Select Committee on Health Written Evidence


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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