Memorandum by the British Dental Association
(WP 78)
BRITISH DENTAL
ASSOCIATION (BDA)
1. The British Dental Association is the
trade union and professional association for dentists and represents
over 20,000 dentists in the UK. Our mission statement includes
promoting the oral health of the nation giving us clear mandate
for commenting on improving health.
Whether the proposals will enable the Government
to achieve its public health goals?
2. The proposals will certainly not enable
the Government to achieve the dental public health goals as there
has been a failure to include dental public health in this report.
3. Dental decay and gum disease are the
two biggest dental problems in the UK—and both are preventable.
Despite this, the recently published Child Dental Health Survey
of 2003 shows that the targets for dental decay for five-year-olds
have been missed again.
4. Dental decay is very prevalent in children.
It is five times more common than asthma, seven times more common
than hay fever. Dental decay can cause considerable pain and discomfort
and may result in children as young as two or three having antibiotics
or even teeth removed. It is the leading cause of general anaesthesia
in children, and there is increasing evidence that dental disease
affects growth in children.
5. Recent evidence given to the Health Select
Committee on the scientific aspects of ageing outlined the role
of sugars in dental decay throughout childhood and on into older
age. The amount of sugar and fluoride to which one is exposed
will affect the amount of dental decay one has. Decreasing the
intake of sugar and increasing exposure to fluoride would have
a positive impact on oral health.
6. Dental decay shares common risk factors
with obesity. It also affects well being and quality of life in
both children and adults. It fulfils all the criteria for a "public
health problem" yet has been ignored in the report.
7. There are 30,000 dentists and as many
dental nurses, hygienists and therapists that have regular contact
with half of the population. This workforce could provide people
with information on diet, oral hygiene and smoking cessation.
Whether the proposals are appropriate, will be
effective and whether they represent value for money?
8. There are three main ways that people
can improve their oral health. Brushing twice a day with fluoride
toothpaste, appropriate use of fluoride (toothpaste or water fluoridation)
and visiting the dentist regularly.
9. The BDA's submission to the consultation
highlighted the cost efficiency and effectiveness of targeted
water fluoridation, a well-recognised mechanism to improve dental
health in the UK. Five-year-old children in unfluoridated Manchester
have three times the level of decay of those in Birmingham where
the water is fluoridated. Oral health inequalities mirror health
inequalities in all parts of the country except in areas where
the water has been fluoridated.
10. Smoking and other tobacco use has a
significant impact on oral health and may result in serious conditions
like mouth cancer. Dentists and the dental team therefore have
both a vested interest and an important role in smoking cessation
initiatives. Evidence suggests that this is both effective and
cost effective.
Whether the necessary public health infrastructure
and mechanisms exist to ensure that proposals will be implemented
and goals achieved?
11. There is a whole network of dentists
that are able to provide dental and public health advice on a
range of subjects including diet and smoking cessation. Often
a person's most frequent contact with the NHS is via the dentist.
Multidisciplinary working with schools, health visitors, Sure
Start and other such bodies could all lead to better oral health,
and an understanding thereof, especially among children.
RECOMMENDATIONS FOR
ACTION
12. The Department of Health must recognise
the importance of good dental public health and reflect this by
including actions to improve dental public health in the list
of goals.
January 2005
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