Annual Report Of The Chief Dental Officer 2012

1. Introduction

1.1. Introduction

It is my pleasure to present the inaugural Chief Dental Officer Annual Report.

This report highlights key oral health messages via the presentation of useful information at national and NHS board level and illustrates some recent trends in oral health. This past year has seen significant changes, with the introduction of new oral health promotion and clinical prevention payments for general dental practitioners and the graduation of the first cohort of Aberdeen's Dental School students who undertook a 4-year programme.

1.2 Scope

The purposes of this report are to draw attention to the progress made within dentistry in Scotland and to inform a wide audience - not just those involved in dentistry - of our oral health status against a background of past trends and aspirations for the future.

Dentistry must not be isolated from general health, and this report shows how oral health is a key component of wider general health and affects quality of life. Investing time and expertise in collaboration with the wider health family on the common risk factor approach helps to address dental as well as general health issues.

NHS dentistry extends across all healthcare sectors, but most activity takes place in the primary care setting in either the independent ("high street") general dental service or in the salaried dental service managed directly by NHS boards. Secondary and tertiary hospital dental services are provided from dental schools, hospitals and institutes, as well as general hospitals.

1.3 Statement of Intent

It is not possible to cover every aspect of dentistry within this report, but I hope to engage your attention with a flavour of what goes on in dentistry so you can appreciate that we are dealing not just with people's teeth but holistically with the mouth as part of the body: oral disease has an impact on our whole-body health.

Oral health is improved through such activities as health education programmes, toothbrushing schemes, application of fluoride varnish, dietary advice and preventive treatment services, as well as regular engagement between patients and primary care dental teams. No single approach alone will deliver improvement to our oral health; rather, a multi-faceted, whole-generation approach is required to tackle people's habits and behaviours. Deeply entrenched, harmful behaviours cannot be broken overnight, and many years may pass before evidence of behavioural change is available. However, the many and extensive prevention and promotion programmes now in place are designed not only to change the behaviours of this generation but also to influence the parenting skills of future generations and thereby further improve their oral health.

This evidence-based, multi-optional, concerted action will realise lasting oral health gains.

Throughout this document the term "oral" will be used, instead of "tooth" or "teeth", to mean all areas of the mouth, including the teeth and gums, tongue, soft tissues of the mouth and throat, chewing muscles and jaws.

Margie Taylor

Chief Dental Officer

1.4 Background

When the NHS was founded in 1948, poor oral health was endemic in Scotland, and the main focus of dentistry was on extracting decayed teeth and prescribing and fitting dentures.

Since then, dentistry has come a long way, with the advancement of dental technology and techniques, in teaching and education, in developing the dental workforce, and in securing an overall decrease in dental caries.

Improvements in oral health, and changes in the pattern of disease, have occurred in recent years. These are clearly demonstrated in the latest surveys, and it is encouraging to note that two thirds of young children are now free from obvious dental decay, compared with well under half of young children 25 years ago (www.isdscotland.org/Health-Topics/Dental-Care/Publications/2012-11-27/2012-11-27-DentalNDIP-Report.pdf).

Dentistry now faces a very interesting challenge and one that might not have been considered outside the dental profession. Although the population is ageing, improvements in oral care and oral health mean more people are keeping their natural teeth but requiring more complex care, often in a domiciliary setting. The key to delivering effective dental services for the future is appropriate skill-mix, particularly in relation to managing patients with co-morbidities - especially dementia.