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Guidance intended to reduce fluoride toothpaste ingestion in early childhood was introduced in Ireland in 2002. In 2007, water fluoride concentration was adjusted from 0.8–1.0 to 0.6–0.8 ppm. The objective of this study was to determine the difference in caries and fluorosis levels following introduction of these 2 policy measures. A before-and-after study compared caries and fluorosis in random samples of 8-y-olds in Dublin (n = 707) and Cork-Kerry (n = 1148) in 2017 with 8-y-olds in Dublin (n = 679) and Cork-Kerry (n = 565) in 2002. Dentinal caries experience (primary teeth, d3vcmft(cde)) and fluorosis (permanent teeth, Dean's index of very mild or higher) were clinically measured. Lifetime exposure to community water fluoridation (CWF) was classified as "full CWF"/"no CWF." Effect of examination year on caries prevalence and severity and fluorosis prevalence was assessed using multivariate regression adjusting for other explanatory variables. There was little change in commencement of fluoride toothpaste use at ≤24 mo following introduction of toothbrushing guidance. Among children with full CWF, there was no statistically significant difference in caries prevalence or severity between 2017 and 2002. In 2017, caries prevalence was 55% in Dublin (full CWF) and 56% in Cork-Kerry (full CWF), and mean d3vcmft(cde) among children with caries was 3.4 and 3.7, respectively. Caries severity was less in 2017 (mean 4.2) than 2002 (mean 4.9) among children with no CWF (P = 0.039). The difference in caries severity between children with full CWF and no CWF was less in 2017 than in 2002 (interaction P = 0.013), suggesting a reduced benefit for CWF in 2017. In 2017, fluorosis prevalence was 18% in Dublin (full CWF) and 12% in Cork-Kerry (full CWF). Fluorosis was predominantly "very mild" with no statistically significant difference between 2017 and 2002. CWF at 0.6 to 0.8 ppm is an effective caries-preventive measure. Results suggested low uptake of toothbrushing guidance, a reduced caries-preventive effect for CWF in primary teeth, and no reduction in fluorosis following introduction of the policy measures. [ABSTRACT FROM AUTHOR]

The article provides milestones in oral health services in Ireland. The first national survey of dental health was conducted in Ireland in 1952 called "Dental Caries in Ireland," under Nutrition Committee of the Medical Research Council of Ireland. Introduced in 1953, it is noted that Health Act gave health authority a responsibility to make available dental treatment and provision of dental appliances to children attending national schools and children less than six years old.

Burke FM, Whelton H, Harding M, Crowley E, O’Mullane D, Cronin M, Kelleher V, Byrtek M. Fluoridation and tooth wear in Irish adults. Community Dent Oral Epidemiol 2010; 38: 415–421. © 2010 John Wiley & Sons A/S The aim of this study was to determine the prevalence of tooth wear in adults in Ireland and its relationship with water fluoridation. The National Survey of Adult Oral Health was conducted in 2000/2001. Tooth wear was determined using a partial mouth examination assessing the upper and lower anterior teeth. A total of 2456 subjects were examined. In this survey, increasing levels and severity of tooth wear were associated with ageing. Men were more affected by tooth wear and were more likely to be affected by severe tooth wear than women. It was found that age, and gender were significant predictors of tooth wear ( P < 0.01). Overall, there was no significant relationship between fluoridation and tooth wear in this study. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is a significant global health issue. National level data on long-term secular trends are relatively sparse. Methods: Data were obtained from three large-scale surveys of school-aged children in Ireland involving measurements of height and weight in 1948, the 1970s and 2002. Results: Significant increases in height and weight were observed in both boys and girls and in all age groups across the decades. The increases in weight were disproportionate to the trends in height. While boys aged 14 years were 23 cm taller 2002 than in 1948, their average weight was 61 kg, compared with 37 kg in 1948, an increase of 24 kg. A substantial proportion of the increase in weight is seen between the 1970s and 2002. Conclusions: The data provide stark and compelling evidence on the evolution of the obesity epidemic in Irish children in tandem with the increase in economic prosperity. [ABSTRACT FROM AUTHOR]

