More than 13,200 children deemed in urgent need of orthodontic treatment are stuck on waiting lists, including 2,772 children who have been waiting over four years, new HSE figures show.
A senior HSE official said the reason for the waiting list was that “demand for services exceeds the current capacity”, while dentists are warning the impact is worst for vulnerable, low-income children.
Children are usually referred for orthodontic treatment during sixth class in primary school with the most urgent cases sent to HSE services.
Figures for September, however, show among those graded five, meaning the most severely affected, 1,136 children have been waiting over four years out of a total of 6,572 children on waiting lists at this grade.
These children might have over-bites or tooth overcrowding affecting their speech or ability to swallow. A total of 1,352 children are waiting between 37 and 48 months for treatment, while 1,936 children are waiting between 25 and 36 months.
In the south-east alone, 1,795 children are waiting for this high level of urgent care, making it the worst-affected area, followed by the south with 1,386.
Children assessed as being grade four have not fared any better, with a total of 6,490 waiting, including 1,636 for over four years. The largest group on this list are children waiting 25 to 36 months, with 1,805 seeking treatment.
“The demand for services exceeds the current capacity to provide the service and, therefore, waiting lists apply across all community healthcare organisations and in the Saolta hospital group area,” said the HSE in response to a parliamentary question from Sinn Féin health spokesman David Cullinane.
National oral health lead for operations, Joseph Green, wrote in his response that a waiting list initiative in 2016 saw 1,996 children sent to private providers, paid for by the HSE. So far under the latest initiative, 676 children have accessed private care.
The pandemic has added to the challenges, with Mr Green saying staff redeployment means even these high figures are “incomplete”. However, the data shows these problems did not start when Covid-19 hit.
Figures given for 2018 are not separated into grades of severity, but show across the country, 18,182 children were on waiting lists. These included 1,170 children waiting over four years.
The south-east was one of the worst-hit with 253 children waiting that long.
By 2019, the overall figure had grown to 19,035 and the south-east again topped the list with 517 children waiting over four years.
Fintan Hourihane, chief executive of the Irish Dental Association, said there is a “sense of despair” among dentists at growing waiting lists for children.
The problem is particularly acute, he said, for families who cannot afford private care to fill the gap.
“We have a real problem, there is going to be long-lasting damage which is going to consign children, particularly in low-income groups, to many years of misery and irredeemable dental decay,” he said.
A screening service aiming to see each primary school-age child three times is, in reality, achieving once or twice, and often only in sixth class when problems may be already severe, Mr Hourihane warned.
“The public dental service is grossly understaffed, the number of dental staff has fallen by 23% in the past decade, but the number of eligible patients, ie, those under 16, has risen by 20%,” he said.
Mr Hourihane also estimated the true figure is higher, up to 100,000, if children missing out on assessments are counted.