Dr. Anne O'Neill:

I will answer that question as it falls within the dental public health sphere. We have issues arising out of the frequency of sugar intake. It tends to be the hard tissue basis for increasing rates of dental disease. The widespread consumption of sugary drinks represents a significant issue. There is some concern about the reduction in calcium sources for girls of certain ages, which then has implications for osteoporosis in later years because, depending on what the commonplace trends tend to be, taking dairy or wheat out alters the food basis.

With regard to reductions that positively impact on dental health, we are looking at the model of three meals and two snacks as being positive whereas the grazing model, ready access to foods and secondary school students having money to buy snacks on the way home impact negatively on oral health. The Senator spoke about the under-resourcing of the school screening system. The difficulty that imposes is that 16-year-olds who have not been able to access a comprehensive treatment plan are arriving into the adult medical card scheme. They may come in with two or three cavities that need to be managed but will only be funded for two so they are automatically starting at a downward point. We have looked at trends. The HSE has funded and participated in epidemiological studies. Nearly all of them show that 12- to 15-year-olds who get that extra independence and a bit more freedom in what they are able to purchase on their own behalf tend to have a higher level of decay starting to arrive because they are no longer under the same degree of parental control. The ready access to sugar-based foods and sugary drinks is still contributing significantly to decay rates. A lot of work can be done in influencing positive habits during the school ranges but it needs that timed intervention over longer periods so that children are supported in learning good habits.