Dentists and the oral health policy

 

Sir, – We refer to the letter from the registrar of the Dental Council with regard to the new oral health policy (July 29th).

On behalf of the Irish Dental Association’s board of directors, its members and the dentists interviewed for the feature published in the Irish Times on July 23rd (Health + Family), we are pleased to clarify that all dentists recognise their privilege and obligation to treat all patients, including children, in accordance with their training and competence.

It is a fact that dentists will very often choose to focus on specific areas of practice without avoiding their duty to care for all the patients they receive and to whom they will provide care or, in the patient’s best interest, refer to a colleague if required.

The provision of care to children is different to the provision of care to adults. Not all dentists treat children regularly because of the specialist skills required, the time demands involved in behaviour management and other legitimate reasons. In children’s best interest it is better that they are cared for by dentists who want to treat children regularly and are best placed to do so.

The concerns our members hold in regard to the care for children relate to the recommendations contained in the oral health policy to effectively transfer responsibility for critical preventive care and treatment of children from the public dental service to general practice.

This shift from a system where every child is screened by public service dentists to making prevention available to those who choose to attend is particularly worrying.

It is notable that elsewhere in the Irish Times last Monday, it was reported that more than two-thirds of eligible adults do not avail of their entitlement to a free annual dental examination and other treatment benefits available to two million persons under the PRSI dental scheme. So moving away from a targeted approach to one where the dentist examines those children who happen to show up is all the more worrying when we read the evidence of how such a policy operates for adults. The big losers when children are not seen by their dentist are those from deprived and disadvantaged backgrounds, as all available evidence confirms.

For the record, there has been no discussion with the association as regards the remuneration or funding necessary to apply and support this proposed new model but, even in its absence, dentists in general practice and the public service are seriously concerned at the proposed transfer of responsibility for screening of children and the provision of limited dental treatments without ensuring appropriate care pathways, provision for specialist referral and the availability of emergency care. Not to mention the waste of vast expertise, experience and administrative support which resides within the service which is already seeking to provide this care, in spite of massive cuts in HSE staffing levels.

The association is committed to advocating the interests of its members and the patients they serve but will never countenance any suggestion that dentists would refuse to uphold their professional obligations to provide care.

This unfortunate reading of the recent Irish Times article should not detract from an open and honest debate about the new oral health policy and its implications for patients but also those dentists whom we are proud to represent. – Yours, etc,

Prof LEO STASSEN,

President,

Mr FINTAN HOURIHAN,

Chief Executive,

Irish Dental Association,

Sandyford,

Dublin 18.