Promoting oral health in the community

Dental caries caused 63,000 children to be admitted to hospital for surgery in 2014. In that year, approximately one-quarter of British five-year-olds suffered with tooth decay and more than one-third of children did not see a dentist[1]
,[2]
. Periodontal disease is most common in those over 64 years and oral health in this age group is often poor[3]
. From a more global perspective, during the London 2012 Olympic Games, 55% of sampled athletes were found to have dental caries and 75% gingivitis[4]
. Tooth and gum disease is a common chronic disease.

Poor oral health in children leads to reduced school attendance and poorer performance result. It also influences a child’s dietary choices and habits. For adults it may reduce work performance and attendance. Crucially, poor maternal oral health can impact on many aspects of fetal health. A spectrum of suboptimal health outcomes and indices of quality of life in the elderly have been linked to any inflammatory processes in their teeth or gums.

Pharmacists play a particularly important role within communities as advisers on oral health. Pharmacies provide a range of toothpastes, toothbrushes and mouthwashes that improve oral health. And these products are evolving rapidly. New therapies, such as probiotics to protect enamel or smart toothbrushes to improve brushing, are being trialled.

Pharmacists come into contact with a broader cross section of the population than many established medical services. Their accessibility in the community can help overcome barriers that prevent individuals seeking advice from dental services. Structures for formally commissioning such activities in the UK are rarely in place — they are needed[4]
. Pharmacists could remind customers and patients to make dental appointments, encourage supervised tooth brushing for children, discuss the importance of reducing dietary sugars or signpost telephone apps and other supportive technologies.

Improving oral health, in particular the removal of bad breath with scented mouthwashes, was one of the busiest parts of an apothecary’s trade in the 17th century. Perhaps this emphasis, with some innovations, needs to be re-established now that we have more effective methods.

Colin Michie

Paediatrician

London

References

[1] Public Health England. Child oral health: applying All Our Health. 4 August 2017. Available at: https://www.gov.uk/government/publications/child-oral-health-applying-all-our-health/child-oral-health-applying-all-our-health (accessed August 2017)

[2] Public Health England. Dental public health epidemiology programme. Oral health survey of five-year-old children 2016–17. Available at: http://www.nwph.net/dentalhealth/201617Survey5yearoldchildren/PROTOCOL_2016_17_5yrolds280816%20LD-3.pdf (accessed August 2017)

[3] Public Health England. What is known about the oral health of older people in England and Wales. A review of oral health surveys of older people. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/489756/What_is_known_about_the_oral_health_of_older_people.pdf (accessed August 2017)

[4] Needleman, Ashley P, Petrie A et al. Oral health and impact on performance of athletes participating in the London 2012 Olympic Games: a cross-sectional study. Br J Sports Med 24 September 2013. Available at: http://bjsm.bmj.com/content/early/2013/09/24/bjsports-2013-092891 (accessed August 2017)

[5] White S. Health Matters: Tackling child dental health issues at a local level. 19 June 2017. Available at: https://publichealthmatters.blog.gov.uk/2017/06/19/health-matters-tackling-child-dental-health-issues-at-a-local-level/ (accessed August 2017)

Last updated
Citation
Clinical Pharmacist, CP, October 2017, Vol 9, No 10;():DOI:10.1211/PJ.2017.20203401