Background: Calls are emerging for oral health system reform under the Universal Healthcare (UHC) domain, while internationally there is an absence of political priority for oral health. In the Republic of Ireland there is very limited coverage of oral healthcare for the whole population. 'Smile agus Sláinte' Ireland's oral health policy published in 2019, represents the first change to national policy in over 25 years., Methods: This research examined the key factors influencing oral health policy, development, and implementation in Ireland during the period 1994-2021. A case study approach was adopted with two strands of data collection: documentary analysis and semi-structured interviews with elite participants. Analysis was guided by Howlett's five stream framework., Results: Ireland shares the international experience of oral health having very low political priority. This has perpetuated unequal access to public dental services for children and special needs populations while austerity measures applied to adult schemes resulted in increased unmet need with no universal coverage for dental care. The only area where there is political interest in oral health is orthodontic care. This low political priority combined with a lack of actor power in national leadership positions in the Department of Health and Health Service Executive has contributed to successive non-implementation of oral health policy recommendations. This is most evident in the failure to publish the Draft National Oral Health Policy in 2009. The research finds a failure to adequately engage with key stakeholders, particularly the dental profession in the development of the 2019 policy. All these weaknesses have been exacerbated by the COVID-19 pandemic., Conclusions: Ireland's new oral health policy, 'Smile agus Sláinte', presents an opportunity for the provision of much needed public dental services. However, successful reform will require strong political will and collaboration with dental leadership to provide advocacy at national level. Global calls to incorporate oral health into the UHC agenda and an agreed political consensus for UHC in Ireland may provide an opportunity for change. Genuine engagement of all stakeholders to develop an implementation strategy is necessary to harness this potential window of opportunity for oral health system reform., (© 2022. The Author(s).)

Background: Community water fluoridation (CWF), the controlled addition of fluoride to the water supply for the prevention of dental caries (tooth decay), is considered a safe and effective public health intervention. The Republic of Ireland (Ireland) is the only country in Europe with a legislative mandate for the fluoridation of the public water supply, a key component of its oral health policy. However, more recently, there has been an increase in public concern around the relevance of the intervention given the current environment of multiple fluoride sources and a reported increase in the prevalence of enamel fluorosis. The aim of this economic analysis is to provide evidence to inform policy decisions on whether the continued public investment in community water fluoridation remains justified under these altered circumstances., Methods: Following traditional methods of economic evaluation and using epidemiological data from a representative sample of 5-, 8-, and 12-year-old schoolchildren, this cost-effectiveness analysis, conducted from the health-payer perspective, compared the incremental costs and consequences associated with the CWF intervention to no intervention for schoolchildren living in Ireland in 2017. A probabilistic model was developed to simulate the potential lifetime treatment savings associated with the schoolchildren's exposure to the intervention for one year., Results: In 2017, approximately 71% of people living in Ireland had access to a publicly provided fluoridated water supply at an average per capita cost to the state of €2.15. The total cost of CWF provision to 5-, 8-, and 12-year-old schoolchildren (n = 148,910) was estimated at €320,664, and the incremental cost per decayed, missing, or filled tooth (d 3vc mft/D 3vc MFT) prevented was calculated at €14.09. The potential annual lifetime treatment savings associated with caries prevented for this cohort was estimated at €2.95 million. When the potential treatment savings were included in the analysis, the incremental cost per d 3vc mft/D 3vc MFT prevented was -€115.67, representing a cost-saving to the health-payer and a positive return on investment. The results of the analysis were robust to both deterministic and probability sensitivity analyses., Conclusion: Despite current access to numerous fluoride sources and a reported increase in the prevalence of enamel fluorosis, CWF remains a cost-effective public health intervention for Irish schoolchildren.

Use of fluoride has led to dramatic improvements in oral health; however, the impact of these improvements on the volume and mix of treatment provided in dental systems is largely unknown. The use of administrative data to analyze trends in treatment provision gives 'real-life' insight into the impact of changing levels of oral health on oral health services. The first aim of this study was to determine the extent to which useful data on temporal treatment patterns could be extracted from a public insurance database. The second aim, contingent on the first, was to investigate whether increased tooth retention and decreases in caries were reflected in the volume and types of treatment provided to adults within a public social insurance scheme between 1997 and 2008. Data were retrieved from the Dental Treatment Benefit Scheme databases, and new datasets were generated to analyze the distribution of treatments and mean treatments provided to 1,271,937 adults over the 12-year period. Provision of restorations, extractions, and dentures decreased, and the ratio of preventive/diagnostic to invasive treatments per dentist increased, which supports reported improvements in oral health. In conclusion, this paper illustrates the decline in invasive treatments, and increase in preventive treatments that accompanied improvements in oral health.

