gms | German Medical Science

Background: In the Republic of Ireland, the HSE Dental Service provides state-funded dental care to children under the age of 16. Many children rely on these services as their sole source of dental care. The services are intermittent and not standardised nationally, resulting in variation in practice and inequity of access. A Guideline Development Group (GDG) was tasked with developing best practice guidance for the HSE Dental Service.

Context: The GDG focussed on the timing, setting and frequency for oral health assessment (OHA) for school-aged children. Recommendations were developed following a review of evidence on ages for tooth emergence and rates of caries progression. Oral healthcare systems for children internationally and relevant guidelines were also reviewed. The widespread practice of school-based OHA for children was identified as a resource-driven activity in Ireland and not in line with best practice.

Best practice:

• •Oral health should be integrated into other primary care services
• •OHA should be offered at school entry and at least annually thereafter, based on caries risk assessment
• •OHAs should be conducted in a dental clinic
• •A school-linked approach to offering OHAs should be maintained and strengthened. Oral health goals for children’s state-funded dental services were also developed.

Lessons: Best practice guidance is important for clarifying what should be done and why, particularly for long-standing programmes operating to outdated policy. Development of best practice highlighted the vast gulf that exists between current and best practice which will require policy and systems changes to close.