Total Copolymer ad A4 IRE-V 16/01/2009 15:36 Page 1
HealtH Matters 73
HealtH & well-beinG
Dental Health
IMPROVEMENTS
Professor Helen Whelton, Dean of Graduate School and Director
of Oral Health Services Research Centre, College of Medicine and
Health in University College Cork writes on the improvements over
the last two decades in public health dentistry and what has brought disabled, children in special needs schools,
them about.
elderly in residential care, development of
oral health policy options for services for the
elderly, standards for fluoridation of water
supplies; up-skilling of staff in research
t
he Hse Public Dental services (PDs) the ‘Dental Health action Plan’ in 1994 as methods.
are currently the subject of review. part of ‘shaping a Healthier Future’ marked an increased focus on evidence-based
Whilst it is important to determine how a turning point for the services. It redistributed practice through the development of PDs
system performance could be improved, it the responsibility for service provision in a evidence-based guidelines for the prevention
is also valuable to consider advances and more equitable way amongst the profession, of caries, use of topical fluorides, screening
successes in the service over the last two allowing the PDs to focus on the care of and use of fissure sealants. research
decades. the PDs is the main provider of children and special needs groups. For the collaboration among the PDs, academia
dental services for children in Ireland and first time, it set out explicit goals and and agencies such as the Health research
employs a cohort of over 350 dentists, over objectives for the service with an emphasis Board, Dental Health Foundation, EU and
400 dental nurses and almost 60 dental on health outcomes rather than activity. Northern Ireland r&D Office to develop
hygienists having responsibility for some changes which have led to public dental services has been an important
approximately one million children and improvements in the PDs in the last two driver in this regard. the Forum on
adolescents and for the special needs decades include: Fluoridation (2002), which reviewed the
population of all ages. In addition, the • The introduction of a choice of dentist safety and effectiveness of fluoridation and
service employs 12 consultant and 39 scheme (the Dental treatment services established the Expert Body on Fluorides,
specialist orthodontists to provide scheme) for medical card holders has also been an important driver of change.
orthodontic treatment for those children • The policy to extend eligibility for care • Further transition from a demand-led
and adolescents with the greatest need. within the PDs to all children up to their service for school-age children to a
the PDs is also the gate keeper of the 16th birthday systematic school-linked service.
Dental treatment services scheme for • Setting up of consultant-led orthodontic • Introduction of electronic patient records
adults with Medical Cards. units and revision of guidelines for referral in many parts of the country.
twenty years ago in 1990, the landscape to prioritise cases most in need • Insisting on the highest standards of
with regard to the provision of public dental • The provision of a scheme for the cross-infection (driven by HIQa).
services was very different. at that time, one education and deployment of Dental • Introduction of audits in radiology in
third of the country’s dentists were employed Hygienists compliance with sI 478.
in the PDs and were responsible for the
provision of services to two-thirds of the Increased targeted educational Important facilitators for these
population, comprising children up to sixth opportunities: Masters in Dental Public developments over the last 20 years
class in primary school, those with special Health (UCC), specialist Cert in Oral Health included leadership within the service and
needs and adult medical card holders. In Promotion (NUIG), Training in Special from successive Chief Dental Officers and
reality, primary school children were Needs Dentistry (tCD) specialist training other key influencers in the Department
prioritised and only an emergency service in Orthodontics (UCC and tCD). among of Health and Children, advocacy from
for the relief of pain was provided to eligible senior PDs staff, postgraduate training is the Irish Dental association, its subsidiary
adults. there was no provision for dental now the norm rather than the exception. groups and academics in the field as well
hygienists to work in Ireland; there was no Use of research and epidemiology as the as public and political pressure. Good
specialised training in dental public health basis for service development; surveys of interagency communication was a critical
or oral health promotion. the publication of oral health of children, adults, intellectually success factor over this period.
210553-FC-HSE-Col_Palm-PG.indd 1 10/03/2010 11:56:21
HM Iss6.1 p71-128.indd 73 12/03/2010 15:24:21
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