Dr. Anne Barry-Reidy:

The Deputy would not be alone in having that experience. Certainly, in the contacts that come in through the political system and directly through patients into the Department people speak of having that experience. It will always be the case that there will be a proportion of the population that needs to access services under some form of sedation or anaesthesia, and we need to do more to improve access to that. The regionalisation model and the integration of community care with acute care will be very important there. In the scenario the Deputy described where a child needs a tooth extracted, we need to get that at a point before the tooth declines to the point where it needs to be extracted. It is about preventative care. We are very clear that people with additional needs who need anaesthesia to access care are the ones who suffer the most from lack of access to preventative care from birth. It is important to state the HSE is in progress of developing new packages of care for nought- to seven-year-olds, starting with nought- to two-year-olds. What that means is that all children can be supported, as is the HSE's recommendation, to attend a dentist for the first time before the age of one. That is not something that is facilitated by our public model of care at present but we acknowledge it is best evidence and practice.

For children who go on to be diagnosed with any sort of additional need or disability, it is really important that they get access to that basic assessment from birth. This is around checking their teeth are coming in, giving advice to parents about minding those teeth and gums as teeth are coming through, basic advice about diet and things like that. It is children who go on to be diagnosed with additional needs who are most in need of that basic preventative care at an early age to prevent problems subsequently developing.