In my last blog, I noted a developing Critical Mass for change in how we address infant caries and its consequences. And barely a month later, the steam pressure has been increased once again.

The Chief Dental Officer Dr Sarah Hurley, is starting to make public inroads into her role, and recently delivered the 2016 Pendlebury Lecture. It was in stark contrast to the one delivered in 2014, demonstrating a wide understanding of the playing field that is dental health.

Critical Mass 2

It comes at the end of a week in which the state of children’s teeth once again was publicly pilloried, on the back of the General Anaesthetic numbers.

While it remains a problem in England, just look at Scotland. After many decades when Scotland has been spiritual home of the UKs dental problems, it suddenly produces numbers through its Child Smile initiative that suggests significant inroads are being made to improve the health of children’s teeth and prevent dental caries [and thereby reduce the costs and morbidity of unrestricted dental breakdown]. It is not really rocket science, they have just been investing in infant dental health.

So we in England [and Wales and Northern Ireland to a similar extent, but out with the CDO[NHSE]’s remit] have a problem.

We know the target population for any changes must now be parents and infants in equal measure.  There seems to be ample evidence that parking the dental professionals in discrete buildings, called Dental Surgeries, is simply not working, and it is evidence that Dr Hurley seeks.

We know that the medical stakeholders are now on board, as obesity and diabetes rear their heads with all the long term cost implications. Indeed it is the medical drive for a sugar tax to discourage the dietary shortcomings that is also driving the publicity that emerged in the Daily Telegraph over the weekend of the 26^th February, and was subsequently widely discussed on broadcast and printed media.

Follow the money

So increasingly the priority is being defined. But the thorny issue will arise of funding.

Which Departments will pay?   How will we [the public] pay for the inevitable targeted measures that are due to follow, as day follows night?  A sugar tax undoubtedly could easily raise the funds but the political will in the chaos pre-Referendum is clearly not there.

There is a serious danger in the current fiscal period of restraint that the HM Treasury will insist on a cost neutral option.  Maybe not, but we must for now assume that.

Could it be that the GDP Budget is being eyeballed [at £3.4Bn] as the low hanging fruit of funding that could or perhaps should be used to address the issue of infant dental health?

The Chief Dental Officer is clearly leading dental health to a better place – but who will pay for this Piper’s plans?

The role must soon change it seems to that of Chief Decision Officer.  

Interesting times, but the sooner we address the issue of Dental Health for the young child, the sooner we can restore some pride to our profession.
 

As a GDP you would do well to plan for big changes. Not sure what but for sure very significant.
 

Have great Easter, assuming the snow has eased back!

2016 letter to Telegraph http://www.telegraph.co.uk/comment/letters/12077501/Letter-The-NHS-dental-health-system-is-unfit-for-purpose.html

Dentistry response http://www.dentistry.co.uk/2016/01/11/nhs-dentistry-letter-published-in-the-telegraph-unhelpful/

Feb 26 article DTel  http://www.telegraph.co.uk/news/health/news/12174796/Thousands-of-children-have-decayed-teeth-out-in-hospital.html

BDAs Press release  https://www.bda.org/news-centre/press-releases/tooth-decay-stats-should-offer-wake-up-call-on-prevention

GDPUK News https://www.gdpuk.com/news/latest-news/2151-gas-for-dental-extractions-in-children-on-increase

GDPUK CDOs response https://www.gdpuk.com/news/latest-news/2152-strong-response-to-child-ga-figures

GDPUK Scan of other media [Dr Tony Kilcoyne]  https://www.gdpuk.com/forum/gdpuk-forum/telegraph-third-world-dentistry-crisis-in-engand-21379?start=130#p239340

Scottish example  http://www.child-smile.org.uk/professionals/childsmile-core/toothbrushing-programme-national-standards.aspx

·         Since 2011, all elements have been delivered in all Health Board areas throughout Scotland.

·         "As a result of our efforts, dental health in Scotland is improving, particularly in deprived communities. In the Primary 7 age group dental health has never been better and on a Scotland level the target of 60 per cent of this age group having no obvious decay has been met. This is a fantastic success story."

