Agenda item

14.00

This paper will discuss the following

·         Provision and capacity of NHS dentists in Oxfordshire

·         Dental health of adults, older adults and children in the Oxfordshire population, including where inequalities exist

·         Programmes of work to promote dental health

·         Dental needs and health in nursing and residential homes

Anna Ireland, Consultant in Dental Public Health (Thames Valley), Public Health England South East, stated that dental health in Oxfordshire is good compared to the national average but, as with general health, there are more problems in some groups, especially the young, the old and the poor.

Hugh O’Keefe, Contract Manager for Dental Services, NHS England South Central, added that in the Thames Valley there has been a 30% increase in people accessing NHS dentists in the last ten years which is a higher rate of growth than for other areas.

There are about 280 NHS practices in the Thames Valley and 150 private providers.  Work focuses on deprived areas with “Starting Well” pilots.  They are also looking at how to provide dental services in care homes.

Dr Eunan O’Neill, Consultant in Public Health OCC, described the oral health promotion service which is trying to improve knowledge and behaviours.  They have trained people to work with children and adults as well training care home workers in older adult oral care.  A report by the Care Quality Commission helped in shaping the response.  Care plans should include oral health.

The Chairman noted that he had seen nursery school children being encouraged to brush their teeth after lunch and asked if this was common.

Anna Ireland said that it was becoming more commonplace but was not universal.  Eunan O’Neill added that they had piloted toothbrushing in primary schools but it was difficult to get schools to keep it up.

Barbara Shaw noted a couple of references in the report to data to be released shortly but one of these referred to data from 2016.  She also asked about variations in the numbers of UDAs Commissioned.

Anna Ireland described two types of survey.  A national survey was delayed due to confusion over who should pay.  A survey commissioned locally in 2016 on 'mildly dependent' was carried out locally but the data is “cleaned” nationally. Both are due but there are no timelines.

Hugh O’Keefe said that the number of UDAs is dependent upon the new contracts and how much NHS dentistry is involved. Cash limiting was introduced in 2006 in areas where there is pressure on contracts and so reflects where demand is and explains the variation.

Councillor Kieron Mallon asked if there was a connection between bad oral health and heart disease.  Anna Ireland said that there were links with aspiration problems and pneumonia but any association with heart disease was not understood.

Anita Higham asked if there were differences between ethnic groups and if more attention should be paid to 11 to 14-year-olds.  Anna Ireland responded that there were different decay rates in different ethnicities but there was no data on brushing.  11 to 14-year-olds in the UK had quite good oral hygiene.  They are most likely to attend a dentist and so would not be a group they would target.

District Councillor Paul Barrow asked what were the high risk groups.  Dr Eunan O’Neill said that they target high levels of deprivation where they provide an offer with schools.  They are moving towards an accreditation programme with primary schools with policies on sugary food, water etc.  Some look to use the pupil premium to invest.

Barbara Shaw asked how they are linking with community dental services and care homes.  Dr Eunan O’Neill responded that they went to a workshop with Healthwatch Oxfordshire and looked at aspects of the care plan. They want to establish an accreditation where staff can do online training that will be free and quick.  Face-to-face training is also available.