Ireland’s public dental service is facing a deepening crisis, with stark warnings that at least 500 additional dentists are needed immediately across the public and private systems to meet basic demand. Evidence presented to the Oireachtas Health Committee in recent days paints a troubling picture of a system that is failing patients, practitioners and, most worryingly, children.
The Irish Dental Association (IDA) has been unequivocal: participation by dentists in the public Dental Treatment Services Scheme has collapsed, and patients are struggling to access even the most basic care. Treatment volumes have fallen dramatically, from almost 1.6 million in 2009 to just over 970,000 in 2023. This decline is not due to reduced need, but rather a system that has become unworkable for those expected to deliver care.
According to the IDA, dentists are leaving the public scheme because of state-imposed restrictions on the treatments they can provide, limitations on materials, excessive administrative red tape, and fees that do not cover the real costs of care. Prior approval requirements from the Health Service Executive (HSE) have added further delays and frustration. The result is a scheme that is largely limited to emergency care and extractions, with minimal emphasis on prevention or early intervention.
This crisis is especially acute in children’s dental services. The State promises dental screening at three key stages in primary school, yet this commitment is increasingly unmet. In 2023, fewer than 104,000 children were screened, down sharply from 152,000 in 2018, despite an eligible cohort of around 200,000. Many children are now seen only once during their entire primary school years, or not at all. This represents a serious failure in preventive healthcare, storing up far greater costs and poorer outcomes in the years ahead.
While the HSE has pointed to increased activity in some areas — with over 307,000 adults receiving care last year and 138,000 new child patients assessed — these figures do not offset the systemic problems. An oral health budget of €182 million and a workforce of 773 staff sound substantial, but they are clearly insufficient when set against population growth, rising complexity of care, and the exodus of dentists from public schemes.
Members of the Oireachtas Health Committee have acknowledged that the public dental scheme is outdated and no longer fit for purpose. Calls are growing for the Department of Health to engage in comprehensive talks on a modernised, properly funded model that prioritises prevention, fair remuneration and reduced bureaucracy.
The message is now unavoidable: Ireland needs 500 dentists today. Without urgent action to reform and properly resource public dental services, oral health inequalities will continue to widen, children will pay the price, and a crisis will become a permanent feature of the health system.
