Dr. Will Rymer:

I would describe it as slack water. We had a situation where there was what was described as an unprecedented investment in the scheme. In 2014, we had 430,000 patients treated but now, in 2023, after those fee increases, we have only 280,000 patients treated. The number of dentists involved in the scheme has not gone up significantly since those fee increases. As advertised, there are 36 dentists in Dublin south west but if one rings around, there are not 36 dentists who are able to take one on a as a medical card patient. Mr. Hourihan used the analogy of only offering amputation and for a young dentist coming into the Irish workforce, it is a highly innovative and highly technological workforce that is trained to a very high standard. We are very lucky in Ireland to have highly trained dentists.

We are not utilising half of their skills and we are not seeing a desire for them to work in a scheme that is offering antiquated, Victorian-era dentistry. It is not what we should be offering to our patients and, because of that, we are seeing a gradual slip in the overall standard of oral healthcare in Ireland.

Smile agus Sláinte is an aspirational document. We have produced a document that we think has a lot to aspire to but, unfortunately, the movement is just too slow. We have described patients who are suffering. There are tens of thousands more patients who are falling between the cracks and we are not hearing their stories and they do not have Deputies to advocate for them, although they have significant problems. There are all of these things that we have talked about today. Children who are presenting later now have more complex treatment needs. I am having to try to explain to an anxious child about the much more complicated treatment they are going to have to undergo because we missed out on the opportunity to do a simple fissure sealant or a simple fluoride application. I am now talking to a seven or eight-year-old about extractions and root canal treatments, with those extractions leading to them requiring orthodontic treatment later. It is very expensive for the parent or the State so we have to get serious about prevention much earlier in their development.