Background: A 50 cent prescription levy was introduced in 2010 on the General Medical Services (GMS) scheme (Irish public health insurance). This study sought to examine patient attitudes and opinions surrounding the 50 cent copayment. Given the small momentary value of the prescription fee, these results are of interest to policymakers internationally who wish to reduce copayments rather than abolish them., Methods: A qualitative research design was used; semi structured interviews were carried out. Twenty four GMS eligible participants were interviewed in 23 interviews. Fifteen females and 9 males took part. Ages varied from 31- >70 years. Patients were invited to be interviewed in both independent and chain community pharmacies in three types of setting; 1) a socially deprived urban area, 2) a suburban affluent area and 3) a rural area. The Framework method was used for data management and analysis using QSR International's NVivo 9.2 qualitative data analysis software. The "Francis method" was used to test for data saturation., Results: Results are of interest to the Irish context and also at a broader international level. Patients were mostly accepting of the prescription levy with some reservations concerning an increased price and the way in which generated revenue would be used by government. Participants identified waste of prescription drugs at the hand of patients (moral hazard), but there was discordant opinion on whether the 50 cent copayment would halt this moral hazard. Interviewees felt the levy was affordable, albeit some may suffer a financial impact more than others., Conclusions: This qualitative study gives important insights into the experiences of GMS patients with regard to the prescription levy. Information regarding the appropriateness of a 50 cent copayment as a symbolic copayment needs to be confirmed by quantitative analysis. Further insight is required from a younger population.

With the many changes occurring in Ireland it would seem an opportune time to review the body of research conducted and policy enacted in the Republic of Ireland on oral health services and oral health. The dental health of the nation prior to water fluoridation, the legislation and policy decisions impacting on oral health up to budgetary changes, and the production of evidence-based guidelines will be discussed. The first national survey of dental health was conducted in Ireland in 1952 - 'Dental Caries in Ireland'. In the intervening 60 years, further surveys of the oral health of people in Ireland have been carried out. Legislation, surveys and policy documents that have shaped dentistry and the oral health of the population are set out in Tables 1 and 2. A more comprehensive description of the policies can be found in the thesis submitted in fulfilment of Masters in Dental Public Health (MDPH) by the lead author.

Objectives: To determine the proportion of Republic of Ireland 35-44 and 65+ year-olds currently satisfying the criteria for a classic shortened dental arch (SDA) of 20 anterior teeth., Research Design: Secondary analysis of data collected in the 2000/02 epidemiological survey of the oral health of Irish adults., Clinical Setting: Participants underwent a clinical oral examination in health board dental clinics and completed a detailed interview pertaining to dental and general health., Participants: The analysis is based on a random sample of adults, aged 35 to 44 years (n = 978), and 65 years and older (n = 714)., Main Outcome Measures: The SDA was measured as 20 teeth in the mouth in the positions normally described as from the left second premolar to the right second premolar in each arch., Results: Only one of the 35-44 year-olds and none of the 65+ year-olds had teeth in their mouths in positions normally described as a classic SDA. However, of the 35-44 year old age group only five patients who had at least a premolar dentition of 20 contiguous teeth had been provided with a removable denture compared to one patient from the 65+ years group., Conclusions: Very few older patients in the Republic of Ireland have a SDA based on the measure used. However, very few have been provided with removable dentures where they already possess at least a premolar dentition of 20 contiguous teeth. Suggested reasons for this may include limitations of the data recorded, patient preferences and economic factors.

