A letter to the Editor printed in todays Irish Times from DHF CEO Orlaith Kennedy and Board of Trustees.
Underinvestment in dentistry
Sir – I read with interest the recent Letter of the Day (“Austerity measures still biting in dentistry”, January 24th), which rightly highlights the long-term consequences of sustained underinvestment in public dental services.
However, the challenges facing dentistry cannot be understood without examining the policy decisions that have shaped the system over many years.
As the letter notes, the Minister for Health, Jennifer Carroll MacNeill, expressed concern on January 22nd that dentists are choosing to work in aesthetic medicine rather than treating children.
This is not a sudden or unforeseen development. Workforce shortages, recruitment difficulties and training constraints have been raised repeatedly at Oireachtas health committee hearings.
Workforce planning in dentistry cannot be separated from education, training and career pathways. At present, the only specialties recognised are orthodontics and oral surgery.
This severely limits career progression within the public dental service and weakens its ability to recruit and retain dentists and other oral health professionals to support the care of the most vulnerable.
A public service characterised by limited advancement and ongoing uncertainty will inevitably struggle to compete.
Dentistry, like other healthcare sectors, reflects rational decisions by universities, students and practitioners. Undergraduate dental places have remained largely static for decades, aside from the opening of the RCSI dental school, as a result of Government policy.
Capacity could be expanded by the State purchasing additional places at full economic cost. Wider societal support also influences career choices.
The absence of accessible, affordable childcare, for example, affects healthcare professionals across the system and shapes working patterns and retention.
Oral health is not the responsibility of any single profession or department. The Healthy Ireland Framework recognised it as a shared societal concern, requiring coordinated action across Government and public services.
Improving access to care for children and vulnerable groups will require sustained, joined-up policy responses.
Focusing narrowly on individual career choices risks deflecting attention from the structural factors that underpin current shortages.
If reform is to be meaningful and sustainable, oral health promotion and prevention must sit at the centre of our dental system, not at its margins.
Aside from the proven success of water fluoridation, prevention has never been prioritised in dental policy.
Yet prevention and a public health approach is how people retain their natural teeth for life, reduce inequalities, and avoid costly and complex treatment later on.
At the Dental Health Foundation, our focus is on promoting prevention and better oral health across the life course.
Healthy teeth, gums and mouth are the most functional outcomes, often the most attractive, and they remain the true foundation of sustainable oral health reform. – Yours, etc,
ORLA KENNEDY,
Chief executive,
Dental Health Foundation Ireland,
Dublin 18.