As the Republic of Ireland awaits its new oral health policy, in Northern Ireland the plan is to focus on specific age groups

As this edition of Ireland’s Dental magazine was heading to print, Northern Ireland’s Department of Health published a consultation response paper: Oral Health Improvement Plans for Children and Older Persons. In an accompanying background note, the department was unusually candid about the likelihood of developing a new oral health strategy that covers the whole population.

“The current Northern Ireland Oral Health Strategy (OHS) was published in 2007,” it said. “In the absence of the significant resources required to develop a new wide-ranging strategy, the Department of Health has determined that the two groups of the Northern Ireland population that would benefit most from updated oral health improvement plans were children and older people.”

The paper notes that a child’s oral health is recognised as being a contributing factor to their healthy development and it has been seen that if preventative interventions are established at an early stage, children have a higher chance of establishing healthy lifetime habits.

At the same time, improved oral disease prevention throughout the course of people’s lives has led to an increase in the number of older adults who are retaining some of their natural teeth. However, as people become older self-care tends to deteriorate and there is a tendency to rely on others for care. This older cohort the population is at increased risk of dental disease and oral health problems.

Judging from the language used in the consultation – it speaks about being in “a time of significant financial challenge” – it would appear that the department has made a tough, but necessary, decision; unable to fund an overarching oral health strategy, it has decided to focus on two key groups, namely the young and the old.

Given the financial challenges faced by the governments throughout the UK and the Republic of Ireland, it is a sound decision. Concentrate on the young, so that good oral health habits can be formed that last through life. Concentrate on older people, whose health can be fragile and who deserve additional support.

That, of course, leaves a big swathe of the population in between. But it can be safely argued that sufficient knowledge and resources exist for this group of adults who should really take responsibility for their own health (albeit there are some sub-groups within this group – the homeless, for example – who should have access to support for their oral health).

So-called Improvement Plans for the young and the old already exist. They identify a range of strategic and ambitious recommendations for progression, which reflects the significant amount of work needed in these areas. Implementation of many of the recommendations made will require business case approval and funding. Hence the need for the consultation, to bolster the department’s case.

It is particularly keen to hear from those with experience of children’s dental services and older person’s dental services, both in general dental practice and in Northern Ireland’s Health and Social Care dental clinics. Also, from organisations that provide support to children and older persons, frontline healthcare professionals, schoolteachers, classroom assistants, care assistants and care home managers, academics and researchers, and the public.

As we report this issue, dentistry in Northern Ireland “remains on the brink”, according to the British Dental Association. The latest Family Practitioner Services Dental Statistics, published in June, show that just 821,835 patients were treated in the year 2023 to 2024 – 79% of the pre-COVID norm and only a 2% increase on last year. Registration numbers fell by 1,825 for children and 43,008 for adults, reflecting the growing number of practices moving away from the NHS.

In the Republic of Ireland, the waiting game continues; the roll-out of its ‘new’ oral health policy, Smile agus Sláinte, which was published way back in 2018, is still yet to happen. Ireland has the fewest dentists per head of population out of 24 European countries, according to a study by the International Dental Journal (IDJ). A significant number of children in Ireland are not getting regular dental check-ups, noted the IDJ.

Action – overarching or targeted – to tackle the oral crisis in Northern Ireland and the Republic of Ireland cannot come soon enough.

Tags: consultation, health, improvement, oral, reports