Michael Kitt (Galway East, Fianna Fail)
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I thank the Ceann Comhairle for allowing me to raise this matter. I also wish to thank the Minister for Health for attending the House for this Topical Issue. I am concerned about the existing dental services in south Galway and particularly in the Gort area. Having spoken to the general public in that area, I know that it was a very good service in south Galway. It was always important for a dentist or a nurse to visit a primary school, and the more medical professionals that can call to schools the better. We have learned that prevention is the best cure and it is good for a young person to have a meeting with a dentist in a school setting. Teachers have told me that such visits have always focused on children in second and fifth class, but sadly this is not happening now. Many parents and teachers have asked me what happens when a child is in pain and needs fillings or sealants, and I wish to raise the issue of staffing in this regard. Another important point is whom one deals with when trying to get detailed information about dental services, particularly in south Galway.

What I am raising is relevant to any part of the country, but there was a good service in south Galway and there is a justifiable demand. Consequently, there is a need to restore that dental service. I hope that more resources can be allocated to the school dental service. It is an important issue in dealing with the alleviation of toothache and other dental problems for young people. If such visits and examinations are taking place in primary schools, eligible children could also be put on the list for orthodontic treatment. We are all aware of the support for young people's confidence and self-esteem provided by orthodontic treatment, including braces.

All branches of medicine remind us of the importance of early detection, which is crucial in fighting tooth decay. That is why the provision of these inspections and examinations in school are most important for children who may otherwise not get to see a dentist. If this service was affordable 50 years ago, surely it should be available today. We all know of the risks to heart and body associated with tooth infections, so oral hygiene and care are best learned in early life.

In Gort in the past, children were referred to a centre or the nearest hospital, which could be University Hospital Galway or Merlin Park Hospital in Galway, while children in east Galway were often referred to Portiuncula Hospital in Ballinasloe. This service was much appreciated and I hope it will continue to be made available to young people.

Leo Varadkar (Dublin West, Fine Gael)
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I want to thank Deputy Kitt for the opportunity to address the issue of the school dental service in Gort and south Galway. I am taking this debate on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, who is in the Seanad at present.

Dental services for children up to 16 years of age and people of all ages with special needs are provided by the public dental service of the HSE through its dental clinics. These dental clinics provide a screening and fissure sealant programme for children at key stages of development, aged between 6 and 8 and between 11 and 13. The service includes referral for further treatment, including orthodontic treatment where necessary. Emergency care for children up to 16 years of age and treatment for special needs patients are also provided.

A reduction in staff numbers since 2010 has led to a reduced service in all Galway schools. The HSE is aware of this difficulty and is currently taking steps to reverse it. There are particular challenges in recruiting staff to work in more remote rural areas but, nevertheless, a recruitment drive is now under way. It will take some time to fully realise the gain associated with the new staff, but the next school year, 2016-17, will see the benefits of this campaign.

In the meantime and for the current school year the objectives are to assess and treat sixth class children in all Galway schools; to assess the same schoolchildren for orthodontic need and refer, as necessary, to the local orthodontic service, to provide a dental service for patients with special needs, and to maintain an emergency dental service.

Prioritisation of the older age group does not mean younger children will not be screened. However, it is particularly important that children are referred for any necessary treatment before the age of 16 years as their eligibility for referral ends at that stage. Where extra capacity is available, it is being targeted at isolated schools. Given the additional challenges of providing an emergency service to isolated areas, such as Clifden and the Aran Islands, they are prioritised for preventative services where resources are available. This work also involves addressing a backlog of some children who had not been seen in sixth class.

To strengthen the service in County Galway, a programme of renovation of dental clinics and the provision of new developments is under way. The renovation of the dental clinic at Merlin Park in the east of Galway city is finished and the renovation of the dental clinic in Shantalla Health Centre is to be completed by the end of January. More clinics are also under consideration, including in Tuam, County Galway. I am confident these measures will result in improved services for all children in the area in due course.

Michael Kitt (Galway East, Fianna Fail)
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I thank the Minister for his reply. He has said some positive things in the reply, especially in respect of assessing and treating sixth class children in all Galway schools. I understand that previously two classes in each school were prioritised and the children in those classes were prioritised for treatment. While I welcome what has been said in respect of Tuam and the services in Galway city, south Galway is still an issue. This is the reason I am raising the matter. We need a dental clinic providing services there.

There is also a need for information to be provided to the public on what is available. I cannot emphasise enough the importance of the school visit for cases requiring treatment and for those who need to be included on the orthodontic treatment list. There is a long waiting list for orthodontic treatment in Galway, particularly in south Galway.

It is unusual that we have orthodontic and dental treatment operating under two different sections of the HSE. The primary care sector deals with dental treatment while the hospital group - Saolta, in the case of Galway - deals with orthodontics. The practical problem is that when we have discussions with the primary care team in Galway, we can only talk about the particular issue of dental treatment. By the way, we are glad to be invited to such discussions. However, orthodontics is an issue we deal with through the hospital group. That could be looked at again.

I hope that the recruitment the Minister has referred to will improve the situation for the next school year. Moreover, I hope younger children will not be forgotten when the Minister puts a priority on sixth class children in all Galway schools. As we all know, prevention is the best way of dealing with tooth decay. The earlier we can intervene, the better. It is important that younger children are screened as well.

Leo Varadkar (Dublin West, Fine Gael)
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I thank the Deputy for his comments and interest in this issue. More than 300 dentists - down from 312 at its peak - 500 nurses and 600 hygienists work in the salaried public dental service. The budget is a little more than €60 million. The Merlin Park clinic has been renovated and plans for Shantalla are under way. Consideration is being given to Tuam, Roscommon and Boyle as well.

Orthodontic referrals are received by the HSE through the dental services schools screening programme. Referrals are assessed for eligibility under the modified index of treatment need, IOTN. In the western area, patients receive treatment more promptly than in most parts of the country, with 27% receiving treatment in less than six months as against 19% nationally, and 24% receiving treatment in six to 12 months as against 19% nationally.

I have noted the Deputy's comments about the split between dental and orthodontic services. That may be related to the fact a certain amount of orthodontic work has to go to surgery and, therefore, to the hospitals. It is something I had not heard of as a difficulty before. I will check it out.