Children and those on lower incomes being failed by collapsing public dental services

• Medical card access collapsing and poor PRSI Dental Benefit Scheme damaging oral health
• No implementation plan seven years after publication of the National Oral Health Policy in 2019
• Number of public dentists at all grades down by a third since 2009
• Children missing basic dental checks with 104,000 children denied dental screening due to staff shortages
• HSE attempting to paint a rosy picture of dental services which flies in the face of fact

Labour’s health spokesperson Deputy Marie Sherlock has today warned that public dental services are collapsing, after the Irish Dental Association told the Oireachtas Committee on Health that more than half of dentists have withdrawn from the medical card scheme, leaving thousands of patients without the free care they are entitled to. Deputy Sherlock has called on Government to urgently reinvest in public dentistry, restore access for medical card holders and children and increase dental training places before further damage is done to oral health across the country.

Deputy Sherlock said:

“Thousands of patients are being denied the dental care they are entitled to because this Government has allowed public dentistry to wither on the vine. More than half of dentists have now pulled out of the medical card scheme and the result is predictable and cruel. The number of directly employed HSE dentists has fallen by about one third since 2009. People on the lowest incomes cannot find a dentist willing to see them, even though they are legally entitled to free care. That is not a system under pressure, it is a system in collapse.

“The situation for children is a ticking time bomb. Basic preventative care is not taking place leading to significant deterioration in oral health. School dental screenings are in a state of crisis because there are simply not enough HSE dentists to carry out basic checks. There are just 249 dentists in all grades employed by the HSE, down by a third from 330 in 2009. We know in parts of the country, sixth class assessments are now being carried out when young people are in sixth year of secondary school.

“We know from the Irish Dental Association that at the end of 2023, 104,000 eligible schoolchildren in Ireland were denied dental screening appointments by the HSE due to a shortage of public-only dentists employed by the HSE. That is how badly this service has been allowed to fall behind.

“The need is clear: the Government must invest in public dentistry to meet unmet needs and build fit-for-purpose public dentistry into the future. We must re-introduce the one/two-year Foundation Training (FT) Programme for students and ensure that students enter dentistry, that colleges have capacity, and that public dentistry is attractive. And crucially, the Department must go to the drawing board to reform the Dental Treatment Services Scheme.

“Data provided by the HSE to my office last summer confirmed what families already know. Dental services are becoming harder to access, particularly for children and for people with medical cards. Delays are growing, coverage is shrinking, and need is being ignored. Early intervention matters in dentistry. When children miss checks and treatment, small problems become lifelong health issues. The cost of that neglect will be paid for decades.

“Cost has also become a major barrier. People are no longer just afraid of the dentist’s chair, they are terrified of the cost of visiting the dentist. The price of even basic treatment puts timely care out of reach for many. Public dental services are being allowed to whittle away in favour of private provision. That leaves those on lower incomes with nowhere to turn. Oral health should never depend on the size of your wallet, yet that is exactly what this Government has allowed to happen.

“The cutback in treatments available under the PRSI dental benefit scheme has made matters worse. People can now only access a very narrow range of services. If you need anything beyond the most basic work, you are forced into the private system and expected to pay up front. That undermines the whole purpose of PRSI. Workers pay in throughout their lives and should receive meaningful dental care in return, not a token gesture.

“This collapse did not happen by accident. It is the direct result of poor staffing levels, a failure to plan, and a hands-off approach from Government. Ministers have watched public dentistry decline year after year and have chosen not to intervene. That neglect is now laid bare by the testimony given to the Oireachtas Committee on Health.

“I am calling on Government to act now by investing properly in public dental services, reforming the Dental Treatment Services Scheme, restoring confidence in the medical card scheme, expanding the range of PRSI dental benefits, and urgently increasing the number of dental places at university level. Oral health is a core part of public health. If Government continues to ignore this crisis, more patients will suffer, more children will fall through the cracks, and the damage will only grow harder and more expensive to fix.”