What is Oral Health?
Oral health refers to the health of people’s teeth, gums, supporting bone, and soft tissues of the mouth, tongue and lips. Poor oral health can exacerbate existing health conditions, impact on wellbeing by causing pain, difficulties with speaking, eating and socialising as well as being an indicator of neglect or difficult social circumstances. Oral Cancers are also considered within the context of Oral Health. Poor oral health is almost entirely preventable.
How can Oral Health be improved?
- Risk factors include smoking, poor diet, stress, alcohol consumption, poor hygiene and injuries. Using a common risk factor approach to address the underlying determinants of poor oral health will help ensure that services can prevent or improve a wide range of conditions
- Interventions with individuals and communities through all important life stages, with a focus on early year’s prevention, will help develop good oral health behaviours and reduce inequalities in oral health outcomes throughout the life-course
Populations at risk of poor oral health
Vulnerable groups include those:-
- from a lower socioeconomic group
- who are socially isolated or excluded, for example, Gypsy and Traveller communities, those in prison or the homeless
- who are old and frail or geographically isolated
- who have physical and/or learning disabilities or autistic spectrum disorder
- who have a mental health condition, including dementia
- who smoke or drink heavily or misuse other substances
- children of parents with the above risk factors and children in care
- from some Black, Asian and minority ethnic groups (specifically where language is a barrier to accessing services)
- with certain clinical conditions such as Diabetes and congenital heart problems, and pregnant women
Oral health in Somerset
- Somerset has 349 dentists at 81 NHS dental practices (at October 2016).
- There were 441,494 courses of treatment (CoT) delivered by NHS dentists in Somerset in 2015/16. This was about 7,000 fewer than in 2014/15. These figures exclude orthodontic treatment.
- The 2015/16 figure represents a rate of 81,515 per 100,000 population, above the England average.
- The practices seeing the most patients in the 2-year period up to June 2016 were 32 Rodden Road (Frome) and Bridgwater Dental Centre.
Key facts for Somerset - Children and young people
- Although decay in five year olds has reduced over time, 23% of children of this age experience tooth decay, slightly below the national average (25%).
- However, the severity of decay varies across the county; children in Sedgemoor are more likely to have multiple decayed teeth. Sedgemoor also has a relatively high rate of sepsis
- The prevalence of tooth decay in twelve year olds in Somerset is slightly higher than that seen nationally (37% v 33%). The figures are relatively high in West Somerset (46%), Taunton Deane (41%) and Sedgemoor (39%). More severe decay is also evident in West Somerset and Sedgemoor.
- 61% of children in Somerset (66,554) were seen by NHS dentists in the year ending June 2016, slightly above the national average (58%).
- However, for children less than two years of age, attendance at primary dental care services in Somerset is below the national average, especially in Sedgemoor and West Somerset (2014).
- The most common age group for dental extraction is in 5-9 year olds. Within Somerset the proportion admitted for dental extraction in this age group ranges from 0.9% in Sedgemoor to 0.2% in South Somerset. The 'Getset' catchment area rates are highest in Sedgemoor South, Taunton North and East and Quantock West.
For details of the 2015 Oral Health Survey of 5 year-olds, please see the Public Health England Dental Health website.
For more survey results and details of planned research, please see the Dental Public Health Intelligence Programme.
For more results from the 2012 National Dental Epidemiology Programme survey of five-year-old children, please see the Dental Health Profile for Somerset.
Key facts for Somerset - Adults
- 58% of adults (249,367) in Somerset visited the dentist in the two year period ending June 2016, slightly above the England average (52%).
- Between March 2011 and March 2014, access rates increased in all districts other than in Taunton Deane and West Somerset
- Courses of treatment involving preventive interventions for adults occur at a higher than national average rate for fluoride varnishing (2.8% v 2.5%); but below the national average for scale and polishes (9.4% v 19.3%)
- Incidence of oral cancer is highest in Taunton Deane and West Somerset. West Somerset also has a higher than expected mortality rate from oral cancers, which requires greater exploration
- 75% of adults over 55 years of age experienced some degree of periodontal disease
Oral health nationally
- There have been substantial improvements in oral health in the past twenty years, but inequalities remain
- In the two years to June 2016, just over half of the England population were seen by NHS dentists
- There is an increasing proportion of younger adults with moderate tooth-wear nationally. This is indicative of rapid tooth wear and is therefore of clinical concern
- Dental extractions were the leading cause of admissions to hospital for children in England aged 5-9 years of age in 2013/14. 25,812 children in this age group were exposed to the risks and stress associated with a hospital admission and general anaesthetic for a predominately preventable condition.
- 12% of three year-olds already have evidence of tooth decay
- In 2013, nearly a third of 5 year olds and nearly a half of 8 year olds had obvious decay experience in their primary teeth
- About a fifth of 12 and 15 year olds reported experiencing difficulty eating in the past three months.
- More than a third of 12 year olds and more than a quarter of 15 year olds reported being embarrassed to smile or laugh due to the condition of their teeth.
Improving Oral Health in Somerset
A strategy for Improving Oral Health in Somerset 2015-2018 focusses on several key themes:-
- Improving diet and reduce the consumption of sugary foods, drink, alcohol and tobacco
- Increasing the availability of fluoride
- Improving oral hygiene
- Addressing inequalities in oral health
- Increasing access to dental services
As part of implementing the strategy, 'Somerset Smiles’ was launched in April 2016. It is a new service that aims to improve the oral health of Somerset’s children, young people and adults.
The new Primary Care Dental Service is commissioned by Somerset County Council and run by Somerset Partnership NHS Foundation Trust. The service will provide community-based fluoride varnish applications in selected early years settings and children’s centres, oral health care training sessions for carers, wider workforce training for professionals and the distribution of toothbrush and toothpaste packs.
For More Information:-
The Health and Social Care Information Centre website (HSCIC) has more detailed information on the following sources of oral health data:-
The most recent Adult Dental Health Survey was carried out in 2009. While data are not available at county level, findings at national and regional levels can be seen on the HSCIC website.