School Dental Service Delivery in the Republic of Ireland

Objectives: To measure current practice with regard to the organisation and delivery of the Primary School Dental Service (SDS) in the Republic of Ireland. Methods: A piloted questionnaire was sent to all 30 Principal Dental Surgeons in the Republic of Ireland. Data were entered into Excel and analysed using JMP IN 5.1.Results: Twenty nine completed questionnaires were returned (response rate 96.7%). All 29 dental areas operated a targeted approach to the delivery of the primary school dental service. Nineteen areas (65.5%) targeted three primary school classes for receipt of dental services, 8 areas (27.6%) targeted 4 or more classes and 2 dental areas (6.9%) targeted 2 classes only. In areas that targeted the same number of classes, there was no consistency in the precise classes targeted. Eleven combinations of target classes were found across the 29 areas. The main reasons given for targeting particular classes were anticipated eruption of permanent teeth and tradition. Further variation was found in the setting used for dental screening, with 15 areas (51.7%) using a clinic setting, 4 areas (13.8%) using a school setting, and 10 areas (34.5%) using both settings. Within the school setting, there was no standardisation of the screening methodology, with differences found in how the child was positioned for dental screening, the type of lighting used and the type of examination kit used. Only 4 areas (13.8%) collected annual dmft/DMFT figures for children in target classes. Conclusion: This study highlights widespread variation the delivery of the SDS throughout the country, leading to inequity in service provision. The development and adoption of evidence-based clinical practice guidelines could facilitate more consistent and efficient practice. Supported by the Health Research Board, Strategic Health Research and Development Research Awards 2004. (grant no. S/A013)