«Tell us what you think Have your say on dental care in Fife Introduction Oral health in Scotland has gradually improved since the 1960s and changes ...»
A Strategic Plan for Oral Health in Fife
Tell us what you think
Have your say on dental care in Fife
Oral health in Scotland has gradually improved since the 1960s and changes in the
patterns of disease have occurred in recent years. However, large amounts of dental
diseases such as tooth decay and gum disease are still present. These largely
preventable conditions are estimated to be among the commonest diseases in the
world. These conditions particularly affect those experiencing disadvantage in their lives, as they are more likely to develop dental disease.
In 2008, Fife published “Improving oral health in Fife: A strategy to keep Fife smiling 2008-2013”. In 2013 a review of the strategy was undertaken and found that many objectives had been met, especially in relation to improving oral health and the priority should focus on addressing inequalities. In 2015, work began to develop a new strategic plan for oral health in Fife. The Fife Health and Wellbeing Alliance (FHWA) published the second iteration of “Fairer Health for Fife” in 2015, which is a plan to reduce inequalities. The three themes outlined in the inequality strategy document form the basis of the aims in the oral health strategic plan. These themes
Supporting healthier lives for individuals and families Creating healthier places and communities Changing the way organisations work The Strategic Plan The development of the Strategic Plan for Oral Health in Fife was led by the Dental Public Health Department of NHS Fife in collaboration with a wide range of partners, both from the NHS and council services. The focus of the strategy is to reduce inequalities and target those most in need. Data were gathered from a variety of sources to represent both local and national priorities. There is a rich policy and strategy background to reducing inequalities and improving health both within Fife and Scotland, therefore this plan was considered alongside these existing documents.
A draft plan was completed in December 2015 and we are now embarking on the consultation and engagement phase to develop the strategic plan. We hope to publish the final plan in 2016.
1|Page Children’s Oral Health Since 2006 Fife has made significant improvements in the oral health of children.
Data from the National Dental Inspection Programme (NDIP) tells us Fife has met the national target to have 60% of children in P1 and P7 free from obvious dental decay, the latest figures show that 70.8% of P1 children and 76.1% of P7 children show no signs of obvious decay (NDIP 2014 and 2015).
However, despite the improvement in the number of children free from obvious decay there are still big gaps between children in Fife with those living in the most deprived areas having 30% more dental decay than those in the least deprived areas and general anaesthesia for dental extractions are still the most common reason for elective surgery.
The improvements noted in child oral health are probably due to the introduction of the Childsmile programme in 2006. Childsmile is the national programme designed to improve the oral health of Scotland’s children and reduce inequalities in oral health and in access to dental services. The programme promotes wider partnership working among healthcare professionals and agencies to deliver primary care prevention programmes, anticipatory care and the appropriate management of dental decay within NHS services and in other settings.
There is still room for improvement. Decay experience is measured at the level where active intervention would be required, i.e. a filling. Prevention programmes are important to reduce levels of disease and stop disease before it occurs. Fife still has approximately 30% of its child population suffering from a preventable disease and therefore significant work, especially targeting those in the most deprived circumstances should continue.
Adult Oral Health The number of adults with no natural teeth has fallen over the past 20 years.
However, like the problems seen in children, it is linked to deprivation and is much more common in older people.
There are groups of adults who may find it harder to access dental services and who experience significant disadvantage in their lives. These include those who are homeless, disabled, frail or dependent on others or those who live in deprived areas.
People with disabilities often have higher levels of gum disease and dental decay and are more likely to have their teeth extracted.
2|Page People in Fife are living longer, and although tooth loss is reducing, the dental aspirations of the population are such that people wish to retain their teeth and therefore need more complex dental care. Longer lives may also bring medical and poly-pharmacy complications for the dental team to manage successfully. Personal care may need to be carried out by carers, which brings further training and support needs.
Oral Cancer Oral cancer is a significant concern; the number of cases of oral cancer has risen in recent years and is linked to a number of different factors including smoking, alcohol, poor diet and Human Papilloma Virus (HPV). Oral cancer is also strongly linked to deprivation.
We must make sure we can support those who develop oral cancer and improve prevention and early detection services.
Dental Services Most NHS dental services are provided by general dental practitioners, or high street dentists, based in local communities. The availability of dental services across Fife has significantly improved and is fairly equally distributed across the health board with approximately 180 general dental practitioners currently working in Fife.
Orthodontic services appear to be provided evenly across Fife, with specialist practices and the hospital services available to patients. We also offer oral and maxillofacial services in the acute hospitals in Fife.
The Public Dental Service (PDS), previously known as the Community Dental Service, provides care for patients who need additional support. This includes anxious patients, those with special needs or disabilities and emergency care. The PDS has fourteen clinics based throughout Fife and is involved in training undergraduate dental students from the University of Dundee.
One key issue for dental services is improving the number of patients attending the dentist on a regular basis. Around 75% of adults and 88% of children in Fife have attended a dentist within the last 2 years but particular groups show much lower rates. We hope to improve the rates of attendance in very young children (aged 0-3 years), teenagers and young adults (13-24 years) and older adults (age 65+ years).
To help us shape the strategic plan to meet the needs of everyone in Fife, please tell us what you think by following this link to answer a few short questions.