WordofMouth ISSUE 06 / APRIL 2013
The true cost of
DENTISTRY
Dental Buddy Do you have what it takes to be a Buddy? BRITISH DENTAL HEALTH FOUNDATION 2013
WordofMouth CONTENTS
David Westgarth
DR NIGEL CARTER OBE 04 Men - brush up to keep it up
Gum disease related with erectile dysfunction
12-13 New dental charges
New NHS dental charges from 1st April
05 Aspirin ‘may cut oral cancer risk‘
14 Sweet treats turn sour
06-07 Dental Buddy
15 New oral health targets
08-09 The true cost of dentistry
16-17 Oral facts and tips
10-11 Dental sedation
18-19 Shop
Aspirin could prevent head and neck cancer
Learning oral health in the classroom
Money makes the world go around
Dr Daz Singh from Ollie & Darsh
Parents are putting oral health in harm
Platform for Better Oral Health in Europe
Dental care for older people
Resource offers for April 2013
In the last issue we touched upon the importance of World Oral Health Day, and once again we’re going to take a closer look at what the findings of the Platform mean to you and I. Cost has always been a barrier people point to for not visiting the dentist, yet spending a few pennies now can save a hefty bill later in life. We also take a look at some groundbreaking research the Foundation reported on. Men – pay attention, as gum disease and erectile dysfunction have once again been linked. Perhaps of more importance is the research suggesting regular aspirin use can cut the chances of developing oral cancer by up to 22 per cent. The Foundation has lead the battle to raise awareness of this disease for a number of years, and such a simple preventive measure
WordofMouth Editor
Chief Executive of the British Dental Health Foundation Hello and welcome to April’s edition of Word of Mouth.
davidw@dentalhealth.org
David Westgarth has some very clear benefits. National Smile Month, another of the Foundation’s major campaigns, is looming on the horizon. Taking place from 20 May to 20 June, we speak to Ollie and Darsh about the provisions in place for the more nervous patients among us. There’s also some great advice on what to do if you lose a tooth. It can happen in the most unusual of circumstances – I even remember the Foundation reporting on someone losing a tooth after being hit in the face with a potato! The new and updated NHS dental charges are out. We have the new list for you, so you know what to expect at your next visit. I hope you enjoy this issue of Word of Mouth. Happy reading and we’ll see you in May - National Smile Month! Dr Nigel Carter OBE
Art Director Doychin Sakutov
Guest Writers David Arnold Dr. Daz Singh
Educational Resources Amanda Oakey Becky Sollis
Severe gum disease in men more than doubles their risk of suffering from erectile dysfunction, according to a new study.
ASPIRIN ‘MAY CUT ORAL CANCER RISK’
More than half (53 per cent) of men in the study had severe gum disease in the group with erectile dysfunction, compared to fewer than one in four (23 per cent) without.
esteem and relationships could suffer too. To avoid it even becoming an issue, there are a number of things you can do to stop gum disease from developing.
Taking a regular low dose of aspirin could prevent head and neck cancers by almost a quarter, according to new research.
The results, published in the Journal of Sexual Medicine1 also revealed men between 30-40 years old are most likely to suffer from erectile dysfunction if they have severe gum disease.
“Removing food stuck in between your teeth close to gum lines is a really important step to preventing gum disease. Using interdental brushes or flossing is the best way of doing this. Brushing alone only cleans 60 per cent of the tooth’s surface, so this is an excellent way of keeping plaque – the cause of gum disease – at bay.
The results of the study1 concluded that people were almost a quarter (22 per cent) more likely to avoid developing head and neck cancers if they took aspirin on a weekly and monthly basis. Throat cancers had the most benefit from regular aspirin use.
