The Irish Dental Association is calling on the Government to make public dentistry a priority, as it claims the system is in crisis and the most vulnerable are suffering.
It says patients are finding it increasingly difficult to access essential care particularly in the public system with a capacity crisis across the country.
In the Midlands, the problem is particularly acute with just one dentist treating medical card patients in Co Laois.
The school dentist scheme has also reached crisis point according to dentists in Laois, with some students not seeing a dentist until 4th year in secondary school, when they should be seen in 2nd class.
28-year-old Paige Langford from Emo in Co Laois is waiting to have two wisdom teeth removed.
Her mother Carmela said she was told her daughter, who has a medical card ,is not eligible for treatment.
"A year and a half ago we discovered Paige had two wisdom teeth and she would have to get them removed," explains Carmella.
"Paige has Prader-Willi Syndrome so she doesn't feel a whole lot of pain but she's uncomfortable, it stops her from eating and impacts her blood sugars, and because she has diabetes that can cause a lot of problems.
"The dentist here in Portlaoise transferred her to Dublin for treatment but we got word that Paige didn't qualify, and we have to go private, but we're still waiting to hear. We don't know how long it could be and how much it will cost."
Enda Whelan runs Churchview Dental practise in Portlaoise. He no longer takes medical card patients as he says the system is not fit for purpose.
"I set up here 25 years ago and back then all five practises in Portlaoise were operating the medical card scheme and you could see all medical card patients and offer them a full set of treatments.
"Now it is limited, and you can only provide the patient with the basics. It's basically an emergency service and there's no dentist operating the scheme here now. In fact, in the whole of Laois, there's only one dentist operating the scheme.
"This has had a dramatic effect on people's treatment. It means they can't access routine treatment and they're presenting very late, and they often are in a lot of pain with swelling and inevitably we are extracting teeth.
"It's very disappointing to think 25 years on we are extracting the same amount of teeth as we were then."
Mr Whelan said the pressure on dentists is also impacting on the health service.
"Only last week I had two patients come down to me in one day who were referred to me from the emergency department. One person had been kept in overnight."
He also said the scheme which sees students examined in primary school is in "dire straits".
"I used to work on that scheme too. I used to see students in 1st, 4th and 6th class. I had a patient ring here last week. Her daughter, who is 15 years of age, had only been seen by the school dentist for the first time. It's too late then. You need to get in and sort out problems early," he said.
'A demand-led scheme to a budget-led scheme'
The Irish Dental Association, IDA, says staffing has become a very serious issue.
A recent survey found 65% of dentists have been unable to recruit a candidate for dentist positions and over half of dentists have been unable to recruit dental nurses.
Regarding the Dental Treatment Services Scheme, which is open to medical card patients, the IDA said cuts imposed by the HSE in 2010 have altered it from a "demand-led scheme to a budget-led scheme".
The IDA said there are now barely 600 dentists operating the scheme nationally.
The Irish Dental Association wants reform of the scheme for medical card holders. It also wants an increase in recruitment of HSE public service dentists.
CEO Fintan Hourihan said the Government needs to sit down and talk to dentists.
"What we're now seeing is many years of neglect has transformed what was a poor service into a state of crisis. We're dealing with an emergency where patients simply can't be seen, or patients are having to travel half the length of the country to get another dentist to see them.
"The Government is doing nothing about it. The Budget only confirms it has no interest in dentistry. We've been waiting for last three years to talk to the Government about changes to the various schemes, but until they actually sit down with us this situation is going to get worse, if that's possible.
"Nobody can have good general health, if they don't have good oral health. The people are paying the price, the most vulnerable, the people who most need help from the state, they're being ignored.
€200 million invested in oral healthcare services each year
In a statement to RTÉ News, the Department of Health said the Government is committed to fundamentally reforming dental services.
It said officials in the Department of Health engage with the HSE on an ongoing basis to understand and address any challenges arising in the provision of public dental services.
The Department said the Government invests over €200 million annually in the provision of oral healthcare in Ireland, targeting those most in need of State support to access care.
It said an additional €3.35 million was awarded in Budget 2024 to support access to orthodontic treatment for those patients who are most in need of orthodontic care.
The Department said the HSE continues to restore dental screening and treatment provided by the Public Dental Service to children up to 16 years of age through recruitment initiatives, prioritising clinical treatment and patient groups and reallocating clinical resources, according to greatest need.
In relation to the Dental Treatment Services Scheme, the Department of Health said the number of medical card patients accessing care and the numbers of treatments being provided have increased since May 2022.
It said the number of dentists on the Dental Council register has increased by 109 compared to March 2023 and currently stands at a total of 3,581.
