Children are now waiting up to four years for orthodontic treatment in the public system, new figures show.
And data provided by the Health Service Executive (HSE) to an Oireachtas committee yesterday confirms that children can also be waiting years for assessment before they are put on a treatment waiting list.
In the south, they can be waiting up to four years to be assessed if they are eligible. If eligible, they can remain on a treatment waiting list for a further four years.
In the midwest, the waiting time for assessment can be up to three years and the waiting time for treatment can be another three years.
In the north-west, children can be waiting over two years for treatment, while in the east, west and south-east the waiting time for treatment can be up to 18 months.
The HSE now intends using the National Treatment Purchase Fund to target the backlog, the Oireachtas Committee on Health and Children was told.
The committee was also told that international guidelines are to be adopted here from this summer for determining which children in the State should in future be eligible for orthodontic treatment in the public system. As a result, considerably more children will become eligible for treatment. The plan to implement the international guidelines is based on a recommendation from a review group set up by the HSE. Its report is to be published shortly.
The review group has also recommended that a model of orthodontic training similar to that provided for dentists in the midwest up to 1999 should be reinstated.
The chairman of the review group, Hugh Kane, told the committee that when the new guidelines for assessing children's eligibility were put in place he hoped that no child would have to wait longer than six months for assessment and, after that, no longer than 12 months to get into treatment. But he confirmed that no such targets had been set down in the review group's report.
Figures he presented to the committee showed that 6,523 children were waiting for assessment and another 10,025 were awaiting orthodontic treatment at the end of last September. The number awaiting treatment in 2006 was slightly above the 2005 number.
Mr Kane said that about 7 per cent more children would be eligible for orthodontic treatment when the new guidelines were introduced.
At present, Department of Health guidelines which date back to 1985 are used to determine eligibility. However, the guidelines are interpreted differently in some regions, and as a result children with overcrowded teeth were not considered eligible by all. Mr Kane said that these children would be accommodated under the new Index of Orthodontic Treatment Need (IOTN) assessment tool.
Questioned by committee members about allegations that some children in the past were damaged by the orthodontic service, Mr Kane said he was aware of children whose care had been "suboptimal" and who had appliances left on longer than they should have been and whose treatment had been interrupted.
Some committee members expressed disappointment that the review group could not reach agreement on how to deal with the historic grievances of a number of orthodontic consultants. Mr Kane said his group had recommended that an independent person, acceptable to all parties, should be appointed by the HSE's chief executive officer to investigate their complaints.
Recommendations
Orthodontic review group's recommendations
• The Health Service Executive should replace existing guidelines for determining eligibility for public orthodontic treatment with the internationally-recognised IOTN assessment tool.
• All staff should be trained in the use of the new guidelines.
• The new guidelines should be introduced within six to eight weeks of the training of staff in their use.
• Consultant orthodontist staffing levels should be reviewed in each region.
• The number of specialist orthodontists employed by the HSE should be reviewed every two years.
• Each region should examine all options to maximise use of existing resources.
• All waiting lists should be validated at regular intervals.
• The HSE needs to continue to access training for orthodontists in dental schools in Ireland and Britain, and through the use of outreach models, such as the distance-learning model that previously operated in the midwest.
• An additional senior lecturer should be approved for the Dublin Dental School.
• An independent person should be appointed by the HSE to investigate complaints made by three consultant orthodontists. These included claims that children were damaged in the past by the orthodontic services.