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Press Release

Press release

Reducing tooth decay in Irish children and teenagers

25 September 2009

A Health Research Board funded initiative, based at University College Cork (UCC) has produced a comprehensive evidence-based guideline to reduce tooth decay (dental caries) in Irish children. Key recommendations include an increased emphasis on early identification of children who are at high risk of developing decay, and strategies to prevent decay for high risk individuals, and for the population at large.

Tooth decay is the single most common chronic disease in Irish children. More than half of five-year olds living in areas with non-fluoridated water, and one in three living in fluoridated areas have one or more teeth that are decayed, filled or are extracted because of decay. Half of all 12-year olds and three quarters of all 15-year olds have experienced decay in their permanent teeth.

'Supported by HRB funding, we systematically reviewed the best international research on prevention of tooth decay in children, and examined relevant guidelines developed in other countries', says Carmel Parnell, the lead researcher and a Senior Dental Surgeon in the HSE. 'This evidence was then considered by our multidisciplinary Guideline Development Group, in the context of the Irish health service and the limited existing public dental services.

Historically, the public dental service has tried to maximise its available resources by focusing on school-aged children and prevention of decay in permanent teeth, but we know we are seeing children too late to effectively prevent decay. With all of the research evidence pointing towards early identification and preventive measures, particularly at a very young age, we realised that we need involve public health nurses, practice nurses, GPs and other primary care workers, all of whom have regular contact with young children, in identifying preschool children at high risk of decay, and channeling them into the dental services. In the context of our current health care system, this seemed the most practical way to develop needs-based access to dental services for high caries risk preschool children'.

As part of the research work, the team consulted with key stakeholders to agree the recommendations contained in this guidelines. These include:

  1. An oral assessment should be incorporated into each child's developmental visit from the age of eight months and recorded in the child's health record.
  2. Referral pathways should be developed to ensure pre-school children, who are at risk from tooth decay, can be referred from primary, secondary and social care services into dental services.
  3. Children should be offered a dental assessment during their first year in primary school.
  4. A formal caries risk assessment should be done for children attending the dental clinic for dental assessment or emergency care, using the newly developed Caries  Risk Assessment Checklist.
  5. The Caries Risk Assessment Checklist should be integrated into the electronic patient record.

Professor Helen Whelton (UCC) who led the project guideline team says,

'These guidelines were drawn up in consultation with groups such as the Public Health Nurses because we recognised that participation of front line primary care staff is a necessary and cost effective way of identifying at-risk preschool children, and getting them into care quickly. We wanted the guidelines to be practical, to use the existing health care services  and to take a patient-centred approach. This guideline offers an efficient framework for early identification and effective treatment of children who need dental services. We are confident that it will receive the support it needs to translate these evidence-based recommendations into practice, which will improve the oral health of children in Ireland'.

Commenting on the new guidelines, Enda Connolly, Chief Executive of the Health Research Board says,

'If health research is going to have a real impact on public health and patient care, it must be grounded in evidence. It also needs to be translated from a good idea into a change in practice or policy for maximum effect. This project is a perfect illustration of how this can be achieved in an Irish setting. It also highlights how investments in research can lead to more efficient practices and delivery of health services'.

The full report is available from the link below.


For more information contact:
Gillian Markey, Communications Manager
Health Research Board
m 00353 87 2288514
t 00353 1 2345103
e gmarkey(at)


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