More than 21,000 children are on orthodontic waiting lists across the State but the true numbers of those requiring treatment could be much higher, an Oireachtas committee heard yesterday.
Orthodontists have been told not to put on waiting lists the names of children who have no realistic chance of being seen due to the shortage of specialists.
The Department of Health's chief dental officer, Mr Gerard Gavin, told the Joint Oireachtas Committee on Health and Children that severe cases had to be seen first. It was "inappropriate" to put children on an orthodontic waiting list if there was "no prospect whatsoever" of them receiving treatment.
His comments led to an accusation from committee member Dr Jimmy Devins that the waiting list figures were being massaged. Ms Fiona O'Malley said she didn't think it at all appropriate that children's names be left off waiting lists.
Ms Beverley Cooper Flynn said the lists were "manicured" to ensure they were manageable.
The Department rejected this assertion. Mr Tom Mooney, assistant secretary, said the figures were those presented by health boards to the Department. There were 11,846 children awaiting orthodontic assessment at the end of March and a further 9,362 awaiting treatment. Waiting times can be up to three years.
However, Mr Mooney stressed there were a further 20,200 children receiving treatment.
He said the Department was addressing the staffing issue by sponsoring orthodontic training for 20 dentists in Dublin, Belfast, Cardiff and Leeds. The training costs the State €1 million a year.
The dentists would have to spend three years working for the health boards after qualifying but there was no guarantee they would all stay in the public sector, he added. But he hoped the Department's decision to create a new career structure would entice them to stay.
In the meantime, the provision of services will continue to be based on prioritisation of cases based on treatment needs under 1985 guidelines, he said.
Committee chairman Mr Batt O'Keeffe said the guidelines were being interpreted in an arbitrary way which was totally unsatisfactory. He wondered if parents had a legal case against health boards.
Mr Mooney said clinicians had to have some discretion in interpreting the guidelines. When there were more staff, the plan was to move to internationally recognised guidelines for orthodontic assessment.