Audit to review more than 7,500 children’s dental work

Audit acts on allegations that children’s teeth were damaged by HSE orthodontic services

Some of the patients affected  may have to be recalled well over a decade after their orthodontic work was performed, the HSE has indicated. Photograph: iStock

Some of the patients affected may have to be recalled well over a decade after their orthodontic work was performed, the HSE has indicated. Photograph: iStock

 

The medical files of more than 7,500 children are being reviewed in an unprecedented official audit prompted by allegations that children were “damaged” by orthodontic services in the greater Dublin area.

Some of the patients affected by the review may have to be recalled well over a decade after their orthodontic work was performed, the Health Service Executive has indicated.

It is alleged some children had braces left in for longer than intended – in some cases over a year – leading to damage to the surface of their teeth. Other children allegedly suffered wires protruding into their gums while some had to get false teeth because excessive spaces were created when specialist appliances were left in place too long.

News of the review comes as the Department of Health prepares a long-delayed oral health policy this week. The plan is expected to propose rolling out free dental care to children from 2020, to include dental exams, fillings, emergency work, extractions and orthodontics.

However, dentists say there was no meaningful consultation with the profession in the drawing up of the plans and no talks have taken place about the provision of the proposed new services.

Critical report

The audit of orthodontic services was begun in 2015 after the HSE received a highly critical report commissioned from two UK experts into the allegations that children’s teeth were damaged by HSE orthodontic services more than a decade previously.

“Due to the scale of the audit and the requirements for specialist staff and resources, the timeline has been protracted, however this work is now nearing its completion,” the HSE said this week.

“While it is regrettable that this work has taken so long to progress, the priority of the HSE at all times has been for a robust audit on which to base any further action required.”

The UK review, carried out between 2012 and 2015, has never been published. Three years ago, The Irish Times sought a copy under freedom of information but this request was refused. The HSE said it was “not yet finalised for publication” and was with its lawyers.

Almost 20,000 children are on the orthodontic waiting list, including almost 8,000 who have been waiting for over two years. Photograph: John Giles/PA
“I was complaining for up to 14 years about damage to children’s teeth. It was obvious there was a problem, but no one did anything about it for years.” File photograph: John Giles/PA

Last week, a spokeswoman said it was “in effect” a scoping report commissioned to advise the HSE on what actions to take if there was a risk of harm to patients.

“The HSE cannot, as a matter of course, commit to the publication or otherwise of such reports prior to their completion, as the benefits of publication must be balanced with the requirement for patient confidentiality, and our obligation to afford natural justice to all other parties concerned.”

Patient recall

When the audit was complete, a serious incident management team would consider the results to determine if a recall of any patient was required and to co-ordinate open disclosure as necessary, she said.

The allegations relate to the period 1999-2002, meaning all the children affected would now be adults.

Retired consultant orthodontist Ted McNamara, who made the original complaint, said it was disappointing the HSE had still not published the review completed in 2015.

“I was complaining for up to 14 years about damage to children’s teeth. It was obvious there was a problem, but no one did anything about it for years.”

In 2007, a Department of Health official told the Oireachtas health committee no complaints had been made about orthodontic services to the Minister for Health, the HSE or the Dental Council.