Younger children to lose out in new dental care plan

Public health dentists have been told to prioritise the care of older children’s teeth, in a move which is likely to see thousands of younger schoolchildren miss out on regular dental check-ups.

For the first time, waiting lists are being created for regular dental screening as priority is given to the needs of 11- to 14-year-olds, under a new plan within the Health Service Executive.

Senior staff have been told the “prioritisation framework” will have significant implications for dental services in the regions, according to an internal HSE document seen by The Irish Times.

The Irish Dental Association, which has labelled the move a "stealth cut", says it has caused major concern among its members in the public dental service. "This represents a fundamental change in the philosophy of dental service. It's effectively the abandonment of young children's dental health," says chief executive Fintan Hourihan.

Earlier screening

“Up until recently, parents could have expected their children’s teeth to be examined in second, fourth and sixth class. Now many will not be seen until they are 11 or 12 and even then, the priority will be orthodontic work.”

For many children seeing a dentist for the first time at the age of 12, it will be too late to stop major problems with decay and gum disease, he says.

The State provides free dental services to under-16s and traditionally this has involved three examinations during the primary school years. However, reductions in staff and funding have led to cutbacks in this service in recent years.

Orthodontic referral

The new approach is outlined in a guidance on prioritisation issued to senior dental staff by

Dr Dympna Kavanagh

, assistant national director, oral health in the HSE.

It says the first priority should be children aged 11-16 years, who should be screened for dental health and referred for orthodontic care when appropriate. “Eligibility for referral from school dental services ceases at 16 years of age and so it is essential that referral is undertaken before this time so that secondary care can be made available as required.”

Children should be placed on a waiting list for care if the local service area is unable to complete care within the academic year, the note advises.

Children aged six to eight are assigned second priority and children aged nine to 11 third priority under the plan. In both cases, staff have been told to place children who are not offered assessment on a waiting list for assessment “at the earliest opportunity”. Operative intervention for permanent teeth should be prioritised “if resources allow”.

The HSE says recruitment of dentists is proceeding “where necessary”. Orthodontic waiting lists have been reduced and further reductions are expected.