Ireland's Differing Dental Systems Share Problems
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- Published: Thursday, 26 June 2025 07:43
- Written by Peter Ingle
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On both sides of the border, there are problems with access to dental care on the island of Ireland. Despite different governments and different systems for providing care, an ever diminishing chance of getting to see a dentist appears to be a shared experience.
The North retains a fee per item system for adults, plus a little under £13 a year in capitation payments. Before older dentists in England get too nostalgic, in 2025 the fee for a regular examination stands at £10.95 and for a precious metal based bonded crown a few pence under £174.
With their pleas for better funding consistently ignored, Northern Irish dentists have been steadily reducing their commitment to the NHS. The change in Government in Westminster has not altered this.
Recently released statistics from its Family Practitioner Services for 2023 to 2024 show the number of treatment claims submitted and paid for adults, has dropped compared to the previous year. The number of patients seen has dropped by a fifth from pre-COVID figures. In this part of the UK which has the highest oral health needs, registration rates among adults and children have now fallen to the lowest levels in a generation with just 50% of adult patients registered.
In 2023/24, the most recent year in which comparable figures are available, Northern Irish dentists filled the largest number of teeth per 100,000 population of any UK nation, a rate over 50% more than England. With 257,000 less patients registered since 2024, the British Dental Association Northern Ireland has warned that the recovery in NHS dental services has stalled, and there is no real urgency from the government to tackle the problem. In Fermanagh and Omagh just 35% of adults remain registered.
An already struggling service has been hit by huge new costs as the result of the last UK Budget. The BDA has called for immediate short-term ‘bridging’ support for dental practices as a lifeline to cover costs, and sustainable long-term funding. Ciara Gallagher, Chair of the BDA Northern Ireland Dental Practice Committee, said: “It’s clear that a sticking plaster approach rather than the radical overhaul needed is putting HS Dentistry out of reach for a sizeable portion of our population. Fewer patients are getting the care they need, vast numbers are no longer on even our books, and many practices are moving away from a broken system.” Her conclusion was that, “without meaningful reform and sustainable funding, this service won’t have a future.”
In the Republic there is a shortage of dentists despite a very different system of payment.
State provided free dental services are only available for adults with a means tested medical card and provided through the Dental Treatment Service Scheme (DTSS). Many of these patients are limited to a dental examination, cleaning, extractions and 2 fillings per year. Whist this may look quite different to the NHS, when it comes to the workforce and their dwindling public sector commitment, a familiar pattern emerges.
There were 810 dentists with a Dental Treatment Service Scheme contract in 2024, down from 1,452 in 2012. The Irish HSE, similar to the UK CDS has also seen a drop in headcount while at the same time the number of children waiting for their first appointment has increased.
An Irish Dental Association survey found that nearly two-thirds of dental practices that tried to recruit in the year to May 2023 could not fill their vacancies for dentists. As a result, a quarter of practices are not able to take on new private adult patients.
In Ireland, TD’s just like their MP counterparts in the UK, have their own ideas on how to improve access. Cork North Central Deputy Colm Burke claims to have a quick and easily implementable solution to increasing the number of dentists in Ireland. The country can have more qualified dentists by increasing the number of places available to Irish students on the undergraduate dental courses at University College Cork and Trinity College Dublin.
Deputy Burke said: “Irish student places in Trinity or UCC have not increased in 25 years. While a new course is commencing in RCSI (Royal College of Surgeons of Iceland) in the Autumn, and this is welcome, the number of Irish students in both UCC and Trinity is not increasing.
“In 2023, there were 61 final year dentistry students in UCC and 46 dentistry students in Trinity College Dublin. This year, 36 final year students in UCC and 21 in Trinity were from non-EEA countries. Half of the places were allocated to non-EEA (European Economic Area) students.
“Due to the reliance on non-EEA students to cross-subsidise the funding of the dental schools, graduates from Irish dental schools have only made up about a third of those registering with the Dental Council for the last 15 years. If additional funding was provided to increase the number of places allocated to Irish students, we would see more dentists working in the Irish system, making it easier for people to access dental services and reducing waiting lists.”
TD Burke called for an increase in the allocation of number of places on dental courses and the necessary funding to be provided to support this.
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