graduates annually, the two dental schools only provide a fraction of the dentists who newly register with the dental council each year. We estimate we need hundreds more dentists to meet the needs of rising population and to replace retiring dentists from both public and private sectors.

“There is an opportunity for Government, as part of Budget 2023, to address these issues in an equitable and sustainable manner so that people can access essential care in their community and reduce the potential burden (patient demand and financial) on healthcare systems in the future.”