The gap between those with good and poor oral health is an 'unacceptable and growing chasm', according to the British Dental Association's (BDA's) recently published Oral health inequalities policy.
The Dahlgren and Whitehead schema of factors that influence health
The policy highlights the close association between low socio-economic status and poor oral health, calling for more focus on preventive dental care. It also says there should be a more integrated approach to oral health from health and social care providers. The paper argues greater priority should be given to particular patient groups, including those with disabilities, older people and the prison population, while the contributions of alcohol and tobacco to oral health inequalities are also stressed, particularly as risk factors for oral cancer.
It calls for resources to enable dental professionals to take a more preventive approach, including counselling patients on the dangers associated with alcohol and tobacco products, referring patients to smoking cessation schemes and the extension of the ability to prescribe nicotine replacement therapy (NRT) to a wider group of health professionals.
Commenting on the publication, Professor Damien Walmsley, Scientific Adviser to the BDA, said, 'There has been a significant improvement in the nation's overall oral health over the last 30 years, but despite that we still see a huge disparity that is all too often related to social deprivation. It is completely unacceptable that in Britain, in 2009, such a wide gap should exist.'
The report follows the Conservative proposals highlighted in a parliamentary Opposition Day Debate last month where a range of dental policy issues, including the need to progress Professor Steele's review, dental access contracts, effectiveness of PCT commissioning and water fluoridation were discussed.
During the debate, Shadow Secretary of State for Health Andrew Lansley said, 'We need additional fundamental reforms so that we can move to a new registration-based contract with payments linked to the good oral health of patients through a capitation system properly adjusted for the patients being looked after – I recognise the Liberal Democrat point about the need to incentivise dentists in areas where oral health is poorest – while also providing a proper incentive for preventive care.'
The session saw the Conservatives highlight many of their policy proposals for reforming NHS dentistry, including the re-introduction of formal patient registration, the renewal of school oral health screening and promotion, and five-year tie-ins to the NHS for newly-qualified dentists.
The BDA's Oral health inequalities policy is available online at