Summary of 2016 Pendlebury lecture http://www.fgdp.org.uk/content/news/synopsis-of-the-2016-malcolm-pendlebury-memorial-l.ashx

The state of the nation’s children’s dental health never seems far from the headlines. Although the NHS insists there has been a vast improvement over the past decade, the fact that nearly 26,000 five-to-nine year olds were admitted to hospital for tooth decay in England in 2013-14[i], means the time for action is now. But a focused, multi-agency approach, based on education and prevention, must consider how a child’s needs change as they grow older and move into adolescence.

Just like other life stages, hormones play a significant part, making a good oral health routine crucial. Research has shown that puberty’s rush of ‘sex hormones’ affects the periodontium.[ii] This is an unavoidable factor; as for an ‘avoidable’ one, a smoking habit usually starts, and gets established, during adolescence, and obviously has many serious consequences for dental and systemic health.

Like smoking, eating disorders are often initiated during the teenage years. Individuals who develop bulimia nervosa may experience acid erosion to the surface of the teeth as a result of vomiting. Anorexia nervosa can lead to increased caries, xerostomia and osteoporosis due to a lack of essential nutrients.

Energy drinks are popular during examination time as they are marketed as boosting energy, decreasing fatigue and enhancing concentration. However, they are often full of sugar, too. Skipping breakfast – or grabbing something unhealthy on-the-go – is also common. New research has shown that teens are twice as likely to suffer from halitosis if they miss breakfast[iii] and, with these years being a defining time socially, bad breath can be a great motivational tool to trigger better oral care!

With finances also likely to be an issue we need to look at simple, cost-effective ways to boost teens’ dental health between appointments. Education about the causes of halitosis, proper brushing techniques and the dangers of smoking of course are important, but they could add some adjunctive products, too, such as CB12 mouth rinse and Boost chewing gum which are clinically proven to neutralise the gases that cause halitosis and keep the the mouth fresh all day.  

With such a drive to improve children’s dental health, we much not forget what comes after. Late adolescence is full of social, psychological and financial pressures and regular trips to the dentist are unlikely to be a priority, especially if an individual has just left home for the first time. The best solutions are always the simple ones, and no one wants to be known as the person with bad teeth or breath! Guidance and support is not just for kids, and will provide life-long benefits.

For more information on CB12 and the extensive research behind it, please visit www.cb12.co.uk

Recent research has revealed that only half (53%) of UK parents, with children under the age of 12, take their children to visit the dentist regularly[1]. Furthermore, just a quarter (25%) of parents believe it is important to take a baby to the dentist as soon as they develop their first baby tooth. This coincides with reported figures that suggest dental caries among children are rising[2] and that more children in England are being admitted to hospital because of tooth decay than for any other reason[3].

These worrying trends highlight the need for healthcare professionals to educate parents on the importance of regular check-ups. Creating a more child-friendly practice could also help to improve the number of children visiting and encourage them to return.

Starting with the entrance and reception area, practices should be inviting and put both adult and child at ease from the moment they walk in the door. Parents should feel comfortable enough to want to bring their babies to the practice, so that the dentist can check on the development of the milk teeth and ensure any problems or signs of decay can be identified and addressed early⁴.

A small number of changes can be made within the practice to enhance a child’s experience, for example:

• Smaller chairs for children to sit on
• A specific area in the waiting room with toys, comic books and magazines
• Experienced and friendly staff who can help to build a child’s trust
• Providing stickers, sugar-free sweets or healthy snacks for children at the end of their treatment.

It is essential to gain a patient’s confidence within the operatory room, and despite including some of the above changes, the dental chair can remain a particularly daunting place. Climbing into an intimidating chair and letting a masked, gloved stranger poke around in their mouth can be a big deal for some young patients[4]. It is important that all patients feel safe and relaxed, and a dental unit that looks and feels comfortable will help achieve this.

A modern stylish dental unit, such as the innovative Skema 8, will reassure patients that they are going to be well looked after and help keep stress to a minimum. Developed by leading manufacturer Castellini, the Skema 8 is designed to optimise the workspace while improving patient comfort. Dentists can work easily without leaning over the patient, and by not intruding so much on a child’s space this may reduce worries and ensure a quick and efficient appointment.

Maximise comfort and provide a professional service to all your patients with the Skema 8 – contact the experienced team at Castellini to find out more.

If you want more information on how to receive Castellini Technical Accreditation, please call 08000 933975 and speak to Castellini UK Ltd directly for assistance.