Table 2 Irish National Oral Health Policies 1994–2019
From: 'Toothless’—the absence of political priority for oral health: a case study of Ireland 1994–2021
Title | Year | Document | Key findings | Main recommendations |
|---|---|---|---|---|
The Dental Health Action Plan | 1994 | An action plan published as part of the national health policy-Shaping a Healthier Future: A strategy for effective healthcare in the 1990s The current policy guidance for all publicly operated dental schemes in Ireland in 2021 | No systematically organised care for pre-school children Care for primary school children is uneven Poorer oral health in medical card holders Increased demand for orthodontics Poor services for those with additional needs | Goals for reduced dental decay across population by 2000 Continue & increase fluoride use (water & toothpaste) with support from industry Consolidate & extend targeted school dental services Extend eligibility for care to age 17 Care for adult medical holders through new scheme (DTSS) |
Draft National Oral Health Policy | 2009 | Unpublished by the Department of Health | Oral health has improved since the introduction of the Dental Health Action Plan for some groups However improved oral health not observed in medical card holders or children under-age-5 Mismatch between peaks of childhood caries and age range the PDS focuses on Deficiencies in care for those with disabilities, special needs and elderly in long stay institutions Overlaps between DTSS and DTBS schemes with co-ordination mechanisms lacking to ensure cost effectiveness and equity | Administration of DTSS and DTBS merged to enhance equity and reduce administration costs PDS: Refocus resources to address need, improve data management andmonitoring of outcomes with a senior clinical manager to head service Identify people with special needs and social disadvantage for appropriate oral healthcare Enhance the regulatory regime governing oral healthcare Recognise specialty of Special Needs Dentistry immediately. Progress specialisation in Public Health Dentistry following new arrangements in PDS Allow dental hygienists operate independently Continue water fluoridation Integrate oral health promotion with general health promotion |
Smile agus Sláinte | 2019 | National Oral Health Policy No implementation strategy published by the end of 2021 | Inequalities in service provision for very young, vulnerable, those with disabilities and elderly Decline in dental decay since 1980s 30% of 5-year-olds, 40% of 12-year-olds have dental decay Symptom led use of services for children under age 6 Poor uptake of oral services by the elderly, rising incidence of head and neck cancer in older groups Three times more dental practices owned by private practitioners than HSE premises Current service not designed to deliver prevention and is not a comprehensive primary care service | 41 actions, DoH leading transformation over 8-years Primary oral healthcare approach with Sláintecare ideals Reorient service into 3 streams: primary care (independent practitioners), community care (HSE salaried practitioners) and advanced oral healthcare centres Care delivered through packages, defined by age Care for adults via medical card only All access will begin at primary oral healthcare, referral to secondary and tertiary care for one off treatment Upskilling of HSE practitioners required National oral health evaluation programme with WHO indicators Oral health promotion programmes for disadvantaged and non-fluoridated areas Topical fluoridation programmes for under-6’s not supported |