James Reilly (Dublin North, Fine Gael)
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Question 12: To ask the Minister for Health and Children if she will reverse the Health Service Executive dental policy decision which advises dentists not to fill cavities in children's teeth in view of the fact that it puts children's health at risk; and if she will make a statement on the matter. [35143/10]

Mary Harney (Dublin Mid West, Independent)
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The HSE has not issued a national directive to dentists working in the public dental service that they are not to fill cavities in children's teeth.

The Deputy may be referring to a clinical policy in Sligo-Leitrim for the past 15 years not to fill milk teeth unless there was clear evidence of an associated health benefit. In response to media reports in August, the principal dental surgeon for the area said that this policy is evidence-based. He stated:

The policy in Sligo-Leitrim focuses on dealing with the causes of the decay and working towards reducing the risk of tooth decay in baby teeth. It also prioritises treatment of permanent teeth. Any baby teeth which are causing pain or which may consequently cause problems for adult teeth are of course treated as required.

The HSE has recently appointed a new oral health lead, Dr. Dympna Kavanagh, to ensure that the delivery of oral health services is in line with national policies and best practice.

James Reilly (Dublin North, Fine Gael)
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I should like to put on the record of the House the fact that I am informed that Navan hospital is not over budget, in response to my last question that was dealt with by the Minister.

In regard to this issue, the Minister will forgive me if I read out a section of a report from the Dental Protection Ireland. Dental Protection Ireland, DPL, the specialist risk management group, has raised concerns about a memo from a HSE senior dental manager sent to dentists working in community clinics indicating that the agency's policy is that dentists are instructed not to provide routine fillings for deciduous, or baby, teeth. The expert advice sought by DPL contradicted the HSE's policy rationale, citing a recent study based on a sample of nearly 7,000 five-year-old children in Scotland, the findings of which did not support a policy of non-intervention for primary teeth. The expert advice stated that dental caries left untreated are likely to progress to a stage which causes pain and suffering for children and said a general policy of non-intervention was "wrong and unjustifiable".

Other claims offered as policy rationale by the HSE were similarly disputed by the expert advice, which concluded that the main issue that had driven the policy was the lack of resources, which was mentioned by the senior dental manager in the memo. Damningly, the expert said that there was no evidence in the dental literature to support this approach and that it would expose children to serious risk of pain and discomfort, and - even worse - abscesses, sepsis and hospitalisation.

Brendan Howlin (Wexford, Labour)
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Please, Deputy, we must have questions. This is Question Time.

James Reilly (Dublin North, Fine Gael)
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Does the Minister accept this opinion, which comes from an internationally respected body with no conflicts of interest in terms of costings? Is this yet another policy born out of a desire to save money rather than saving children from pain and distress?

Mary Harney (Dublin Mid West, Independent)
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This is not a directive or policy of the HSE but a policy that has been pursued for the past 15 years by Dr. Joe Mullen, the principal dental surgeon for Sligo-Leitrim. I will not dispute what he believes is best practice because I am not a dentist, and I understand the Deputy is not either.

James Reilly (Dublin North, Fine Gael)
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The Minister listens to experts; I listen to experts.

Mary Harney (Dublin Mid West, Independent)
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With regard to evidence from research, a project is under way in the UK to examine the benefits of providing baby tooth fillings and also to examine other methods of restoration and assess the best outcomes. I understand the results will not be available for at least five years.

James Reilly (Dublin North, Fine Gael)
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I will ask the Minister a simple question. Does she accept the literature that is available in the dental world in the moment, or will she depend, as she so often does, on information to come in the future when dictating policy that affects the welfare of our children?

Mary Harney (Dublin Mid West, Independent)
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The dental policy that applies was initiated by the Deputy's party colleague when he was Minister for Health. A new dental policy will be published later this year. The HSE has just appointed a clinical lead in this area, and we will see dental services being given greater priority. However, the issue raised by the Deputy is a practice that takes place in only one region of the country.

James Reilly (Dublin North, Fine Gael)
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Would the Minister not accept, then, that this person is out of kilter with the rest of the HSE, and does she not think it appropriate for her to seek advice from the remaining dental practitioners within the HSE about whether it is safe to continue this practice?

Mary Harney (Dublin Mid West, Independent)
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The person concerned is a principal dental surgeon and, as the Deputy knows, clinical independence operates in such areas. That is the policy pursued by that particular dentist, and it would be a matter for the chief dental officer, if he felt the policy was inappropriate, to intervene in the situation. It is certainly not a matter for me.

Brendan Howlin (Wexford, Labour)
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That concludes Priority Questions. We will now move on to Other Questions.