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Fighting for prevention in oral health

Blog Author Dr Robert Witton

Blog Date 27/11/2020

​Chair of the BDA’s Dental Public Health Committee, Dr Robert Witton, outlines the key role that dental public health plays in oral health prevention and the need to protect this specialty.


The tooth trainThe tooth train: a popular prop used in Devon’s supervised brushing scheme to raise awareness of tooth-brushing and healthy eating © Peninsula Dental Social Enterprise CIC


In the midst of a global pandemic, some may feel that prevention in oral health should be put on the backburner. But tooth decay, and the need for extractions under general anaesthetic, continues to be the main reason young children are admitted to hospital.


New data is likely to show that oral health inequalities have widened during this pandemic. Access problems added to the suspension of public health programmes and sugar-laden lockdown diets have accelerated these problems. It now more important than ever that we focus on prevention for oral health and that is exactly what we in dental public health are committed to doing.


Dental public health is essential

As the Government’s spending review sets out plans for spending on public services over this coming year, we have joined with 49 other organisations, including Cancer Research UK, to call on Government for a levelling up of public health funding in the face of this crisis. We know that sustained cuts to local public health are a false economy and dental public health budgets must be recognised and protected if we are to win the fight for oral health prevention. And oral health prevention is something we are committed to despite PHE being partly merged into the new National Institute for Health Protection and the uncertainty that this brings to our programmes.


Right now, our colleagues are frustrated and feel abandoned, and we are concerned that years of work and experience may fall by the wayside. That’s why, we have called on Government to protect our members’ jobs and ensure that dental public health continues to be valued and resourced.


Good oral health, including sugar reduction and the importance of tooth-brushing, must be recognised for the fundamental impact it can have on health and wellbeing. It should be considered alongside obesity. I, and the other members of the BDA Dental Public Health Committee, will continue to communicate this to the Government and the public.


Losing the war on sugar?

With limited access to routine dental care for children due to COVID-19 and the likelihood of ‘lockdown diets’ increasing people’s consumption of sugary food and drinks, it is now more important than ever to focus on the importance of prevention. Sugar intake is still a fundamental problem when it comes to children’s oral health and we need to continue to raise awareness amongst the general public. But are we losing the war on sugar?


Recent results from PHE’s sugar reduction report are not encouraging. They reveal that there has been minimal progress to reduce sugar levels in food. There has been ‘little or no reduction’ between 2015 and 2019. Industry has cut barely 3% of sugar from products over this period. This shows that voluntary action on reformulation is not working. It’s clear that we need to encourage sustained behaviour change.


The Government’s public health campaigns, including their drive to reduce sugar intake via the Change4Life Sugar Smart campaign has had some success. However, studies show people’s reduction of sugar tends to be short lived. Societal barriers and confusion over which sources of sugar to avoid, won’t be changed overnight.


Progress is possible. Dental public health plays a vital role by doing research and collecting data on the state of oral health across the UK, and ensuring that we can build on successes. We also take the lead in driving dental public health improvements at a local level, working with communities and key stakeholders, including community and hospital dentists and GDPs.


Getting supervised brushing back on track

A huge part of our remit is to educate the public on good oral health and our supervised brushing campaigns in schools do just that. Implementing supervised tooth brushing schemes in schools plays a vital role in not only promoting tooth-brushing habits and the importance of a healthy mouth, but communicating why this is an essential part of the overall health and wellbeing of a child.


We have recently been successful in getting most of our supervised brushing schemes in Devon back on track, following new guidance from the Government, to minimize risk of COVID-19 transmission, and to ensure patient safety. This is excellent news, as nearly all of our 300 nurseries and schools have confirmed that it is an important priority even during the pandemic.


School staff and our local clinical teams made this possible. And I’m proud to see such great feedback for their work, it really shows what a difference we can make: “All the children really enjoy the brushing bus club and understand the importance of having healthy teeth and gums. The programme is very well organised and the resources are very accessible.”


Fighting for oral health to be given prominence

In dental public health, projects often take a long time to come to fruition. This programme took nearly 10 years to get off the ground. Despite these challenges, we are fighting for oral health to be a prominent part of the wider health agenda. We know that won’t happen overnight, but I believe that there’s never been a more important time to be making this case.


I believe our supervised brushing campaign in Devon is innovative and provides an excellent way forward, we’d like to see our model being rolled out in other counties, in collaboration with other examples of best practice we know are happen across the UK.


The BDA has long been calling for a national scheme for supervised brushing, and Public Health England fully supported this. With a commitment from the Government and the required funding to back it up, we can have a true impact on the nation’s oral health - let’s not lose this opportunity.


We all know that prevention is better than cure, it is time to make this a reality.


Dr Robert Witton


Dr Robert Witton, Chair
BDA Dental Public Health Committee

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