Objectives: To assess the impact of differing degrees of enamel fluorosis on dental aesthetics according to Irish adolescents. The same participants also aesthetically rated other variations in dental appearances including a carious lesion, bleached teeth and a demarcated opacity., Methods: One hundred and fifty adolescents examined seven identical template photographs of an attractive dental smile displaying varying levels of enamel fluorosis (TF1, TF2, TF3), a demarcated opacity, no fluorosis (TF0), anterior caries and very white or bleached teeth. By indicating their level of agreement or disagreement with five statements on a five-point Likert scale, the participants rated the aesthetic acceptability of each of the photographs., Results: Using paired t-tests with the Bonferroni correction, it was found that the photographs depicting the very white teeth and anterior caries were rated as the most and least aesthetically pleasing images, respectively. There was no significant difference in the ratings of the photographs displaying TF0, TF1 and TF2 levels of fluorosis indicating that these photographs were viewed similarly (P>0.002). The remaining two photographs (TF3 and the demarcated opacity) were rated similarly and significantly worse (P<0.002) than the photographs showing no or low grades of fluorosis (TF0, TF1 and TF2)., Conclusions: TF3 level of fluorosis represented the break point at which enamel fluorosis became aesthetically objectionable to these participants. Low grades of fluorosis (TF1 and TF2) were rated similarly to the photograph depicting no fluorosis (TF0)., (© 2011 John Wiley & Sons A/S.)

Objective: To investigate the response of dental practitioners to administration and remuneration adjustments to the Dental Treatment Services Scheme (DTSS) in the Republic of Ireland., Design: Following the introduction of a series of administration and fee adjustments by a third party payments system in December 1999 the pattern of extractions and restorations are examined to determine whether the adjustments had influenced provider behaviour, in particular whether a substitution effect from extractions to restorations would result from a relative fee increase of 62% for amalgam fillings., Data and Methods: Data on patient and provider characteristics from June 1996 to April 2005, collected by the Health Service Executive (HSE) National Shared Services Primary Care Reimbursement Service to facilitate remuneration to dentists providing services in the DTSS, was used in this analysis. A graphical analysis of the data revealed a structural break in the time-series and an apparent substitution to amalgam fillings following the introduction of the fee increases. To test the statistical significance of this break, the ratio of amalgams to restorations was regressed on the trend, growth and level dummy variables, using Ordinary Least Squares (OLS) regression. The diagnostics of the model were assessed using the Jarque-Bera normality test and the LM to test for serial correlation., Results: The initial results showed no evidence of a structural break. However on further investigation, when a pulse dummy was included to account for the immediate impact of the fee adjustment the results suggest a unit root process with a structural break in December 1999. This implies that the amalgam fee increase of December 1999 influenced the behaviour patterns of providers., Conclusions: System changes can be used to change the emphasis from a scheme that was principally exodontia/emergency based to a scheme that is more conservative and based on restoration/prevention.

Objective: To identify the socio-economic, demographic and behavioural determinants of dental treatment needs of those aged 65 and over in the Republic of Ireland., Design: The treatment needs data is based on detailed clinical oral examinations in the NSAOH carried out between October 2000 and June 2002. To determine factors influencing treatment needs, three measures are used: a dichotomous variable expressing the need for any dental treatment, a dichotomous variable expressing the need for dentures, and a dichotomous variable expressing a Community Periodontal Index of Treatment Need (CPITN) score of three or greater representing a need for periodontal treatment., Methods: Factors such as age, gender, dental services eligibility status, fluoridation, employment status, educational attainment, anxiety about dental visits, frequency of brushing, and attendance patterns were regressed on a dichotomous version of prevalence of Decayed Missing Filled Surfaces, DMFS including the visual component, and CPITN scores. Associations were estimated using multivariate logistic regression and expressed as odds ratios (OR) with 95% confidence intervals (CI). Goodness of fit was evaluated by estimating sensitivity, specificity, positive/negative predictive values and accuracy., Results: Being female, smoking, frequent snacking and anxiety about dental visits increased the odds of having a periodontal treatment need. Having primary education only, and being a smoker increased the odds of having a need for any treatment including dentures, whereas being female, regular usage of dental services, and access to fully fluoridated water supplies reduced the odds., Conclusions: Socio-economic factors such as lower levels of educational attainment, demographic factors such as age and gender and not having access to fully fluoridated water supplies, and behavioural factors such as smoking, frequent snacking, anxiety about dental visits, influence above average treatment needs amongst the elderly in the Republic of Ireland.

