Only 25 dentists in Co Kerry and 13 in Co Clare currently accept medical card patients, while in Co Cork just a quarter of the 200 participating dentists are based outside Cork city, according to new figures from the HSE.
Nationwide, dental services for more than 1.5 million medical card holders are in “a state of almost permanent collapse,” the Irish Dental Association (IDA) has warned.
The shortage is also affecting private patients. An IDA survey last year found that 25% of dental practices were not taking on new patients.
A national dental policy published in 2019 has yet to be implemented, despite years of work on an action plan. This delay comes as eligibility for medical cards has expanded, following a government decision to raise income thresholds.
IDA chief executive Fintan Hourihan said the dental workforce has not grown to meet rising demand. While waiting lists attract attention, he said the larger issue is the unknown number of people receiving no dental care at all.
“People are becoming increasingly aware of the consequences, as their oral health continues to decline,” he said. He added that oral health inequalities are stark, with those on lower incomes suffering most when public services fail.
A routine clean and polish can cost from €80 privately. Workers paying PRSI are entitled to one such appointment each year for €15. Under the HSE dental scheme, private dentists are paid to treat adult medical card patients.
Before the pandemic, around 1,400 dentists participated in the scheme each year. That number fell to 1,151 in 2021 and dropped sharply to 810 by 2024, the latest year for which data is available. In the north Tipperary and east Limerick region, just 20 dentists remain in the scheme, while Mayo has only 25. Mr Hourihan expects further declines in 2025.
He said many dentists believe the scheme is no longer viable due to excessive bureaucracy and payments that fail to cover costs. “They can’t afford to run their practices at a loss,” he said.
High demand for private care has given dentists alternatives to HSE work, while some have moved into cosmetic treatments such as Botox and dermal fillers.
Mr Hourihan called for “an entirely new system” for medical card patients and warned that delays in reform could be critical. “This may be the last chance to fix our dental crisis,” he said.
Fine Gael TD Colm Burke also raised concerns about gaps in dental care for both children and adults. “Access to dental care should not depend on the ability to pay,” he said.
He backed the IDA’s call for reform and urged increased recruitment in Cork and Kerry, adding that children deserve timely preventive care rather than years on waiting lists.