Senior HSE official Pat Healy said in the school year covering 2024 and 2025 around 216,000 should have been screened in these classes.
An estimated that around 70,000 were not assessed but “we try to follow them through and have them seen by junior cert,” he told Sinn Fein TD David Cullinane.
HSE and Department of Health officials were being quizzed at the Oireachtas health committee where earlier the Irish Dental Association warned of a crisis in free dental schemes for schoolchildren and medical card holders.
Labour TD Marie Sherlock said she was told by one public health specialist that children who lost out on screening in primary school are being assessed so late that some are driving to the HSE clinic and nearly finished their education by the time they are called.
She said she was told that children with special needs in parts of the country are having to travel many miles to different counties for dental care.
Serious dental and orthodontic problems are not being picked up early due to the lack of school screening, the dentists warned.
Dr Bridget Harrington Barry, a HSE dentists in Galway said there are particular difficulties with delays faced by children with special needs who need sedation during treatment.
She has got hospital beds for scheduled appointments for her paediatric patients which cannot be used for other patients in University Hospital Galway, and this has made a big difference to her waiting list but this was not the case in other areas.
A special clinic closed in St James’s Hospital in Dublin some years ago and another was due to open in Connolly Hospital but this has not happened.
Sinn Fein TD Sorca Clarke said she was aware of a five year old child with special needs who is in pain but waiting for specialist dental care.
Committee chairman deputy Padraig Rice criticised the failure to produce an implementation plan for the oral health policy published before the pandemic.
Fintan Hourihan, chief executive of the Irish Dental Association said that with only 600 dentists now left in the scheme to provide free care to medical card holders, a whole new scheme is needed.
The issue is not just one of fees but the limited treatments the dentists can provide, he added.
Tony Canavan, regional executive officer of the West and North West HSE region, said that following the introduction of a number of changes and fee adjustment in May 2022, there has been a significant increase in activity under the dental scheme for medical card holders.
In 2025, over 307,000 adults received care under the scheme —up 20pc on 2022. More than 1.05m treatments were delivered last year, a 30pc increase over the same period. Investment has grown by 43pc with €69.9m paid to contractors in 2025.
“Dental services for children under 16 years are delivered through 17 dental areas nationwide. In the period to November 2025 over 138,000 new patients were assessed, including 94,800 under targeted programmes in respect of school and special care programmes with over 40,000 others assessed in the non-target groups including emergencies,” said Mr Canavan.
He said the “HSE provides orthodontic treatment, free of charge, to children who meet defined clinical criteria under the HSE Orthodontic Guidelines Waiting list initiatives. These initiatives have delivered a significant impact over recent years.
“Over €20m has been invested in contracted orthodontic care, resulting in more than 5,200 removals from waiting lists. A dedicated orthognathic surgery programme has supported 206 patients to date, addressing complex needs that cannot be met through orthodontics alone.”
However, he acknowledged that acess to dental services remains a significant challenge for some groups of patients. In addition, access to services in some parts of the country is particularly challenging.
“We acknowledge the impact that this has on patients and are committed to making every effort within the resources available to us to improve access to all dental services,” he said.
There are currently 373 staff working across the HSE services including consultant orthodontists, dental surgeons, dental nurses and hygienists.
While progress is evident, challenges remain. Recruitment and retention of dental professionals continue to impact service delivery, particularly in the public dental service.
There are persistent waiting times for orthodontic and complex care require sustained investment and innovative solutions.
He said access to sedation and general anaesthetic facilities for patients with additional needs remains a critical issue, given the demand for hospital-based resources.