According to the National Institutes of Health2, erectile dysfunction, also known as impotence, is defined as the inability to attain and or maintain an erection sufficient for satisfactory sexual performance. It is a condition that affects one in ten men worldwide, and is more commonly experienced after the age of 40. When people suffer from gum disease, bacteria from the mouth can get into their bloodstream, so it should therefore come as no surprise that this piece of research has linked vascular erectile dysfunction, another cardiac-related condition, with gum disease. Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, hopes the increasing liberal attitudes towards sexual health problems will prompt men across the country to take steps and lower their risk. Dr Carter said: “Sexual health problems, particularly for men, are no laughing matter. The link may seem frivolous, but the research clearly points to severe gum disease as a possible cause of erectile dysfunction. “Not only does oral health become a problem, self-confidence,
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MEN – BRUSH UP TO KEEP IT UP
“Regular visits to the dentist will also give your dentist the best possible opportunity to monitor your oral health. If they feel it is deteriorating and plaque is building up, a simple scale and polish can put you on the right track, provided you keep up a good routine at home. “The first sign of gum disease is blood on the toothbrush or in the rinsing water when you clean your teeth. Your gums may also bleed when you are eating, leaving a bad taste in your mouth. Your breath may also become unpleasant. If you notice any of these over a period of time, it may be worth booking an appointment to see the dentist.”
References
1. Oğuz, F., Eltas, A., Beytur, A., Akdemir, E., Uslu, M. Ö. and Güneş, A. (2013), Is There a Relationship Between Chronic Periodontitis and Erectile Dysfunction?. Journal of Sexual Medicine, 10: 838– 843. doi: 10.1111/j.1743-6109.2012.02974.x 2. National Institutes of Health Consensus Development Panel on Impotence. Impotence. JAMA 1993; 270: 83-90.
More than 16,000 people in the UK are affected by head and neck cancers every year. One of those is mouth cancer, a disease on the rise that affects more than 6,000 people and claims more lives than testicular and cervical cancer combined. Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, stressed the importance of the findings but urged a word of caution. Dr Carter says: “Mouth cancer cases are increasing, so this piece of research is encouraging. Regular aspirin use has been linked to preventing a number of cancers, and if it is a particularly successful practice for warding off mouth cancer, it should act as a springboard for more research. “But as much as these results are encouraging, people should not be fooled into thinking that taking aspirin counteracts the dangers of mouth cancer. If you smoke, drink alcohol to excess, have a poor diet and are at risk from picking up the Human Papillomavirus (HPV), often transmitted via oral sex, aspirin use will be irrelevant.
“Mouth cancer can affect all parts of the mouth, tongue and lips. It could be a painless mouth ulcer that does not heal normally. It is important to visit your dentist if these ulcers do not heal within three weeks. “Other signs and symptoms to look out for include red and white patches in the mouth and unusual lumps and swellings. “The good news is if spotted early, survival rates are almost 90 per cent. However, too many people come forward too late, because they do not visit their dentist for regular examinations, and this means survival rates tumble to as low as 50 per cent. Our advice is simple – if in doubt, get checked out.” Using data from the National Cancer Institute Prostate, Lung, Colorectal and Ovarian Cancer (PLCO), a large scale investigation of the effect of aspirin and ibuprofen on head and neck cancer risk was undertaken. For those aged 55-74, a ‘significant’ reduction of head and neck cancer risk was observed between weekly and monthly aspirin use; daily aspirin use and ibuprofen were not significantly associated with a reduced risk.
References 1. British Journal of Cancer (2013) 108, 1178–1181. doi:10.1038/ bjc.2013.73
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Your chance to help Dental Buddy explore oral health in the classroom! Schools contacting their local dentist are generally pleasantly surprised how willing they are to give up some of their time to visit the classroom. Often, they can have a profound effect on the attitude children will have towards the dentist.
INTRODUCING YOUR CHILD TO
DENTAL BUDDY
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The British Dental Health Foundation is looking for ‘Buddies’ to aid its quest to improve oral health in children. The charity is asking dental professionals, teachers and educators to take up the challenge and deliver oral health education in a bid to increase your child’s oral health.
Foundation has launched www.dentalbuddy.org - a website with a range of free materials and resources to encourage more dental professionals and schools to work together to deliver oral health messages to children in the community.
