Dr. Joe Green:

The HSE sets priorities of trying to see children in second class, sixth class, and fourth class if possible. There are a number of areas in the country where fourth class has not been reached due to capacity, as we discussed earlier. The amount or increment of treatment that is often required at fourth class is much less if children have been seen in either first or second class. Focusing on permanent teeth for the moment, if fissure sealants have been placed on the permanent teeth in either first or second class, by fourth class visits would hopefully concentrate more on looking for dental milestones such as the eruption of permanent teeth, occlusion, and reinforcing preventative measures such as dietary advice, advice to parents, tooth brushing, as well as reinforcing good dental attendance. In the event that children are not seen in fourth class, the increment of decay that may have occurred between second class and fourth class would be the one that could not be treated at that time. Where possible, those children are followed up on if resources allow, and they would then be seen in either fifth or sixth class, depending on the approach of their local area. As I said, the outcome of treatment at first or second class is critical. If those children had been seen, a lot of preventative treatments would have been put in place, and that can help.