NHS dentistry and oral health October update

Jason Wong, Chief Dental Officer, England and Sarah Price, Director of Public Health, NHS England focus on issues around emerging public health issues, in particular mpox, measles and vaping:

"Current issues in public health have oral health implications and our profession must remain vigilant to these. This follows on from our previous bulletin which outlined the bidirectional relationship between oral health inequalities and general health inequalities.

Mpox has recently featured again in the news. A global outbreak in 2022 led to cases being documented in countries other than those in West and Central Africa. And last month, the World Health Organisation (WHO) declared mpox a public health emergency of international concern. The risk of catching the disease in the UK remains low, and as of August 2024, the government webpage on mpox states that no cases of the more serious type of mpox have ever been detected in the UK. But to help prevent transmission and out of precaution, the UK Health Security Agency (UKHSA) has issued an alert. In addition to following the NHS advice on mpox, in this bulletin we look at what oral health professionals can do to remain vigilant.

Since 1 January 2024, over 2000 cases of measles have been confirmed in England, resulting in the highest number of cases since 2012. The rise in this disease is being associated with missed MMR vaccines and the NHS has launched a campaign urging parents and carers to book their children in for their missed vaccinations. Oral health professionals can help with this messaging, as well as looking out for signs of infection. Whilst the NHS has delivered 180,000 additional doses this year so far, the MMR uptake rates are still too low in some areas in England, increasing the risk of seeing potential outbreaks.

While there is no change in national infection prevention and control policy for measles, NHS England has published guidance on infection prevention and control measures for clinically suspected and confirmed cases of mpox in healthcare settings. I also reference our recent bulletin with information on further infectious diseases.

The increasing popularity of vaping (inhaled vapour produced by nicotine delivery systems, including e-cigarettes) poses questions around the associated oral health and wider health implications. This growing concern comes as the UK government considers a ban on outdoor smoking to improve general health and reduce the smoking-related burden on the NHS. According to an NHS vaping mythbuster nicotine vapes are one of the most effective stop-smoking aids. Smoking cessation is fundamental to the Core20Plus5 approach to reducing health inequalities.

An England evidence update on nicotine vaping in 2022 did show that whilst vaping is significantly less harmful than smoking, it is not harmless. Evidence linking vaping devices to poor oral health outcomes is currently developing and the long-term health effects are still being determined. Meant only as a tool to quit smoking, anecdotal evidence suggests an increasing number of younger people are taking up vaping without a history of smoking. Oral health professionals should consider enquiring about the use of vapes when taking a smoking history. Whilst the evidence base continues to be established, we should ensure that patients are informed of the possible side effects (noted below) and give responsible advice around their use.

Having perhaps the most MECC opportunities of any healthcare service, dentistry continues to adapt to ever evolving population health needs. Our profession is one of continued learning and I thank you all for your ongoing awareness of wider issues that can affect your patients. Please do take a moment to sign up to the Primary Care bulletin to receive updates on public health across healthcare, as well as policy guidance specific to dentistry. 

Jason Wong, Chief Dental Officer, England and Sarah Price, Director of Public Health, NHS England

Read the full NHS bulletin here.