ESRI research examines the potential cost of a range of dental care packages

The research estimated the costs of a number of potential care packages with the objective of informing a new national oral health policy. The new policy, Smile agus Sláinte, has also been published today by the Department of Health. The cost of the services proposed in Smile agus Sláintedraws on costs analysed for a number of different packages examined in the ESRI report.

The new oral health plan will provide services to all children under 16, who total 1.1 million, and all medical cardholders over the age of 16, who total 1.3 million. The ESRI analysis found that the services would cost between €49.5m and €83.9m in total, depending on the range of services offered and the number of people eligible for them. The final packages proposed by the Department of Health in Smile agus Sláinte include components from a number of different packages examined in the ESRI research and would cost €48m for adult medical cardholders and €32m for children per annum.

For both adult medical cardholders and children, estimates are provided for a core package of preventive dental healthcare services, as well as for alternative packages that differ in terms of the eligible population, treatment frequency and available treatments. The proposed packages cover services such as oral examinations that are already covered, but also some services (e.g., fissure sealants for young adults) that are new.

Main findings

The following information highlights key points from the range of potential packages examined by the ESRI.

• Estimates of annual expenditure for the provision of preventive dental healthcare packages to all children under the age of 16 years range from €26.0 million to €41.1 million. Services to be provided under these preventive packages for children include regular examinations, fissure sealants and fluoride therapy;
• The annual cost of a package of preventive dental healthcare for adult medical cardholders is estimated to range from €6.9 million to €42.8 million. These packages cover the cost of regular oral examinations, prophylaxis and other preventive treatments (e.g., fluoride therapy);
• The range of estimates reflects differing assumptions about the scope of services available (e.g. allowance for extractions), eligible populations (e.g. relevant population for fluoride therapy) and usage frequency (e.g. annual vs. biennial oral examinations);
• Further analysis of the capacity implications, potential behaviour change on the part of both providers and patients and the cost of providing more complex services (e.g., orthodontic care) will need to be undertaken to assess the full implications of the proposed policy changes for public dental healthcare expenditure, practice and outcomes.

Dr Anne Nolan, ESRI Associate Research Professor and author of the report said: “The range of estimates illustrates the sensitivity of cost estimates to differences in key policy parameters. This range of estimates was designed to assist policymakers tasked with designing and implementing alternative packages of preventive dental healthcare services for adult medical cardholders and children in Ireland.”

Dr Dympna Kavanagh, Chief Dental Officer at the Department of Health commented: “The Department of Health is grateful to the ESRI for the considerable work undertaken in costing the initiatives for Smile agus Sláinte. This work will inform the implementation of proposed services in the new Policy”.