Latest figures reveal a third (33 per cent) of 12-year-olds have some kind of cavity while around one in seven (14 per cent) of eight-year-olds have signs of decay in permanent teeth, with one in 100 losing a tooth to decay.
Director of Educational Resources at the Foundation, Amanda Oakey, is asking for dental professionals and teachers to become a ‘Buddy’ themselves and take their expertise into the classroom.
Children who learn good oral health habits early are far more likely to carry them into adulthood - that is why the
Amanda said: “Teachers have a lot of pressure to deliver education that meets national targets in literacy, numeracy
The symbol of the campaign is Buddy, a spaceman character who will set out to explore oral health in partnership with children.
Schools, working with parents and health professionals, have an important role to play in educating young people about healthy lifestyles, including their oral care. Introducing oral health into the school curriculum, especially at Key Stage One and Two, should make a big difference. Contact your teacher to enquire about how much time is spent teaching your child about oral hygiene, and urge more hours to be spent on it - it could be one of the best lessons your child can learn.
and areas such as Personal, Health & Social Education, which oral health happens to fall under.
Based on the Foundation’s three core messages, the aim of the campaign is to educate children on:
“By working with local practices and oral health teams and sharing their knowledge and experiences, there is every chance to really make a positive difference for many children in the UK, particularly in more deprived areas where inequalities in health are more apparent.
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The importance of brushing their teeth for two minutes twice a day using a toothpaste containing the correct amount of fluoride;
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Their diet and to cut down on how often they have sugary foods and drinks;
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The importance of visiting the dentist regularly.
“Oral health levels of children in the UK are generally very good but fundamental problems still exist. Children not being taken to the dentist, not being provided with toothbrushes and fluoride toothpaste and having imbalanced diets loaded with sugar. These are basic lessons we can pass on directly to the children themselves and teach them the value of good oral hygiene.”
Resources on the website include lesson plans, activity sheets and presentations, geared specifically towards Early Years, Key Stage One and Key Stage Two children. Please visit: www.dentalbuddy.org
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THE TRUE COST OF DENTISTRY Liza Minnelli once sang the lyrics ‘money makes the world go round’. In a time where many people are scrimping together their last pennies just to keep their head above water, cost is a particularly sensitive topic. So why, you might ask, am I going to talk about spending money on something more than 50 million people in the UK place little or no value on? Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, explains why. “There is some very strong evidence out there that suggests the benefits of preventing tooth decay far outweigh the cost of restorative and emergency treatment. A report commissioned by the Platform for Better Oral Health in Europe revealed the true scale of the problem. “The 27 current EU Member States are spending an estimated €79bn on all aspects of care and treatment provided by dentists. This is a staggering amount, yet
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The Platform for Oral Health in Europe meeting in Brussels last month. the cost of neglecting oral health has a significant financial burden on individuals and our society. “Oral diseases are a major problem across the EU. Spend on treatment eclipses the money spent on other diseases including cancer, heart disease, strokes and dementia. All of these fall in the public spotlight with Governmentdriven campaigns as they pose a risk to the health of the nation. Poor oral health poses a bigger risk, yet awareness remains considerably lower.” In the UK, an estimated £9.65 billion was spent on oral health care in 2012 – a figure which is predicted to increase by almost a fifth (17.2 per cent) to £11.31 billion by 2020. So what can we do to make sure spend on dentistry doesn’t spiral out of control? Dr Carter suggests a two-pronged
approach. “Poor oral health has been linked to four of the five major killers: cancer, heart problems, strokes and respiratory problems – and investing in dentistry could potentially save millions of pounds treating these diseases, enabling the money to be ploughed back into the NHS. “Earlier this year Secretary Hunt’s mortality call to action outlined his ambition to save 30,000 avoidable deaths from the five major causes – cancer, heart, stroke respiratory and liver disease – and to make England among the best in Europe. With these conditions currently killing more than 150,000 people under 75 every year, and with cardiovascular disease (CVD) representing about 30 per cent of all deaths in 2011, taking action on these five
big killers will have a major impact in saving more lives. “The other option is for individuals to take responsibility for their oral health. The mounting evidence only reiterates the Foundation’s long-held view that regular check-ups, regularly changing toothbrushes and buying toothpaste with the correct amount of fluoride in it really are not luxuries. “You wouldn’t skip an MOT on your car because you think there’s nothing wrong with it, and you certainly shouldn’t skip investing in your oral health because you’re not in any pain or discomfort. If you forego basic check-ups due to cost, there’s every chance when something goes wrong and you do need to visit the dentist you’ll have to pay a much larger amount upfront.”
