One in six Irish people over the age of 54 have lost all of their teeth, and some teenagers are requiring root canal treatment.
That is according to Dr Will Rymer, incoming president of the Irish Dental Association, who said tooth decay was a major problem for all age groups.
"A fifth of children are showing signs of decay by the age of eight," he told RTÉ News. "Half of 12-year-olds and three-quarters of 15-year-olds are affected by tooth decay."
Dr Rymer said having thousands of children waiting for urgent dental treatment amounted to "State-sponsored neglect".
The Dáil heard recently that 7,000 children were awaiting specialist dental treatment, with 1,000 on lists for a number of years.
"When you have delays of three and four years for children to be seen - particularly when they are in pain - to me that's not a delay anymore. It's a case of neglect."
Dr Rymer, who practices in Roscrea, Co Tipperary, said he will often refer a child for specialist treatment, but when he sees them for routine check-ups their condition has worsened.
"What was once a minor dental treatment that needed specialist intervention has now become a much more complicated case," he said. "We're now talking about root canal extractions as opposed to simple fillings."
The average age at which an Irish child sees a dentist is seven or eight - when the HSE school screening kicks in. But a shortage of HSE dentists means some are waiting much longer.
"I've seen a number of children from the Laois-Offaly area. They are, at times, not being seen until they get to Transition Year. They should have been seen in second class."
Dr Rymer said the HSE had lost dentists while the number of teens had grown.
"We need to recruit 120 dentists to the HSE to bring us to where we need to be," he said.
The Department of Health said the HSE's oral examination programme in primary schools had been impacted by capacity challenges in recent years. There are currently 34.7 posts vacant across dental healthcare grades, which the HSE is working to fill.
"The Government acknowledges the need to do more to support access to this current programme while transformation towards the new model of care proceeds through implementation of the National Oral Health Policy," a HSE spokesperson said.
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Dr Rymer said that the IDA was very concerned that medical card holders were under-served.
The main problem, he believed, was the limited number of procedures and treatments allowable under the Dental Treatment Services Scheme.
"I treated patients for a number of years under that scheme, and sadly the quality of their mouths deteriorated."
Dr Rymer left the scheme hoping it would be replaced by something better for patients and dentists.
"I genuinely believe it is State-sponsored neglect of that cohort of people," he said.
A statement from the Department of Health said 820 contractors, including dentists and clinical dental technicians, were operating the DTSS.
"In 2024, over 44,208 extra patients were treated and 227,691 additional treatments were provided nationally under the DTSS when compared with 2022."
The statement added that the Government was committed to reforming oral healthcare services.
"In Budget 2025, €2m was allocated for this year, increasing to €4m in 2026. This will be used to implement a national policy to support everyone achieve their personal best oral health and to reduce inequalities.
"It will be prevention-focused and tailored to each age group," added the statement.
The department said measures would include supporting families to reduce the volume of sugar in young children's diets, along with water fluoridation and other fluoride therapies.
It added that a new model of oral care would eventually see children attending community dentists instead of HSE dentists.
