Free dental care plan would cost €80m a year, ESRI says

Providing free dental care for adult medical-card holders and all children as proposed under the Department of Health’s new oral health policy would cost €80 million a year, according to an analysis.

The policy, published on Wednesday, proposes a move from the current “diagnose and treat” approach to dental issues to a preventive approach.

Children aged under 16 will receive eight free oral-health “packages” according to their age, the policy proposes, including examinations, assessments and emergency care. Medical card holders aged over 16 will also be provided with oral health packages.

The policy, which would cover 1.1 million children under 16 and 1.3 million medical card holders, would cost €48 million a year for medical card holders and €32 million for children aged up to 16, according to analysis by the Economic and Social Research Institute (ESRI).

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The ESRI’s costing does not include other aspects of the plan, including staffing, governance changes and dental education.

The proposed packages include services such as oral examinations that are already covered for medical card holders, but also some services, such as fissure sealants for young adults, that are new.

The packages have not been discussed or negotiated with dentists, who reacted sceptically to the publication of the policy.

The Irish Dental Association (IDA) said the policy, named "Smile agus Sláinte", would be judged by what it delivered, not what it promised.

While welcoming the “long overdue” publication of the new oral health policy, 25 years after the previous one, and its focus on prevention, IDA president Dr Kieran O’Connor pointed out that his organisation’s members hadn’t been consulted on it in any meaningful way or involved in its formulation.

Complete reversal

Dr O’Connor said the association would need to study the plan carefully to see how it compared with the IDA’s vision for oral health services. He said nothing short of a complete reversal of Government policy would be required if the policy was to be rolled out successfully.

Most dental care for children will pass from HSE public services to private, local dentists under the new policy. No major proposals are made for changing the current provision for adults who do not have medical cards, but Minister for Social Protection Regina Doherty said on Wednesday she would consider expanding the current system of funding for insured adults.

The new strategy is supportive of the current policy of water fluoridation and proposes a targeted topical fluoride programme, including a mouth-rinsing programme, for children over six years of age.

This would help reduce the imbalances in oral health between children living in fluoridated areas and those living in areas where fluoride is not added to the water supply.

For people living in residential care and older people living in remote rural areas, fluoride therapies, such as the use of high-fluoride toothpaste, will be promoted.