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DENTAL SEDATION Your dentist may recommend an intravenous or IV sedation. This is given by injection, either in the back of your hand or in your arm. The dose will depend on the amount of treatment needed and the length of time it will take to complete.
National Smile Month takes place 20 May - 20 June. It is an opportunity to educate and raise awareness of oral health matters by promoting three of the simplest messages: that people should brush their teeth for two minutes twice a day using fluoride toothpaste; that people should visit the dentist on a regular basis; and that people should limit their intake of sugary foods and drinks. It all sounds so simple, but the statistics don’t lie. More than a third of adults have been found to postpone getting dental treatment due to cost, and it doesn’t help when more than half of UK workers are not given paid leave for dental visits.
Dr. Daz Singh are far reaching and can lead to problems being left unidentified and untreated, leaving people in a situation where they run the risk of having to pay more for major dental treatment when, or if, they step into a dental practice. But everyone deserves access to dental treatment, and now. Help is available through sedation If your oral health is being affected by a phobia of the dentist then dental sedation is an effective solution to help you put your fears aside and get the treatment your teeth and gums need. There are dental practices investing in this area in terms of training and equipment, along with other patient care initiatives, to help patients receive treatment in a calm and comfortable environment. This also results in future appointments and check-ups being less stressful to attend, providing real long-term benefits to your oral health.
Are you a candidate for dental sedation?
Benefits of sedation Helps patients to remain calm and relaxed
Dental fear What if fear is standing in the way of your oral health? Fear of needles, fear of pain, fear of choking. It may sound like hocus pocus to some people, but the effects are real and can have a negative impact on a person’s dental health. We are here to tell you that you should not let a fear of the dentist stand in your way. The statistics have got it right, once again, with 60 per cent of people aged 65 and over being found to regret that they did not care for their teeth earlier in life. So please do not become just another statistic. In the UK an increasing number of people are avoiding regular dental check-ups due to dental fears. The implications
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Reduces symptoms of fatigue associated with extended dental treatments Assists patients who struggle to become numb Means less time dental chair the dentist is with a relaxed
in the because working patient
Proven to be beneficial to patients with a range of dental fears
This is an option which has proven to be effective when used with a range of dental treatments, ranging from a scale & polish and advanced periodontal treatment, to the placement of dental implants and crowns. If you are unsure whether or not you are a good candidate the following questions will improve your insight: • • • • • •
Do you become nervous about visiting the dentist? Does a particular dental treatment make you nervous? Have you been left mentally scarred by a previous traumatic experience at the dentist? Do you have difficulty becoming numb? Are you scared of needles? Do you have difficulty controlling your movements due to conditions such as Parkinson’s Disease or Cerebral Palsy?
If the answer is yes to one or more of the above questions then dental sedation is an effective means of improving your comfort in the dental chair and making sure that treatment is always unattainable. Ollie & Darsh are a specialist cosmetic dentist based in Liverpool.
