Delivering Better Oral Health version 3 Lisa Howells, Senior Dental Officer, Welsh Government

What am I going to talk about? Using Delivering Better Oral Health - why use it? - how to use it? - who should use it?

Why use DBOH? 1. Preventing the preventable - Dental teams want to prevent disease - it’s part of our duty as health professionals - There’s a lot of preventable oral disease out there – caries, root caries, erosion, gum disease, mouth cancers - People are living longer and keeping their teeth 2. To ensure dental team members give consistent advice in practices and across Wales 3. HIW inspections include Are patients given oral health promotion, cancer screening and smoking cessation advice when indicated. Does the practice know about Delivering Better Oral Health version 3? 4. Dental Protection Risk Wise …. “dental members are advised to ensure they are familiar with… DBOH” (eg the dentist says one thing, the dental nurse another and the hygienist something else. In the end the patient goes with an article in the waiting room copy of Woman’s Own)

Caries in 3 year olds 2013 - 14 Survey of 1,483 children in 187 day care and nursery settings. A 3 year old in Wales with tooth decay will have about 3 decayed teeth (Welsh Oral Health Information Unit, 2014). Many parents don’t clean their child’s teeth until about 18 months, and only once a day.

Proportion of 3 year olds with at least one tooth affected by decay (% with d3mft>0*) Source: WOHIU

Fluoride Varnish NHS GDS data – The number of children who received fluoride varnish treatment continues to increase, from 5,787 children in 2010-11 to 44,137 children in 2014-15. But……….

Child Courses of Treatment that contain selected clinical treatment between 1 April 2014 and 31 March 2015 (NHS DS)

Children receiving FV as a part of D2S* *2014-15 figures are provisional. Source: WOHIU

Information for parents Fluoride Varnish is a safe and proven way to help to prevent tooth decay. It can be applied by a dentist or other trained dental team member. Dentists and their teams are advised to apply Fluoride Varnish twice a year to children age 3 and over, but it can safely be applied up to four times a year for children who are more likely to have tooth decay. The applications do not have to be evenly spaced through the year Designed to Smile website, Information for Professionals http://www.designedtosmile.co.uk/fluoride_varnish_new3.html

Adult Dental Health Survey 90%of adults were dentate – average about 24 teeth each 10% were edentate – down from 37% in 1978 13% of dentate adults were classed as periodontally healthy with no calculus or bleeding 7% of dentate adults had excellent oral health – 21 or more teeth, 18 or more sound and untreated teeth, no active decay, no pocketing, plaque or calculus. ADH Survey 2009 – Wales Key Findings

Mouth cancer About 700 new cases in Wales every year (oral and pharyngeal cancers) 5 year survival rates ; 40% to 59% Treatment – surgery / radiotherapy / chemotherapy Source – Welsh Cancer Intelligence and Surveillance Unit, April 2014

Smoking cessation Smoking is the leading single cause of serious illness and avoidable early death in Wales. - About 21% of adults smoke - About 14% of pregnant women smoke - 2/3 report they would like to stop The Tobacco control Action Plan aims to reduce smoking levels to 20 per cent by 2016 and to 16 per cent by 2020.  

Alcohol Misuse About 22% of adults exceed the guidelines for alcohol consumption - 83% of those don’t think it’s a risk to their long term health The Service Framework for the Treatment of Alcohol Misuse in Wales advocates brief interventions in primary care for those drinking excessively but not requiring treatment for alcohol dependence

DBOH How to use it? Who should use it?

Health and Care Standards Standard 4.1 Dignified Care People are supported to maintain a clean, healthy, comfortable mouth and pain-free teeth and gums, enabling them to function as normal (including eating and speaking) and prevent related problems.

Thank you – any questions?