The role of dental hygienist in Ireland

Sviatlana Anishchuk and Ceara Cleary explore the dental hygienist role and discuss how implementing direct access in Ireland is a ‘necessary step’ that could help improve public health outcomes

Dental hygienist training

To become a dental hygienist in Ireland, you need to complete a two-year Level 7 Diploma in dental hygiene course. Currently, there are only two dental schools that offer this course:

• Trinity College Dublin (TCD)
• University College Cork (UCC).

TCD, Dublin Dental University Hospital

This course has eight places (four Central Applications Office [CAO] applicants, and four mature students). To apply, school leavers should apply through the CAO.

In 2024, the minimum CAO points required for admission to the dental hygiene programme at Trinity College Dublin was 534. Mature students (over the age of 23 years) must apply through the CAO directly.

UCC Dental Hospital

This course offers 12 places. Applicants must apply directly to UCC when the application campaign is open.

Through both dental schools, the maximum number of dental hygienists being trained in Ireland each year is just 20.

This number has not increased for more than 20 years, despite the increase in population and oral health needs. This topic has recently been highlighted and discussed in the Seanad by Senator Gareth Scahill who called for more dental hygiene places in third level education.

Registration

In addition to having a recognised qualification in dental hygiene, to work in Ireland as a dental hygienist you must also be registered with the Dental Council of Ireland. Someone who completes a dental hygiene qualification outside of Ireland may be required to take assessments/examinations to register with the Irish Dental Council.

Currently, there are just over 600 dental hygienists registered with the Dental Council. However, we do not know how many of them are actively working. The majority of hygienists are in private practice with only 70 employed in the HSE.

Workforce crisis

Ireland is currently seeing a workforce crisis in dentistry in both the public and private sectors. Although the call for more dentists has been heard loud and clear in the media, what’s not been heard is the shortage of dental hygienists.

At this year’s Irish Dental Association (IDA) annual conference, the Irish Dental Hygienists Association (IDHA) was inundated with requests from dentists unable to find a dental hygienist due to the shortage. This is being felt throughout Ireland.

Retention issues

With such limited places for dental hygiene courses in Ireland, some who want to pursue this career are forced to study abroad.

In other countries, like the UK, people looking to study dental hygiene can also train to become a dental therapist also. This pathway offers more options and a broader scope of practice, as a dental therapist provides restorative and preventive dental care, often focused on children and individuals with high treatment needs.

At present, dental therapy is not recognised in Ireland but is internationally, making working abroad more attractive.

Also, in countries like the UK, Canada and Australia, dental hygienists have been granted direct access. Direct access means patients can book an appointment with a dental hygienist without needing to see a dentist first. Dental hygienists can offer important services like early screenings, routine check-ups, teeth cleaning, gum care, oral health advice, and tips on healthy eating, all without a dentist’s referral.

This approach is already working well in other countries, helping people get faster and easier access to basic dental care. Working in these countries is an attractive option due to this extension of duties and autonomy afforded to the role of dental hygienist that they can’t get in Ireland. In our opinion, we are behind our colleagues on European and international levels.

Preventive led services for the most vulnerable groups

Current regulations delay essential treatment. This can lead to higher rates of periodontal disease, tooth loss, and related health risks among vulnerable groups. A change in legislation would significantly improve oral health in communities through early intervention, particularly for individuals with disabilities, medically compromised and those in long-term residential care.

Research shows those with intellectual disability are seven times more likely to have periodontal disease, twice as likely to have no teeth, 12 times more likely not to wear a denture, and twice as likely to suffer difficulty eating.

Poor oral hygiene in vulnerable people is also linked to higher risk of bacterial pneumonia. One in 10 cases of pneumonia results in death, which could be reduced by improving oral hygiene. This highlights the urgent need for accessible preventive care, yet Ireland lags behind counties like the UK and other EU countries in modernising dental hygiene services.

Dental hygienists are already fully qualified to perform these duties without additional training. Updating the legislation is a necessary step to remove unnecessary barriers, improve public health outcomes and ensure those most in need receive timely and effective oral care.

The future for dental hygienists

The Irish Dental Hygienists Association urges the government to update the Dental Act 1985, to grant direct access to dental hygienists, allowing them to see patients without a dentist referral. We believe this change would significantly improve oral health in communities through early intervention, particularly for individuals with disabilities and those in long-term residential care.

Sviatlana Anishchuk is president of the Irish Dental Hygienists Association and Ceara Cleary is its continuous education officer.