New NICE guidelines set out how high street dentists can promote better oral health.

15 Dec 2015 03:58 PM

The National Institute for Health and Care Excellence (NICE) has today (Tuesday 15 December) published new guidelines to improve people’s oral health by focussing on the experience of visiting the dentist.

Oral health in England has improved greatly over the last 30 years. However, tooth decay [1] and gum disease [2] are still widespread, despite being largely preventable.  Around 31% of adults [3] and almost 28% of children [4] have obvious tooth decay.  The incidence of oral cancer, caused by alcohol, tobacco use and the HPV virus  [5] has increased by around a third in the UK in the past decade, with over 7000 new cases in 2012 alone [6]. 

Oral health can affect general health and wellbeing – poor oral health can be painful, affecting people’s ability to speak, eat, or socialise.  Over a quarter of adults report dental pain [7]. Even though going to a dentist for check-ups contributes to good oral health, many leave it until they have a dental emergency (22% of high and 34% of low socioeconomic groups report only attending the dentist in an emergency [8]).

Oral health problems can also be expensive to treat – each year the NHS in England spends around £3.4billion on primary and secondary dental services [9].  

The new NICE guideline sets out the best ways for high street dentists to support patients to maintain good oral health.    

Key recommendations include:

• Give all patients (or their parents or carers) tailored advice during dental examinations, including:
  • advice on oral hygiene and the use of fluoride, and
  • advice about diet, smoking, smokeless tobacco, and alcohol intake. 
• Encourage the entire dental practice team to develop good relationships with patients to encourage them to maintain good oral health.  This includes the importance of creating a welcoming environment for people from a range of different social and ethnic backgrounds, families with very young children, and children and adults with physical or sensory impairment. 
• Be aware of the personal, cultural, social, environmental and economic barriers to good oral health, including:

• the links between poor oral health and socioeconomic deprivation,
• recognising that some people may not think it is important to go to the dentist regularly,
• understanding that some parents or carers may not realise that it is important to keep children’s primary teeth healthy,
• being aware that people may need help to use dental services.

Professor Gillian Leng, NICE Deputy Chief Executive and Director of Health and Social Care, said: “It’s well known that poor oral health and too much sugar in the diet can lead to dental problems such as tooth decay and gum disease. It’s perhaps less well known that dentists are also trained to detect early signs of oral cancer, and can support a patient’s attempts to reduce their smoking and alcohol use. It is important that everyone in a dental practice promotes good oral health – from receptionists and support staff to the dentists themselves. This includes giving advice during dental examinations on tooth-brushing, diet, smoking, and alcohol intake. This new NICE guideline outlines the best ways to do this, so that oral health can be improved right across the population.”

Professor Stephen Lambert-Humble MBE, Postgraduate Dental Dean, Health Education England, said: “Health Education England is pleased to see the publication of this new NICE guideline on oral health promotion approaches for dental practitioners. The clear direction of travel is for a more preventive approach to be taken by dental teams with patients, and HEE would endeavour to support the training needs of the dental population to deliver this.”

References

1. Tooth decay occurs when acids in the mouth dissolve the outer layers of teeth.NHS Choices.  http://www.nhs.uk/conditions/Dental-decay/Pages/Introduction.aspx

2. Gum disease is a very common condition where the gums become swollen, sore or infected. It is caused by a build-up of plaque on the teeth. Plaque is a sticky substance that contains bacteria, which forms when you eat and drink.NHS Choices.  http://www.nhs.uk/conditions/Gum-disease/Pages/Introduction.aspx

3. Adult Dental Health, survey 2009.http://www.hscic.gov.uk/pubs/dentalsurveyfullreport09
4. National Dental Epidemiology Programme for England, oral health survey of 5 year old children 2012.  http://www.nwph.net/dentalhealth/survey-results5.aspx?id=1

5. NHS Choices.  http://www.nhs.uk/Conditions/Cancer-of-the-mouth/Pages/Causes-v2.aspx

6. Cancer Research UK.  http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/oral-cancer

7. Pau A, Croucher R, Marcenes W. Demographic and socio-economic correlates of dental pain among adults in the United Kingdom, 1998. British Dental Journal. 2007;202(9):E21-E
8. Adult Dental Health, survey 2009.http://www.hscic.gov.uk/pubs/dentalsurveyfullreport09
9. Improving dental care and oral health – a call to action.  https://www.england.nhs.uk/wp-content/uploads/2014/04/imprv-oral-health-info.pdf

 About the guidance

The new guideline is available at: http://www.nice.org.uk/guidance/NG30

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

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To find out more about what we do, visit our website:www.nice.org.uk and follow us on Twitter: @NICEComms.