HSE dental policy puts children's health at 'serious risk'

Dental Protection says advice regarding routine fillings 'flies in the face of patients' best interests', writes JOANNE HUNT

Dental Protection says advice regarding routine fillings 'flies in the face of patients' best interests', writes JOANNE HUNT

A dental indemnity body has said that a HSE memo advising dentists not to fill cavities in children’s teeth exposes children to harm.

Dental Protection, which provides legal advice and indemnity to dental health professionals has said that dentists adhering to the HSE memo which instructs them “not to provide routine deciduous fillings” could leave children “at serious risk of pain, discomfort and even worse, abscess, sepsis and hospitalisation”.

The concerns about the HSE memo were made by a paediatric dentistry consultant in Dental Protection’s magazine, Riskwise.

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The HSE memo, sent by principal dental surgeon Dr Joe Mullen to dentists in the Sligo/Leitrim area, states that “routine filling of deciduous (baby) teeth is not indicated by the available published evidence and may cause more harm than good”. The memo says: “Accordingly, dentists are instructed not to provide routine deciduous fillings.”

The memo goes on to say that while dentists are not prohibited from filling a deciduous tooth, “such fillings should be exceptional and be prompted by an obvious health gain for the patient”.

Dental Protection says the HSE policy statement “flies in the face of patients’ best interests, is not supported by contemporary evidence and leaves the clinician in a difficult ethical position”. It says that “there is strong evidence that children with severe caries [cavities] weigh less and that after the caries was treated, body weight increased and their quality of life improved”.

Meanwhile, president of the Irish Dental Association (IDA), Dr Billy Davis, said the appointment of a chief dental health officer (a post now vacant for seven years) “to review and update government dental health policies would have avoided the current confusion on the provision of services to children”.

Dr Davis went on to say that “recent government decisions on dental health are undermining the substantial progress on dental health in Ireland over the past 50 years”. He said: “We’re in danger of entering a new era of dental poverty where people without access to private dentistry are effectively penalised.”

A spokeswoman for the HSE said “this system has always been the case” and the memo “is purely a reminder to dentists to ensure that they work to the Dental Treatment Scheme for Children guidelines”. She said: “If a child is in pain, then treatment is obviously provided . . . however there is little to be gained in putting a child through dental treatment if the tooth is liable to be replaced with a permanent tooth.”

Dental Protection told Irish dentists that it seems that “the main issue that has driven this policy is a lack of resources”. The article goes on to say that “leaving disease untreated routinely as a matter of policy is not only indefensible but will expose children to serious harm”.