Oral Health

Introduction

Oral health is integral to general health and essential for wellbeing.  Good oral health implies being free of largely preventable diseases and disorders that affect the teeth, gums and supporting bone and the soft tissues of the mouth, tongue and lips.  The most common oral diseases are dental caries (tooth decay) and periodontal disease (gum disease).  Other conditions include oral cancer, developmental disorders such as cleft lip and palate and malocclusions.

The causes of oral diseases are multifactorial and many of the key factors that lead to poor oral health are risk factors for other diseases.  The common risk factors include diets high in sugary foods and fizzy drinks, smoking, excessive alcohol consumption, poor oral hygiene, inappropriate infant feeding practices and inadequate exposure to fluoride.  People living in areas of material and social deprivation and other vulnerable groups in society have poorer oral health and they often access dental services less frequently.  Poor oral health also has major financial and psychosocial impacts on both the individual and society at large.

What are the big issues?

  • The dental health of children in Warwickshire is significantly better than the average measures for the West Midlands and England.  The 2007/08 survey showed that almost 80% of 5 year olds in Warwickshire were free of dental decay.
  • There is some variation at district level with figures showing that children in Nuneaton & Bedworth and North Warwickshire have the poorest dental health in Warwickshire.
  • Access to NHS Dentistry remains a key government priority. The needs assessment identified significant variations in the access to NHS primary care dental service at ward level.  Some additional capacity has been commissioned across the county to improve access.  Other communities would require implementation of alternative options to meet their needs for NHS dental services.
  • Lack of a comprehensive secondary care orthodontic service across the county.

What do people say?

  • An Ipsos-MORI poll commissioned by NHS West Midlands in 2008 showed that accessing NHS dentistry was the top priority for improvement in Warwickshire.
  •  A new patient experience indicator to assess success in getting an NHS dental appointment has been introduced as part of the GP Patient Survey.  The latest survey (July – September 2011) shows that 96% of Warwickshire respondents were successful in getting a NHS appointment in the last 2 years.
  • In terms of their overall experience of NHS dental services 86% of respondents said it was very good or fairly good whilst 6% of them thought it was fairly poor or very poor.

What do we need to do?

Work with healthcare commissioning partners to improve access to NHS dental services in the county by:

  • Improving the offering and exploring avenues to encourage utilisation of available services in areas with low uptake of services e.g. social marketing campaigns.
  • Consider alternative service provision options for low population density rural communities e.g. mobile dental service.
  • Increasing the efficiencies derivable from current contracts by improving performance monitoring.
  • Supporting the procurement of a secondary care orthodontic service across Coventry and Warwickshire.

Work with Warwickshire Public Health, Warwickshire County Council, Public Health England, National Commissioning Board and other partners to improve the oral health of residents of the County by:

  • Ensuring the continuation of the fluoridation of the water supply in Warwickshire to help with reducing the prevailing dental health inequalities.
  • Commissioning an oral health promotion programme targeted at children of pre-school age in the county.
  • Promoting the common risk factor approach to health promotion and integrate oral health promotion into other health promotion campaigns such as smoking cessation, healthy eating and healthy weights programmes.
  • Ensuring that dental practices encourage healthier lifestyle choices for patients through active participation in the smoking cessation and healthy eating programmes (Making Every Contact Count – MECC).
  • Encouraging early attendance of children to dental services to benefit from preventive measures such as fluoride varnish applications and oral hygiene advice.

Who Needs to Know?

  • Clinical Commissioning Groups
  • District and Borough Councils
  • National Commissioning Board
  • Public Health England
  • Voluntary and Community Sector Groups
  • Warwickshire County Council
  • Warwickshire Public Health

Further information

A Needs Assessment for Primary Care Dental Services in Warwickshire