The changes to NHS dentistry

The changes to NHS dentistry

09 Jan 2011

 Chief dental officer for England, Dr Barry Cockcroft talks about changes to NHS dentistry...  

The publication of the ‘NHS White Paper’ heralds the most significant proposed changes to the National Health Service for a very long time. It sets out the Government’s vision for a patient-centred NHS with the aim of achieving health outcomes that are amongst the best in the world, while allowing healthcare professionals the freedom to tailor services around their patients with a focus on continuously improving results. So, what does this mean for dentists?
Even though there have been improvements in oral health, the Government has been clear that there is still more that can and should be done to tackle persistent inequalities.
That is why we are committed to introducing a new dental contract after a period of piloting, which will focus on registration, capitation and quality, with the primary aim of improving oral health for adults and children, as well as increasing access to NHS dental services.
This new approach, based less on activity and more on outcomes, should really start to encourage a greater emphasis on the prevention of disease.
And prevention is the key. The two main dental diseases, caries and gum disease, are almost unique in that they are almost totally preventable purely by patient or parent action. However, for prevention to be successful, we need to support patients from an early age to help lay the foundations for good oral health throughout life.

While 70 per cent of children are now caries-free, tooth decay in children remains a serious problem. It can cause a great deal of pain and discomfort, and treating it is very costly for the NHS. Focusing on prevention is not only better for the children, but also better use of NHS resources.
Prevention needn’t be difficult. Strategies which support eating healthily, tooth brushing twice a day with a fluoride toothpaste, and following the personal advice offered by DCPs, offer the best chance of securing further improvements in dental health.

There is also overwhelming evidence that the use of fluoride varnish benefits all children. It is straightforward, easy to use and tolerated by children. Since the publication of ‘Delivering Better Oral Health’, we have seen a significant increase in the use of fluoride varnish in primary dental care. This is very encouraging and we want to see this increase further.

We are currently working on a third edition of the ‘Delivering Better Oral Health’ toolkit and have started work on a version of the document which is targeted towards patients rather than clinicians, which we hope to make available in the new year.

Following on from the publication of the ‘White Paper’, we are expecting a further White Paper before Christmas on the future of public health. Ministers have already said that public health services will be linked to local authorities. This offers major opportunities for dental practices to work with local authorities and commissioners to develop formal links between dental practices and schools. Having recently visited practices where such formal links are currently being established, it is clear that these vital links will prove to be more than beneficial.

Overall in England, we have good oral health, comparable to anywhere in the world, but the inequality between those who are free of disease and the smaller proportion who do have disease is both unacceptable and – perhaps more significantly – preventable.

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