Without meaningful reform, improved access to dental care is doomed to fail

Without meaningful reform, improved access to dental care is doomed to fail

(13 Oct 2021)

We are disappointed by the lack of detail provided by the Government regarding measures to improve access to dental care announced in Budget 2022. In the absence of specifics, yesterday’s announcement is nothing more than a veneer that does little to meaningfully address the crisis in oral health care.

There are now only 750 dentists treating medical card patients, which is less than half the number of DTSS contracts held by dentists up to two years ago. To put it in context, that is one dentist per 2,000 medical card patients. It means that there are now parts of the country where there is just one dentist covering an entire county or region.

Dentists want an entirely new scheme that reflects modern dental practice and care, one that allows vulnerable groups to access routine dental care in their community. We have never understood the rationale behind a scheme that restricts the number of preventative treatments allowed, such as fillings to save a tooth, while permitting an unlimited number of extractions.

In addition, we continue to have serious concerns regarding access to dental care for children due to the significant deterioration in the level of service provided through the public dental service. The budget has offered nothing to allay our concerns.

Over the past decade, there has been a 30% decline in the number of dentists in the public dental service, despite a 23% increase in the number of eligible under-16s due for assessment. There are now an estimated 100,000 children on waiting lists for a public dental appointment, and there is a six-year waiting list for orthodontic treatment.

Understaffing of the school screening system, coupled with cuts in service provision because of the Covid-19 pandemic, means that the number of children being seen for targeted check-ups is a fraction of what it should be. These missed assessments are unlikely to ever be recovered.   

We do welcome the planned changes announced to the PRSI scheme, which will allow more young workers to access dental care. However, in terms of national oral health policy, our members remain deeply frustrated that they have been repeatedly denied meaningful engagement with the Department of Health, whether through representation in the development of policy or constructive engagement in its preparation.

Put starkly, without meaningful reform, existing schemes like the medical card are doomed to fail. An entirely new scheme is required, and we continue to call on the Government to engage with the Irish Dental Association on an alternative proposal for a more sustainable solution that ensures access to care for those who need it most.