Rory Hearne (Dublin North-West, Social Democrats)

I thank Deputy Stanley for tabling this motion on what is a very important issue. The public dental care service has declined significantly in recent decades. It is incredible how the idea of access to dental care is considered a luxury rather than a public service that should be universally available on the basis of need. It should not be about whether people can afford to pay. It is an incredible indictment of how we have developed our public services that areas such as dental care are not seen as core to the public health system.

The Government can argue about the funding it has put in - and it will speak about that - but the reality for people is that trying to access dental care in the public system, including for an emergency, is extremely difficult. One of my children needed a tooth out. People who need a tooth out are told it will take a certain amount of time. As a result, they have no choice but to go private. The cost of private dental care is astronomical. This is another part of the quasi-privatisation or outsourcing in our public services. It is deeply disappointing.

The Social Democrats believe in a public universal health system under which people have access to dental care as a human right and a basic human need. Dental care is interconnected with so many aspects of our lives. The problems have been outlined, including underfunding, under-resourcing and understaffing.

I want to speak about children and dental care. Since 2023, more than 100,000 children nationally have been missing dental checkups annually. Two thirds of posts advertised remain unfilled as the staffing crisis worsens. A total of 65% of dentists have said that staff shortages impact on the care of their patients and their capacity to deal with emergency appointments. Delays in visits result in escalating need. Delayed intervention requires more intensive and emergency care, particularly for children. It is no different to early years intervention for additional needs in education. Dental intervention in children is key to preventing the much more expensive and traumatic procedures that must happen if we do not have proper preventative care and intervention.

Dental care is an extreme financial burden on families. Children are suffering as a result of the lack of dental care. As I have said, oral healthcare is not a luxury; it is necessity. The current model of access denies children this necessary care. Dental health and general health are not two separate things; they are intertwined. Unfortunately, as a result of the cost-of living-crisis, people have far less disposable income. The Irish League of Credit Union's annual back-to-school survey has found that one in three parents will get into debt to cover back-to-school costs. Along with covering rising rents and the rising cost of food, families have to consider whether they can afford to go to the dentist. What does this mean? It is an incredible decision when we think about it. Families have to decide whether or not they can bring their child to the dentist. They will put off this care. The child might be in pain but they put it off because they cannot afford it that week. Then it ends up being a much worse situation. Parents have to choose between food and going to the dentist. It is wrong that children should bear the cost and pain of inadequate public dental healthcare.

As recently as 2023, 104,000 eligible schoolchildren were denied screening appointments by the HSE's dental service due to a shortage of public-only dentists employed by the executive. The Irish Dental Association has voiced serious concerns regarding access to dental care for children. There are two-year waiting lists for treatments requiring general anaesthetic, as my colleague Deputy Quaide outlined, with decisions having to be made on which children have the greatest need. This is a sanitised way of saying dentists are being forced to choose which children are in the most pain in order to treat them first.

In my constituency of Dublin North-West, the number of dentists contracted to the dental treatment service scheme in January 2024 was a shocking 31. Almost 20,000 children in Dublin North-West are being treated by 31 dentists. It is a simple and sad fact that these children will not receive the oral and dental care they need and deserve. Figures released by the HSE in February indicate that 6,289 children were registered as new patients for scheduled assessments Dublin North-West. This cohort is to be assessed by 31 dentists and is in addition to their current patients. Acute need for dental care impacts on vulnerable children and children with additional needs. Children with autism or special needs face extremely long waiting times as they often need more specialist care and there is no staffing capacity for it.

It is clear that chronic underfunding, historic under-resourcing and, I would argue, a lack of commitment to a public dental care system and model, have resulted in this crisis. It has to be addressed. Children cannot be allowed to languish on waiting lists without access to appropriate healthcare or to suffer the pain and indignity of poor access to the dental care that should be available as a human right and a public need. It is the least we should be doing in a republic that is committed to cherishing all children of the nation equally.

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