Background: Childhood obesity is emerging as a major public health problem in developed and developing countries worldwide. The aim of this survey was to establish baseline data on the prevalence and correlates of overweight and obesity among children and adolescents in the Republic of Ireland (RoI) and Northern Ireland (NI)., Methods: The heights and weights of 19,617 school-going children and adolescents aged between 4 and 16 years in NI and RoI were measured using standardised and calibrated scales and measures. The participants were a representative cross-sectional sample of children randomly selected on the basis of age, gender and geographical location of the school attended. Overweight and obesity were classified according to standard IOTF criteria., Results: Males were taller than females, children in RoI were taller than those in NI and the more affluent were taller than the less well off. The overall prevalence of overweight and obesity was higher among females than males in both jurisdictions. Overall, almost one in four boys (23% RoI and NI) and over one in four girls (28% RoI, 25% NI) were either overweight or obese. In RoI, the highest prevalence of overweight was among 13 year old girls (32%) and obesity among 7 year old girls (11%). In NI the highest prevalence of overweight and obesity were found among 11 and 8 year old girls respectively (33% and 13%)., Conclusion: These figures confirm the emergence of the obesity epidemic among children in Ireland, a wealthy country with the European Union. The results serve to underpin the urgency of implementing broad intersectoral measures to reduce calorie intake and increase levels of physical activity, particularly among children.

Background: An all Ireland/North South survey of Oral Health was carried out in 2001/2002., Aims: To compare levels of dental caries and enamel fluorosis among children and adolescents in the fluoridated Republic of Ireland (RoI) with those in the non fluoridated North of Ireland (NI)., Methodology: Cross sectional oral health survey of a representative, random, stratified sample of 5-, 8-, 12- and 15-year-olds in Rol and in NI (N = 19,950). WHO examination criteria with the addition of visible, non cavitated dentine caries were used for recording caries. Fluorosis was measured using Dean's Index., Results: In the RoI, the mean d(3c)mft / D(3c)MFT for 5-, 8-, 12-, and 15-year-olds with full domestic water fluoridation (n = 9,975), was 1.0, 0.3, 1.1 and 2.1 respectively. The corresponding means in non fluoridated NI (n = 1,475) were 1.8, 0.3, 1.5 and 3.6 respectively. (p < 0.0001, NS, p < 0.0005 and p < 0.0001). The prevalence of enamel fluorosis has increased in RoI since 1984, 23% and 36% of 8- and 15-year olds respectively in fluoridated areas had Dean's Index scores at the questionable or greater level in 2002 compared with 6% and 5% respectively in 1984., Conclusions: In 2002 apart from 8-year-olds, caries levels were lower amongst children resident in fluoridated communities in RoI than amongst corresponding age groups in non-fluoridated NI. Caries has declined in fluoridated and non fluoridated groups in both jurisdictions since the early 1960s. In RoI fluorosis levels were higher amongst lifetime residents of fluoridated communities and have increased since 1984.

Objectives: The aim of the study was to assess the reliability and construct validity of the Child Oral Health-Related Quality of Life for 8-10-year-olds (COHRQoL [8-10]) using confirmatory factor analysis (CFA) and to test the measurement properties of latent variables believed to define the multidimensional construct of OHRQoL., Methods: A convenience sample of 270, year 4 children from six schools was obtained. The administered questionnaire included the 25-item COHRQoL [8-10] and the Coopersmith Self-Esteem Inventory-School Form. The analytical method was based upon CFA using maximum likelihood estimation. A second-order factoring approach was applied to determine the extent that the latent variables tapped a single over-arching domain of quality of life., Results: Seven items were withdrawn for low endorsement and poor association with resultant factors. The COHRQoL [8-10] was confirmed to measure a single construct of three latent variables invariant to gender. Internal consistency of the three scales derived comprising a total of 18 retained items was acceptable. Associations with self-esteem and with a single question on the extent that the mouth was a problem were confirmed and strengthened the construct validity of the COHRQoL [8-10] measure., Conclusions: Reliability and construct validity were demonstrated for COHRQoL [8-10] and supported the scale for adoption as an epidemiological and scientific tool for group comparisons. CFA showed that the three constructs or latent variables underlying the overall COHRQoL ratings were discrete measures that can be reliably assessed in children. Further model testing with additional data will increase generalization of these findings.