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NEW DENTAL CHARGES Dental charges depend on the treatment you need to keep your mouth, teeth and gums healthy. You will only ever be asked to pay one charge for each complete course of treatment, even if you need to visit your dentist more than once to finish it. If you are referred to another dentist for another, separate course of treatment, you can expect a second charge. Some minor treatments are free. These are the new NHS dental charges brought in from 1 April 2013: Band 1 course of treatment – £18.00 This covers an examination, diagnosis (eg X-rays), advice on how to prevent future problems, a scale and polish if needed, and application of fluoride varnish or fissure sealant. If you require urgent care, even if your urgent treatment needs more than one appointment to complete, you will only need to pay one Band 1 charge. Band 2 course of treatment – £49.00 This covers everything listed in Band 1 above, plus any further treatment such as fillings, root canal work or if your dentist needs to take out one or more of your teeth. Band 3 course of treatment – £214.00 This covers everything listed in Bands 1 and 2 above, plus crowns, dentures and bridges. If you would like more information or advice on dental charges please contact the Dental Helpline on 0845 063 1188.
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SWEET TREATS TURN NEW TARGETS TACKLE ORAL HEALTH SOUR INEQUALITY AND COST Parents are putting the oral health of infants and young children in harm’s way by giving them ill-advised foods and drinks, a new report reveals. According to the Diet and Nutrition Survey of Infants and Young Children (DNSIYC), two in every three (62 per cent) children aged 12-18 months had ‘sugar, preserves and confectionary’ foods. The pattern of perilous goodies continued with drinks, as one in four (26 per cent) 12-18 month old infants also enjoyed fruit juice and soft drinks. As well as the number of infants and young children having sugary foods and drinks rising, the amount they were consuming also increased, causing concern for leading oral health charity the British Dental Health Foundation. The results present an obvious problem to the oral health of children, particularly if sugary foods and drinks are consumed too often. In fact, in 2003, less than half of five-year-olds (41 per cent) had obvious tooth decay and by 2008 only three out of ten (31 per cent) five-year-olds in England had decay. Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, said: “The most important message to remember is it is not the amount of sugar children eat or drink, but the frequency of sugary foods and drinks in their diets. Children aren’t born with a sweet tooth. It is acquired over time
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due to their dietary habits. “Of real concern to the Foundation is the potential for an erosion explosion in children’s teeth. Fruit juices are becoming increasingly popular and the fruit content can make them seem like a good idea. However, they contain very high levels of sugar and acid and so can do a lot of damage to the teeth. “If your child has a drink in between meals it is important to have only still water or milk instead of sugary drinks, which can cause decay. Savoury foods such as cheese, pasta and vegetables are better than sweet foods. Food that does not contain sugar is better for your baby’s teeth. Ask your health visitor for more advice about a balanced diet for your baby. “At such a young age it is unrealistic to remove sweet foods and drinks altogether from a child’s diet. To combat this, it is important to try to keep their consumption to mealtimes. Snacking is also allowed, but do bear in mind it is better for the child’s teeth and general health if they have three meals a day instead of 7 to 10 ‘snack attacks’, many of which will contain sugar. Try to have no more than two snacks in addition to regular meals.” The survey, carried out on behalf of the Department of Health and Food Standards Agency, provides detailed information on the food consumption, nutrient intakes and nutritional status of infants and young children aged 4 up to 18 months living in private households in the UK. The full report can be read here http://transparency.dh.gov.
