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NHS Dentistry and Oral Health bulletin - A focus on health inequalities

By DTA/CDO | 14th August 2024 | News

In this month's NHS Dentistry and Oral Health bulletin Jason Wong Chief Dental Officer England takes the opportunity to focus on health inequalities:

"As we welcome in a new government, I wanted to take this opportunity to thank you for your continued work towards improving oral health care for the nation and continuing to deliver quality NHS dental care under considerable pressure.

Recent evidence shows that satisfaction with NHS dental care remains high but that contrasts with the lack of satisfaction to gaining access to NHS dentistry. No doubt there will be future discussions about priorities as regards oral health and dental care and I look forward to working with our new Secretary of State and his team.

Last weekend you may have seen coverage of the launch of the new NHS England and Asda partnership - putting NHS advice on toothpaste and mouthwash packaging. It's one element of a new campaign encouraging people to be 'body aware' and contact their GP with potential mouth cancer symptoms. As we know, dentists are often the first healthcare professional to spot the signs of mouth cancer, so this is welcome awareness-raising. The campaign launched on World Head and Neck Cancer Day and the seven products featuring the NHS advice will be in more than 500 Asda stores UK-wide. The toothpaste and mouthwash that feature the NHS advice are all from Asda's Just Essentials and own-brand range, ensuring the message is landing in the baskets and homes of budget-conscious consumers.

I thought this issue would be a good opportunity to focus on health inequalities. The 2021 survey of adult oral health, published earlier this year, illustrates many of the stark inequalities in oral health across the UK, and we know that oral health can impact general health at every stage of life.

A healthy mouth enables nutrition of the physical body, enhances social interactions, and promotes self-esteem and feelings of wellbeing. Poor dental health is linked to serious conditions such as heart disease, diabetes, and respiratory infections. Despite this, oral health is often marginalized in wider health discussions, contributing to substantial disparities among different population groups.

Children from lower socioeconomic groups experience higher levels of tooth decay according to the Royal College of Paediatrics and Child Health 2020 report on Oral Health - updated in May 2021 - which describes caries as the top reason for hospital admission among children aged five to nine.

Diabetes is a growing global health concern, with its prevalence particularly high in populations of high deprivation. This health disparity reflects a complex interplay of socioeconomic factors, access to healthcare, lifestyle choices, and environmental influences. The bidirectional relationship between diabetes and oral health means that improving one of these health issues improves the other. For this reason, I am pleased to share with you our recent update to the Commissioning standard: dental care for people with diabetes. This commissioning standard supports commissioners within England's Integrated Care Boards with the implementation of a standardised framework for the local commissioning of dental services for people with diabetes (type 1 and type 2) and people with non-diabetic hyperglycaemia (NDH).

We in the dental profession know that there is much evidence demonstrating how systemic diseases manifest in the oral cavity. However, this is not necessarily reflected in the way health and care pathways are currently built. For instance, oral complications occur in nearly all patients who receive radiation for head and neck malignancies. Embedding timely dental input into regional cancer pathways would contribute significantly to improving health outcomes for patients, reducing treatment delays and ultimately reduce health disparities.

The Mouth Care Matters programme provides a useful guide for hospital healthcare professionals to address disparity in staff knowledge, skills, access and support in an effort to 'put the mouth back into the body'.

I continue to welcome action by dental professionals in response to Public Health England's guidance Inclusion Health: applying All Our Health. The OCDO team continues to act on commitments for the NHS Long Term Plan by seeking to embed oral health improvement and care within other aspects of healthcare. This, alongside Local Dental Network Chairs working with ICBs, is paramount to bring about collaboration and effective change. Although oral health is already a named component of the Children and Young People Core20PLUS5 initiative, more can be achieved by integrating oral health and dental care into programmes and pathways arising from the Core20PLUS5 approach to adult health inequalities. I believe integration will accelerate NHS England's aims to reduce healthcare inequalities at national and system level.

I would like to highlight the work of Professor Bola Owolabi, the director of national healthcare Inequalities improvement programme at NHS England, whose informative blog posts on tackling health inequalities describe how lateral thinking can contribute to significant improvements in health inequalities.

I look forward to continuing to work with you to address health inequalities in England."

Jason Wong, Chief Dental Officer England

NHS dentistry and oral health update 

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