Young people with severe difficulties face three-year wait

ORTHODONTIC SERVICES in Ireland have never been up to standard. For at least 20 years, successive ministers for health have attempted to tackle waiting lists to help children who have crowded teeth, bite problems and jaw disharmony.

At present, children referred into the system aged 12 or 13 may be 16 or 17 before they begin treatment.

The optimal time for adjusting these children’s teeth, while they are still growing, may have already passed. The treatment they require may be more complex, more costly and possibly less successful as a result of the delays.

Instead of hoping to have their braces off by aged 14 or 15, they are wondering how they will look with “train-tracks” at their debs.

Today’s figures show the situation is as bad as it has ever been or worse.

In the Health Service Executive West region, for example, there are more than 3,600 children who have been assessed as needing treatment and they have been waiting for up to three years. In 2002, the number awaiting treatment was 1,066 and they were waiting for about the same length of time.

In between, two Dáil committee reports have been produced and a Seanad sub-committee has examined the delays.

A HSE orthodontic review group also reported and, though not implemented, recommendations were made to introduce orthodontic auxiliaries, who could work under the supervision of orthodontists. Dentists were also sent abroad to train as orthodontists.

Yet children are still waiting into adulthood in some areas before they get treatment, if they get it at all.

The grading system used by the HSE means only the most serious cases of misalignment qualify. Children who fit into category four and five on the five-point modified Index of Treatment Need can be approved. These are children who have severe difficulties including cleft lip and palate, mandibular joint pain or whose teeth are so misaligned they have difficulty eating.

Children who do not meet the criteria are considered to need orthodontics only for cosmetic reasons and are entirely excluded from the scheme. It doesn’t matter that a child might be too self-conscious to smile, participate in class, or in some cases raised by orthodontists, so embarrassed by how their teeth look they don’t want to leave their bedrooms.

Their parents must find the money to have them treated in private practice, at a cost of €4,000 to €5,000, or do without.

It means yet again the less well-off are excluded and only the children of those families who can afford it, will have the gift of a confident smile.

The HSE has said another review of the service will be carried out this year. Given the result of previous reviews, perhaps the money would be better spent on addressing the waiting lists.