Objectives: This paper is primarily concerned with the only proven risk associated with water fluoridation: enamel fluorosis. Its purpose is to review current methods of measuring enamel fluorosis, its aetiology and metabolism. A further objective is to identify risk factors to reduce the prevalence of enamel fluorosis and employ methods to manage such risk factors., Data: The prevalence of enamel fluorosis is increasing in Ireland and internationally. A critical period has been identified at which teeth are most at risk of developing enamel fluorosis: 15-24 months of age for males and 21-30 months of age for females. The data included took these two factors into account., Source: A thorough narrative review of published literature was conducted to identify studies concerning the aetiology and metabolism of enamel fluorosis. Risk factors for fluorosis were identified from these studies., Study Selection: As it is the pre-eruptive phase of enamel development which represents the greatest risk to developing enamel fluorosis, studies examining sources of fluoride ingestion for young children were selected. These included studies on ingestion of fluoride toothpaste by young children, fluoride supplementation and infant formula reconstituted with fluoridated water., Conclusions: There is evidence that the age at which tooth brushing with fluoride toothpastes is commenced and the amount of fluoride placed on the brush are important risk factors in the incidence of dental fluorosis. It is recommended that brushing should not commence until the age of 2 and that a pea-sized amount (0.25 g) of toothpaste should be placed on the brush.

Background and Design: parental accompaniment of children during dental treatment has always been a contentious issue. One of the factors that should be considered is the preference of the parents. The aim of this paper is to report the preference of parents of eight-year-old schoolchildren in Ireland in relation to accompanying their child during dental procedures and is part of the National Survey of Children's Dental Health in Ireland, which was conducted between October 2001 and June 2002. The survey had a cross sectional design and parents of children (average age 8.4 years) selected for dental examination were asked to complete a questionnaire., Results: 3629 completed questionnaires were obtained from parents of eight-year-old children giving a response rate of 68 per cent. Sixty-seven per cent of parents expressed a preference to accompany their child during dental treatment, while nine per cent expressed a preference not to accompany their child. The sex of the child (p = 0.33) or the fact that the parents were holders of a medical card (surrogate for disadvantage) (p = 0.08) did not affect parents' preference. However, parents of a single child had a higher preference (78 per cent) for accompanying their child than did parents with greater than one child in the family unit (66 per cent) (p = 0.0009)., Conclusion: If given the choice, the majority of parents would prefer to accompany their child when receiving dental treatment.

Background: A national survey of oral health of children and adolescents was carried out in the Republic of Ireland (RoI) in 2001/2002., Aims: To compare the prevalence of caries between child and adolescent residents in fluoridated and non-fluoridated communities in the RoI whilst controlling for disadvantage. To compare caries levels amongst disadvantaged and non-disadvantaged groups with and without water fluoridation. To report the changes in caries levels between the 1960s and 2002 in RoI. To report the changes in dental fluorosis levels between 1984 and 2002., Methodology: Cross sectional oral health survey of a representative, random, stratified sample of 17,851 5-, 8-, 12- and 15-year-old children and adolescents in RoI. WHO examination criteria with the addition of visible, non-cavitated dentine caries were used for recording caries. Fluorosis was measured using Dean's Index., Results: In the RoI the mean dmft/DMFT scores for 5-, 8-, 12-, and 15-year-olds were 1.2, 0.3, 1.1 and 2.3. For those with domestic water fluoridation since birth the scores were 1.0, 0.3, 1.1 and 2.1 respectively. In non-fluoridated areas of RoI the mean dmft/DMFT scores for 5-, 8-, 12-, and 15-year-olds was 1.7, 0.3, 1.3 and 3.2, respectively. For 5-, 12- and 15-year-old age groups dental caries levels were lower amongst children with fluoridated domestic water supplies (all p<0.0001). The prevalence of dental fluorosis has increased in RoI since 1984. 23% and 36% of 8- and 15-year olds respectively in fluoridated areas had Dean's Index scores at the questionable or greater level in 2002, compared with 6% and 5% respectively in 1984., Conclusions: Caries levels are lower among children with fluoridated domestic water supplies. Decay levels are much lower in 2002 than they were in 1984 and in the 1960s. The oral health of the less well off is worse than that of the rest of the population. The prevalence of dental fluorosis is higher amongst children and adolescents with fluoridated water supplies. Comparisons with 1984 data show an increase in the prevalence of fluorosis since that time.

