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The cost of austerity? Irish children aged 6 are getting teeth extracted under general anesthetic

Previously, Irish children received free dental check ups in 2nd, 4th and 6th class but there has been huge cuts to those services.

THOUSANDS OF IRISH children are being put under general anaesthetic to have their teeth pulled because of failures in the Irish dental system.

Every year, some 10,000 children are undergoing painful operations because routine screenings are no longer taking place and issues are not being identified in time.

Confirming the distressing statistics for TheJournal.ie, Irish Dental Association chief executive Fintan Hourihan said the average age for children undergoing such extractions is now just six years old.

Some children are having more than nine teeth extracted,” he added.

Previously, Irish children received free dental check ups in 2nd, 4th and 6th class. However, austerity measures in the wake of the 2008 crash have seen massive cuts in services.

In 2015, at least 16,000 primary school children who were due a school screening did not receive one.

As local politicians attempt to highlight the issues in their areas, the HSE has admitted the problems are country-wide.

Sinn Féin Councillor Mark Ward says concerns of parents in Clondalkin, Dublin 22 have been heightened by the closure of two nearby dental surgeries, Booth Road and Deansrath. He said:

Not only have 2nd and 4th class check-upsbeen eradicated but there is a danger that due to lack of dental resources that children will not receive their 6th class check-up.

In a letter seen by TheJournal.ie, the HSE told Ward that the situation “is not unique to Clondalkin” and that “some areas offer appointments to 6th classes only and emergency services to other children under 16″.

hse dentist

In a separate statement to TheJournal.ie, the HSE said it ”provides all children with a check-up and primary dental care at least once between the ages of 11 and 13 (6th class)”.

It added that the Public Dental Service (PDS) provides pain-emergency treatment to all children under 16 years of age and “routine dental examinations and care for school children at key stages of development”.

The majority of HSE dental services also provide for children between the ages of six and eight years of age and the HSE is currently endeavouring to ensure equity of access to this age group in every area.

However, the Irish Dental Association pointed out that “figures for six community care areas – for which exact numbers are available – show that almost 16,000 primary school children missed their school screening in 2015″.

“A partial screening service at best is on offer in most other counties,” it continued.

Numbers not adding up

Hourihan also revealed that dentists in some areas are ‘pulling out almost as many children’s teeth as they are filling’.

It is a stark example of how bad the situation has become, he says.

One parent told TheJournal.ie that her child’s hygienist said they hadn’t seen this type of tooth decay in over 30 years.

shutterstock_393626509 Source: Shutterstock/santypan

Discussing how 10,000 Irish children are having extractions under general anesthetic every year, Hourihan said, “There is no way this level of extractions should be happening in a first world country.

For example, the situation in Laois/Offaly is simply shocking. In 2015, in Laois, dentists carried out 1,200 extractions and 1,800 fillings. In Offaly it was 915 extractions and 1,100 fillings.

“We believe this is a direct result of the collapse of the school screenings in these areas as children in these counties are not being seen until they are in first year in secondary school.”

There is also a lack of dentists working within the public sector contributing to the problem.

Hourihan conceded that while the under-16 population had increased by 20% over the past decade to 1.1 million, the number of dentists in the Public Dental service charged with looking after their oral health had dropped by 20%. However, he says this is due to a recruitment embargo.

“In Laois the number of under 16s has increased by 40% since 2002 but the number of dentists has fallen by 42% since 2008,” he said.

Undisputed figures

The figure of 10,000 children going under general anestheticwere initially refuted by the HSE and the Health Minister at the time Leo Varadkar.

Speaking on RTE’s Morning Ireland in October 2015, Varadkar said, “I’m informed by the HSE and the chief dental officer that the IDA is incorrect, that there are 3,600 such cases in Ireland, not 10,000 and that includes day cases and may even be an over-estimate.”

However, TheJournal.ie can verify the Irish Dental Association figures after seeing a draft report from the HSE published just two months later.

The report confirmed that there were 8,601 inpatient dental procedures carried out on children under 15 years of age and also explained that many operations carried out under general anesthetic are not recorded.

Minor surgical procedures, such as extractions and/or restorative care under local anaesthesia, do not trigger an admission to hospital and as such are not recorded on HIPE (Hospital Inpatient Inquiry).

This includes the 3,000 plus children who were treated each year in the St James’ Clinic prior to its closure.

The draft ‘National Clinical Programme for Paediatrics and Neonatology model of care for paediatric healthcare services in Ireland’ report also states:

Unfortunately, much dental activity under general anaesthesia (GA) is not recorded on HIPE, so the recorded figure likely represents a gross under-representation… The lack of accurate HIPE data leads to underfunding of services.

Most vulnerable at risk 

Problems within the dental sector are hitting the most vulnerable people – the youngest and oldest people in society.

Earlier this month, one of the country’s most senior dentists told TheJournal.ie that the lack of appropriate dental care for the elderly is causing “untold damage” to the oral health of thousands of nursing home patients.

Irish Dental Association vice president Dr Anne Twomey said, “Patients who’ve kept their own teeth into old age can lose them in as little as three months

Very often the situation has reached crisis proportions by the time I’m called in and I have to take out 15 to 20 teeth over a short period of time.

HIQA said it was aware of the situation agreed that “a greater emphasis should be placed on good oral hygiene and the provision of dental care in nursing homes”.

7939 Simon Harris_90503364 Source: Sam Boal

Hourihan has called on the Health Minister Simon Harris to intervene in the situation, first calling for the return of school screenings immediately.

“If we are serious about turning back the clock on years of cut backs and mismanagement we need to establish a dedicated budget for HSE dental services and we need a full-time HSE Director of Oral Health and a full-time Chief Dental Officer independent of the HSE to be appointed,” he added.

Read: Lack of dental care sees nursing home patients needing up to 20 teeth extracted at once>

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