Dentists critical of dental care for primary school children

Cutbacks in HSE services mean children’s teeth are not being checked until sixth class

Thousands of children are missing out on essential dental checks until the end of primary school due to cutbacks in Health Service Executive services.

Dental screening for children in second class and orthodontic extractions in Cork, for example, are being “placed on a lower priority” due to resource issues, according to a directive to staff seen by The Irish Times.

“If parents of children in second class enquire about screening appointment explain that due to available resources, we are currently prioritising sixth class,” local HSE staff have been instructed.

The Irish Dental Association (IDA) says increasing numbers of children are only being offered examination and dental care for the first time at sixth class – instead of at first/second, fourth and sixth classes.


"This has been confirmed as policy in Cork, which joins many other parts of the country in this regard," according to IDA chief executive Fintan Hourihan.

The association last week boycotted meetings convened by the Department of Health to prepare for implementation of the Government's new national oral health policy, announced earlier this year.

Private practitioners

The policy proposes shifting the dental treatment of children from public HSE services to private practitioners, who would hold a contract with the State to treat children. In line with the policy, the Government announced free dental care for under-sixes in this month’s budget, but this will first have to be negotiated with the IDA.

The association, whose privately employed members are dissatisfied with the fees paid under existing State dental schemes for adults, says the proposed new approach is flawed.

IDA representatives met Minister for Health Simon Harris in August, and claim the Minister agreed to discuss alternative approaches.

The document claims a dentist earns just €1 net from performing an extraction under the State scheme

However, the Minister’s officials wrote to the association last week saying it “will not reopen discussions” on the oral health policy, and only wishes to engage with the IDA on its implementation.

Following an emergency board meeting, the association resolved not to attend further meetings with the department until its concerns are addressed.

Policy document

Separately, it has published a policy document in support of “independent dental practice” which reflects the dissatisfaction among the profession with the State dental schemes.

Dentists are less reliant than GPs on State work, with an average of 20 per cent of income coming from this source. The document claims a dentist earns just €1 net from performing an extraction under the State scheme, compared to €47 privately.

Earnings under the Dental Treatment Services Scheme for an X-ray are just €2, compared to €24 privately, and €12-€13 for a filling, compared to €47-€57 privately.

Mr Hourihan said successive governments had “taken a cleaver” to the State dental schemes, leaving dentists feeling “let down”. While there might be some scope for private dentists to take on more work with children, the HSE dental services needed to be beefed up and private practice was not equipped to handle children’s emergency services, he said.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times