A "mass withdrawal" of dentists from a Health Service Executive scheme to treat medical card holders is leaving children and adults with special needs with only an emergency dental service, according to the HSE's national lead for oral health.

Assistant national director with the HSE Dr Joseph Green warned that the oral health of medical card holders will suffer unless urgent action is taken "at the highest level" to address the departure of dentists from the Dental Treatment Services Scheme (DTSS).

The comments were revealed in a parliamentary reply to questions from Sinn Féin health spokesman David Cullinane.

In the past year, 208 dentists have left the scheme, leaving some areas of the country with only emergency cover.

The DTSS is a HSE run programme which allows private dentists to treat public patients.

However, hundreds of dentists have left the scheme in recent years, with many raising concerns that it restricts the number of preventative treatments allowed, such as fillings to save a tooth, while permitting an unlimited number of extractions.

Almost all areas of the country have seen dentists exiting the scheme, leaving some counties with little or no dental cover.

Responding to a question about dental services in Louth and Meath, Dr Green said: "The greatest threat to the ability of HSE dental services in Louth Meath to continue to provide elective care to children is the mass withdrawal of private dentists from the Dental Treatment Services Scheme (DTSS) for adult medical card holders.

"Unless the provision of basic dental services to adult medical card holders is addressed urgently at the highest level, the HSE Louth Meath dental service may be forced to confine dental services to emergency treatment only, to the detriment of the oral health of both children and adults in particular those with special care needs."

The Irish Dental Association has called for the scheme to be entirely redesigned to include more preventative treatments.

In a statement to RTÉ's This Week programme, the HSE acknowledged that medical card holders are having difficulties in accessing dental services in some parts of the country through the DTSS.

It said "where the HSE is notified that a patient is having difficulties, assistance is offered in helping them access a dentist".

"The HSE operates the DTSS within the parameters of the scheme and would welcome the opportunity to provide a modern dental service for adult medical card holders, with a strong emphasis on prevention," it added.

"The HSE is working closely with the Department of Health on addressing difficulties currently being faced by medical card holders in accessing treatment" and that the "Minister of Health has committed to a full review of the scheme, but this has been delayed due to the Covid-19 pandemic."