Dental teams should screen for diabetes and offer dietary advice in the global battle to control the onslaught of the disease.

World Health Day is on Thursday (7 April) and this year’s campaign focuses on the growing epidemic of the disease, looking at the causes, the costs and the need for prevention.

Some 350 million people around the world have diabetes and this figure is set to more than double in the next 20 years.

In a bid to halt the rise in cases of type 2 diabetes, in particular, Amanda Gallie, president–elect of the British Association of Dental Therapists (BADT), is suggesting dental practices could – and, therefore, should – expand their health remit to include blood glucose testing, diet and wellbeing advice and motivating patients to better health habits, thereby minimising the risk of diabetes.

She said: ‘Preventive health care lies at the very heart of the role of the dental profession and, in primary care, we are better placed than most health providers to alert patients to the early signs of health-threatening behaviours as we see patients so regularly.

‘Offering in-practice screening for diabetes, in the form of blood glucose testing, not only adds value to the patient’s dental experience but also acts as a key marker regarding risk for pre-diabetics and can be a catalyst to discussions about the importance of good dental hygiene and other preventive measures.

‘When we consider the current financial restraints within the NHS – and the seemingly unstoppable increase in chronic conditions such as diabetes – the role of dentistry has never been so important in an overall health care. The government should consider funding these diabetes tests as an investment in the future health of a nation because, with regular screening, and education about preventive measures we can draw attention to this disease and keep the associated health risks at bay.’

Fiona Sandom, president of the BADT added: ‘Effective health promotion and prevention of oral disease, including supporting general health improvement activities around diet and nutrition, are key parts of what dental therapists do. Day in day out, they deliver oral health care that's evidence based while offering education about the risks of poor diet, and the dangers of smoking and excessive alcohol intake to patients, for example. As many of our members work closely with the public on a daily basis, they are in an excellent position to talk to people about their wellbeing and help them make healthy choices.’

This year, Philip Preshaw, professor of Periodontology and consultant in restorative dentistry at Newcastle University, is the keynote speaker at the BADT’s annual conference – From Cradle to Grey: Developing 21st century strategies for age-related oral care – taking place in Manchester on 23 and 24 September.

He will be addressing the clinical challenges presented by diabetic patients, will look at how the disease increases the risk for periodontitis and will offer an insight into the links between periodontal disease, diabetes and heart disease.

For more information, visit www.badt.org.uk

For more on World Heath Day, visit http://www.who.int/campaigns/world-health-day/2016/en/

For more information, visit www.badt.org.uk or contact Julie Bissett on 079 39 89 09 72 or email This email address is being protected from spambots. You need JavaScript enabled to view it..

There is a concept in nuclear chemistry which many will be familiar with. Critical Mass has been adapted to apply almost any situation nowadays.   When a process of change is beginning, Critical Mass is used to refer to that point when change becomes inevitable.

What starts as a mood that change is needed becomes a minority activity with early adopters, eventually tipping over the edge for widespread general change for the better.

The bigger the system, the more one can see change with necessary Critical Mass at work on a daily basis

Early Years - has General Dental Practice failed?

Is “Early Years” dentistry about to undergo a change of massive significance? Is the state of children’s teeth [as it relates to caries and GA Admissions] about to trigger a political Critical Mass change

The problem of course is this:

£3billion of funding, give or take, by the Government, aims at funding dentists to sit there waiting for patients to wheel their little rug-rats in for a ‘check-up’.

Sadly, two facts suggest this time-honoured approach is a fail.

Firstly only 50% of the population actually go to the dentist, and that is without weighting the numbers towards any problems with new migrant or ethnic groups.

Secondly, by the time the child appears for their check-up age 3-4, the caries is already established, the dietary patterns are embedded and the Prevention horse has, by and large, well and truly bolted.

http://www.hscic.gov.uk/catalogue/PUB17794/prov-mont-hes-admi-outp-ae-April 2014 to March 2015-toi-rep.xlsx  is a spreadsheet of child hospital treatment number suggesting in England alone some 110000 admissions for dental caries at about £670 per admission .

My back-of-my-vape-packet estimate is that some £73Million is spent [in England alone] with hospitals sorting out the fact that community prevention of dental disease in children has failed.  The medics have now woken up to the fact that this same diet is leading to an epidemic of child obesity and diabetes.

This pressure for change, smouldering for some time,  arguably gathered pace with the excellent planning document, Delivering better oral health: an evidence-based toolkit for prevention at

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/367563/DBOHv32014OCTMainDocument_3.pdf

Then we have the January 2015 Faculty of Dental Surgery issuing this report:

The state of children’s oral health in England at

https://www.rcseng.ac.uk/fds/policy/documents/fds-report-on-the-state-of-childrens-oral-health

GDPs do their best - but what is needed?

Patently dental teams who care for caries affected early-years-children do their best, often with imaginative and innovative outreach, but the numbers for GA Admissions suggest the problems fires are still raging despite the attempts to limit the spread by the profession from the GDP model.

Is the demand for planning of a different dental intervention for the first three years beginning to gather momentum? Are we indeed reaching a point where the energy and desire for change to be planned means that significant change will indeed become a priority?

Just look at the last year of public domain comment and criticism of the present status.

The Sugar-Obesity-Diabetes-Caries complex

Sugar is now being discussed in a widespread public debate about obesity [be it child or adult] and diabetes but led his time our medical colleagues. Caries is being discussed too.

Dentistry was the subject of an adjournment debate in the House of Commons this last week

Various media events [including the 3^rd Daily Telegraph Letter] have taken place in which members of the profession have presented the view that the present system of delivery of dental care is simply failing to deliver any effective prevention to the early-years child.

It is also unclear if the new GDP Pilots will change much in the context of a developing problem and reducing financial resources in Government spending plan. It is clear the new CDO [NHSE] has sensed this and is trying to wind the initial changes back and see where the true problem lies an th evidence takes her.

Evidence?

Sadly, there is no real evidence, because we have a problem which requires action for which an integrated approach has never been trialled, let alone undertaken.

One example of the media attention is a recent BBC Look North slot with Dr Tony Kilcoyne.  The BDA it is reported are meeting with the Chief Medical Officer’s team.

Dentistry on its own is a small backwater of medical provision.

But when we start to get frequent interventions by the medical profession, increasing interest by the broadcast media, and an increasing public desire to understand and discuss the situation as it relates to THEIR dental health and that of their children,  … well anything can happen.

Now what happens to the GDP’s element of the  NHS Budget on the back of such changes is, of course, a separate discussion.

But can all this really happen? Will we really witness 2016 as the year that Critical Mass for real change will be reached.

Dentistry and Medicine united?

I suggest the need for a “National Early Years Preventive Strategy” will be crafted which integrates medicine and dental care into a program targeted at mothers and their children and wider families that will aim to influence the diet and dental care of the under 3’s.

We as a profession have arguing this case for years and the Department of Heath have merely sat by.

I sense the medical profession are not going to sit idly by and watch the sugar/obesity/diabetes/caries scanal  wreak further havoc, be it to personal heath or their budgets.

We can but hope. 

We can hope that as a profession we are included in the delivery of a  solution.

We can but hope that something better comes out of it for the wider work of Geneal Dental Practice.