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​Five point plan for better oral health in Northern Ireland

Following Improving oral health in Northern Ireland: our manifesto


1.  Deliver a new oral health strategy

Northern Ireland has the worst oral health inequalities in the UK. A 10-year old Oral Health Strategy needs an urgent update.


The DHSSPS 2007 Oral Health Strategy has recommendations now some ten years old and based on data from 2003.  A new Oral Health Strategy needs to be underpinned by the latest evidence and outline key priorities and actions for commissioners.


Despite improvements over the last 30 years, Northern Ireland still has the worst oral health in the UK strongly linked to deprivation. Worryingly, large proportions of children continue to be affected by poor oral health. 72% of 15-year-olds in Northern Ireland have tooth decay in Northern Ireland compared to 44% in England and 63% in Wales.


In order to achieve sustained, long-term improvements in oral health and close the inequalities gap a new Oral Health Strategy must be a priority for the incoming Executive.


2. Real action on sugar

Sugar is fuelling an avoidable epidemic of decay. It's time for real action on marketing, education and taxation of sugary drinks and snacks.


An unacceptable number of children suffer from tooth decay and the biggest single factor is sugar. Rates of tooth decay have been found to be much higher among children in more deprived families.  In Northern Ireland, more than double the amount of 15-year-olds had teeth missing due to decay (13%) compared to 6% in England.


Untreated tooth decay can lead to young children needing dental treatment under general anaesthesia. In 2013, over 5300 young people in Northern Ireland were admitted to hospital for tooth extractions. In those 5300 cases dentists extracted 24,154 teeth. It is scandalous to think that 22,056 of those teeth were rotten baby teeth. This is a distressing experience for both children and their parents and is entirely preventable.


We welcome the news that the UK government will introduce a sugar levy on the soft drinks industry from 2018. This is a step in the right direction and BDA calls on the incoming Northern Ireland Executive and Assembly to press ahead with a comprehensive action plan to reduce sugar consumption to include action on advertising, food labelling and public education.


3. Efficient and effective regulation

Dental regulation is costly, time-consuming, and unfocused, and patients and dentists deserve better. We call on the Assembly to review the current regulations.


Patient safety is dentists' paramount concern and dentists acknowledge and accept the role of regulation in maintaining high standards, reassurance and confidence to their patients. However there is a need to secure regulation of the dental sector which is proportionate, takes account of the reality of dental care, the costs and benefits to be achieved.  


In Northern Ireland practices are inspected more frequently and regulated as 'independent hospitals'. BDA believes that by changing the regulatory regime, adopting a risk based approach and reducing the frequency of inspections, can utilise resources more effectively and deliver real benefits for patients and the sector.


BDA is calling on the Assembly to review the current legislation that governs the regulation of dental practices.


4. Cut red tape

Dentists are bogged down with bureaucracy that doesn't benefit patients and causes huge delays. It's time the Assembly eased the restrictions on treatment.


In Northern Ireland, dentists are required to submit claims for approval to carry out health service treatment, if the cost of the dental work exceeds £280. The threshold has not increased since 2003. The approvals process is causing unnecessary delay to patients where even routine dental care is subject to prior approval. 

Dentists and patients are becoming increasingly frustrated by lengthy delays in getting the go-ahead for treatment plans. BDA is calling on the Assembly, as a matter of urgency, to make the legislative changes required to increase the prior approval threshold.  


5. Plan for the future

With ever-growing demand, let's ensure NI is training the dental professionals it needs. It's time for dedicated workforce planning, and contracts fit for the future.


If the Assembly is to make best use of its limited resources to deliver good quality, preventive dentistry for patients, planning is required. 


Workforce planning plays a crucial role in ensuring services are sustainable and the planning of training to meet future population needs, in particular, overcoming the challenges associated with an ageing dentate population. The increasing requirement for more complex and specialised dental care needs to be addressed. We welcome the progress the DHSSPS has made towards carrying out a dedicated workforce planning for dental professionals but this must be continuous, long term and strategic.


Inevitably informed workforce planning will need to be underpinned by new contracts that are fit-for-purpose. The incoming Executive and Assembly must renew its commitment to the funding, development and introduction of new contracts for general dental services and community dentists.