Dental report: The criteria being used to decide which children in the State are eligible for orthodontic treatment should be immediately changed, according to an Oireachtas subcommittee report to be published tomorrow.
A subcommittee of the joint Oireachtas Committee on Health and Children, which has been examining problems with the public orthodontic services, will recommend that current Department of Health guidelines for assessing children's orthodontic needs be scrapped, to make the system fairer.
At present under Department of Health guidelines when patients are assessed they are put into one of three categories according to their perceived need.
Category A includes children with congenital abnormalities, such as cleft lip and palate, which may require surgery.
Category B includes those with skeletal discrepancies between the sizes of their jaws, and Category C consists of children with severe overcrowding and crooked teeth.
In some regions of the State no children in category C were being treated.
The Oireachtas subcommittee has said a system used in the UK called the Index of Treatment Need (IOTN) which grades patients from 0 to 5 according to severity should replace the current system.
It would allow children with severely overcrowded teeth to be treated and is regarded as a less subjective assessment tool.
The subcommittee's report also deals in detail with the need to train more orthodontists to work in the public sector.
Subcommittee chairwoman Fiona O'Malley said a training regime had operated successfully in the mid-west for a number of years and "was collapsed because it was so successful".
The result was longer waiting lists.
"We have hit a crisis. A lot of TDs spoke to the committee about people coming into their clinics in exasperation," she said.
The subcommittee would recommend a return to regional orthodontic training programmes, she said.
"These regional schemes were assessed independently and there was no question of them being inferior," she added. These could be accredited by overseas training institutions.
Ms O'Malley also said the Dental Council, which overseas dental education and training, needed to look to Europe "for reciprocal arrangements with other European universities so that different types of training programmes could take place in this country".
She said: "We are trying to stop the monopoly on training the Dental Council has in the country and to provide alternatives."
The Oireachtas health committee was told two years ago there were more than 21,000 children on orthodontic waiting lists across the State but the true numbers of those requiring treatment could be much higher, as orthodontists had been told not to put on waiting lists the names of children who had no realistic chance of being seen due to the shortage of specialists.