The aims of this study were to estimate the average maximum mouth opening and range of mouth opening in a representative sample of the Irish adult population, to compare mouth opening in patients with and without signs or symptoms of temporomandibular joint (TMJ) dysfunction syndrome and to investigate the association between mouth opening and stature among populations. As part of the Irish National Survey of Adult Oral Health, maximum mouth opening was measured and questionnaire data collected for 1513 adults, aged 16-99 years. The average maximum mouth opening was 43 mm for males and 41 mm for females. Mouth opening was found to reduce with age, independent of gender. No link was found between reduced mouth opening and TMJ dysfunction or between mouth opening and stature in populations.

The basis for the constitutional challenge to the Health (Fluoridation of Water Supplies) Act 1960 in the Republic of Ireland and the judgements of the High Court and Supreme Court are described. Pre-fluoridation baseline surveys and various surveys conducted over the last 30 years in the Republic of Ireland show, that amongst of fluoridated communities, children experience lower levels of dental caries and adults retain more of their natural teeth when compared with residents of non-fluoridated communities.

The visit of Dr. Trendley Dean to Dublin in the mid-1950s helped accelerate the decision to introduce water fluoridation as a public health measure in the prevention of caries in the Republic of Ireland. A challenge to the constitutional validity of the Health (Fluoridation of Water Supplies) Act 1960 failed and in 1964 the water supplies of Dublin city were fluoridated. Over the next seven to eight years all the major urban communities in the Republic of Ireland were fluoridated. Currently, 67 percent of the 3.5 million people in the country reside in fluoridated communities. Studies conducted over the last 20 years show that residents of fluoridated communities have better dental health than those in nonfluoridated communities--the mean dmft is lower in children and the number of natural teeth present in adults is higher.

The aim of this study was to investigate the effectiveness of a school-based fortnightly 0.2% sodium fluoride mouthrinse programme after children ceased to participate. The programme, which commenced at age 6 and ceased at age 12, was investigated 4 years following its cessation. Three groups of 12-year-olds and three groups of 16-year-olds were examined, i.e. children who had participated in the mouthrinse, those attending non-participating nearby schools and life-time residents of a fluoridated community. Significant differences in mean DMFT in the 12-year-olds between the mouthrinse and the control group were not found in the 16-year-old group. Mean DMFT for the mouthrinse group and those in a fluoridated community (which were the same in 12-year-olds) showed a statistically significant difference in those aged 16. Most caries found, both in 12-year-olds and in 16-year-olds, occurred on molar teeth and was found on pit and fissure surfaces. The cessation of these programmes at age 12 should be reappraised and the combination of school-based fluoride mouthrinse programmes with a fissure sealing programme is recommended.

The implementation of the Health (Fluoridation of Water Supplies) Act 1960 was preceded by a survey of child dental health in the Republic of Ireland. A follow up national survey in 1982 showed that caries had declined in both fluoridated and non-fluoridated communities, although more so in the former. An adult dental health survey reported in 1992 showed that tooth loss had declined in the period 1979 to 1989.

Evidence of accidental damage to permanent incisor teeth was recorded as part of a national survey of adult dental health in Ireland. A total of 746 adults aged between 16 and 34 years were examined. The prevalence of injury was considerably higher in males and the majority of subjects in both sexes had just one tooth affected. There was a continuing increase in prevalence with age which appeared to level out after the age of 24. A high level of untreated injuries was noted in both age groups; of those injuries which were treated, composite restorations were more common in the younger age groups while extraction and replacement by a denture was more common in older subjects.

In a national survey of adult dental health conducted in the Republic of Ireland in 1989/90 a total of 1,527 subjects aged 25 and older were examined for root surface caries. It was found that the prevalence of root surface caries was highest in older age groups and also amongst males, residents of non-fluoridated communities and those earning low incomes. Tooth loss masked the potential prevalence of root surface caries. With more persons retaining their natural teeth into middle and old age the prevalence of root surface caries is likely to increase in the future.

A study to determine the pattern of chewing gum consumption amongst the Irish population was undertaken by means of a questionnaire completed by approximately 1,500 respondents from primary and secondary schools and third level colleges and employment exchanges. The results showed that approximately one-third of the respondents chewed gum at least once per day and a sizeable proportion of the younger population use sugar-free gum.