Dental Tribune UK Edition, October 4-10, 2010, No.24 Vol.4

EverClear™ a triumph in clarity For details of Carl Zeiss and our wide range of other dental products contact: See what you are missing... Carl Zeiss EyeMag Smart 2.5x loupes Carl Zeiss GTX Carl Zeiss EyeMag Pro prismatic loupes Carl Zeiss OPMI® Pico Nuview Ltd, Vine House, Selsley Road, North Woodchester, Gloucestershire GL5 5NN Tel: 01453 872266 Fax: 01453 872288 E-mail: info@nuview-ltd.com Web: www.voroscopes.co.uk • Floorstand, ceiling or wall mounted • Photoport for digital camera • Five step magnification • Superlux 180 Xenon daylight illumination V2 LED Illumination T here are fears that the oral health of children in de- prived areas is being put at risk as a result of budget cuts affecting schemes such as Sure Start. Despite reassurances from the White Paper Equity and Ex- cellence: Liberating the NHS that NHS spending is ring fenced, the public health agenda could be compromised through cuts in other departments and at local authority level. The result could be that so-called efficiency sav- ings will affect service delivery, with the greatest impact in more deprived parts of the UK which are already burdened with some of the greatest health inequalities. Declining child oral health A report from the Audit Commis- sionhasfoundthatdespite£10.9bn being spent since 1998 on ini- tiatives that aim to improve the health of children, dental health among the under-fives is declin- ing and the overall health gap between the richest and poor- est children has become wider. In the last 10 years there has been a dramatic increase in the number of children with de- cayed, missing and filled teeth. Research published in the August issue of the British Dental Journal reports that a quarter of three year olds surveyed in Great- er Glasgow have tooth decay, and that in deprived areas this figure rises to 1 in 3 (out of 4000 chil- dren examined). Andrew Lamb, BDA director for Scotland, said that as adult, oral health can be predicted by childhood dental health and targeted interventions are vital to closing the gap in oral health inequalities. The Sure Start scheme, an initiative aimed at providing health and social services for the under-fives, involves health initiatives typically focusing on oral health promotion and fluo- ride toothpaste. Programmes such as Brushing for Life, deliv- ered by health visitors, provides toothbrushes, toothpaste and dental health education mate- rial at children’s eight, 18, and 36 months developmental checks. However, these schemes are po- tentially facing the axe at worst and severe funding cuts at best. In June 2009, the BDA’s Oral Health Inequalities policy paper called for adequate resources and remuneration to enable the dental team to spend time with patients and carry out their role effectively. It called for an evidence-based, integrated ap- proach between all healthcare and social services. However, in light of recent budget announce- ments, Peter Bateman, Chair of the BDA’s Salaried Dentists Com- mittee commented that: “Social deprivation remains a sadly ac- curate predictor of poor oral health. Closing the gap between those with the best and worst oral health must be a priority.” The White Paper proposes the introduction of a new den- tistry contract with a particular emphasis on improving child- rens oral health and increasing access to NHS dentistry. It also says that the NHS will need to release £20 bn efficiency savings by 2014 through cutting admin- istration and management costs, implementing best practice, and increasing productivity. Peter Bateman has a clear vi- sion of what the role of the den- tist should be during this time of financial adversity: “It will be more important that the new contractual arrangements for dentistry support a preventive approach to care for both child and adult patients. It is also es- sential that the profession is engaged in the development of these new arrangements.” Central to the proposals of the White Paper is collaboration be- tween the NHS and other depart- ments. However, the Department of Education, which administers the funding of Sure Start and an- cillary health and social services for children, has been ordered to slash £1 bn from its budget, and it is inevitable that this will filter through to the detriment of chil- dren’s health services. However, the DH is not concerned about any domino effect: “The Department will continue to work closely with the Department for Education on services for children to en- sure that the changes in the NHS White Paper and the subsequent public health White Paper sup- port local health, education and social care services to work to- gether for children and families.” Increasing cost New figures published by the NHS Information Centre high- light the increasing expense of providing dental care. The report Dental Earnings and Expenses in England and Wales 2008/2009 shows that expenses borne by dental practices are escalating at a faster rate than incomes, which does not bode well with the gov- ernment’s ambition of increasing the number of people accessing services. According to the Local Commissioning Survey from the British Dental Association, nearly 17 per cent of PCTs had spent less than 95 per cent of the ring fenced dental budget during 2009/2010. It is not clear whether re- maining funds were completely unspent or diverted to non-dental spending. The BDA warns that in order to be effective, dental services must be fully integrated within primary care to help de- velop local solutions, and that dentistry should be more inte- grated in health services to im- prove holistic patient care. Figures from the NHS Infor- mation Centre, NHS Dental Sta- tis tics, shows that in the 2-year period ending June 2010 a total of £28.5m patients were seen by an NHS dentist, an increase of 376,000 on the March 2006 base- line. However, the percentage of the population seen by an NHS dentist, at 55.4 per cent, remains below the March 2006 level of 55.8 per cent. The report also shows that areas with the high- est percentage of NHS patients (up to 79 per cent) are in poorer boroughs, compared with richer boroughs such as Kensington and Chelsea where only 23.8 per cent of people see an NHS dentist. Peter Bateman said that: “Dentists work hard to improve the oral health of the whole population and the new arrangements must support that work. A focus on the oral health of young people makes sense be- cause instilling good habits en- courages good oral health.’’ The question yet remains: who is going to pay for this? DT Safeguarding the oral health of children Maria Anuguita looks at children’s oral health References: Audit Commission (2010) Giving Children a Healthy Start. Audit Commission, London Davies GM (2010) The dental health of three year old children in Greater Glasgow, Scot- land. British Dental Journal 209: 176-177 NHS Information Centre (2010) Dental Earnings and Expenses In England and Wales 2008/2009. NHS IC, London British Dental Association (2010) Local Commissioning Survey. BDA, London NHS Information Centre (2010) NHS Dental Statistics 2009/10. The Health and Social Care Information Centre. British Dental Association (2009) Oral Health Inequalities Policy. BDA, London Campbell D (2010) Doctors and Nurses among 1700 staff sacked at Department of Health. Guardian: 20 September Maria Anguita, BSc(Hons), MA, DHMSA 9FeatureOctober 4-10, 2010United Kingdom Edition