uk/2013/03/13/dnsiyc-2011/
The Platform for Better Oral Health in Europe has unveiled fresh targets in an attempt to address the challenges of rising costs and increasing inequalities across oral health by 2020. To coincide with World Oral Health Day 2013 [Wednesday, March 20], the Platform held a roundtable discussion at the European Parliament where the proposed targets were presented to EU policymakers and to a panel of public health stakeholders and professional associations. Revealed as part of a European-wide consultation, the planned targets focus on three key priorities, which include data collection systems, preventive policies, and education and awareness. The targets will serve as a basis to benchmark EU Member States’ progress towards increased prevention of oral diseases and improved oral health in Europe by 2020. Presenting the 2020 targets, Professor Kenneth Eaton, Chair of the Platform, said: “The burden of oral health disease continues to challenge Europe, particularly Southern and Eastern European countries where significant disparities already exist and where access to affordable treatment grows more and more difficult. “Meaningful actions to increase disease prevention and improve the state of oral health across Europe are needed now. We are calling on stakeholders across
Europe to help us make our proposed 2020 targets a reality, and to ensure that more Europeans take advantage of the simple, effective tools that can help them improve their oral health today.” In the UK, £9.65 billion was spent on oral health care in 2012 – a figure which is predicted to increase by almost a fifth (17.2 per cent) to £11.31 billion by 2020. Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, highlights the growing need for strategic oral health prevention policies in order to lower the overall amount spent on treatment. “These targets will attempt to assist in the development of a coherent European strategy for the promotion of oral health and the prevention of oral diseases. We must begin to recognise the common risk factors for oral diseases and other chronic diseases and work towards linking oral health policies across other European policies. “We need a better integration of these policies in the UK, as well as across Europe, in addition to addressing the socio-factors of health inequality. Encouraging supportive environments in key local communities such as schools and colleges, hospitals, workplaces and care organisations, will help to lower the disparities which still exist predominately among the vulnerable and those on lower incomes.” The consultation is open to all interested individuals and organisations: www.oralhealthplatform.eu.
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TEN FACTS 1. Older people are keeping their teeth for longer; 85 per cent of 65-74 year olds, 70 per cent of 75-84 year olds and 53 per cent of 85’s and over have at least one natural tooth. 2. By the age of 65 the average number of teeth is 10.5. 3. 77 per cent of 65-74 year olds attend the dentist for regular check-ups, the most in any age bracket recorded. 4. More young people are afraid of the dentist than old people. 5. The use of a chlorohexidine varnish can prevent and treat tooth decay. 6. You are entitled to free NHS dental treatment if you are claiming the Pension Credit Guarantee Credit benefit. 7. The longer you smoke and/or drink alcohol, the worse your oral health will be. 8. Dry mouth can occur as you get older as a result of medication or a pre-existing medical condition. 9. Cosmetic treatments are available to replace missing teeth and to repair them. Dentures, implants, crowns, bridges and fillings are other restorative options. 10. 45 per cent of people aged 65-74 years and 70 per cent of people aged over 75 wear dentures.
ORAL FACTS AND TIPS DENTAL CARE FOR OLDER PEOPLE There aren’t many certainties in life, but getting old is one of them. It’s only natural for things to begin to show wear and tear, and your teeth are no exception. However, it is no guarantee you will lose your teeth. With the right care, keeping them through life is possible. To ensure your teeth continue to stand the test of time, the British Dental Health Foundation are offering the following dental advice for older people.
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FIVE TIPS In addition to following the Foundation’s three key rules for good oral health*, the following tips are recommended for older people: 1. For people with limited movement, consider using an electric toothbrush to minimise the amount of work you will need to do. Interdental cleaning is particularly important too. 2. If you have dentures, remember ‘brush soak brush’ Clean them twice a day and keep them moist at all times. 3. If you spot some signs of gum disease – blood on your toothbrush, receding gums, loose teeth, bad breath – clean more thoroughly. If the signs do not abate, talk to your dentist or hygienist on how to improve your current routine. 4. Always tell your dentist about any medical conditions you may have. This will enable the dentist to treat you in the safest possible way. 5. If you are unable to visit the dentist, contact your local Primary Care Trust to find out which dentists can visit you.
* The British Dental Health Foundation promotes three key messages for good oral health: • • •
Brush your teeth for two minutes, twice a day, with a fluoride toothpaste. Cut down on how often you eat sugary food and drinks. Visit your dentist regularly, as often as they recommend.
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For enquiries, to request a complete catalogue, or to order call: 01788 539 793 email: order@dentalhealth.org or visit www.dentalhealth.org/shop
OFFER APRIL 2013 Place your order for resources to the value of £75 and choose one of the following special offers. Call 01788 539793 and quote EDSP03. Subject to availability.
PROMOTE TREATMENTS AND
EXPLAIN CONDITIONS A resounding hit with dental professionals, the Foundation’s range of patient information leaflets provide the perfect way to explain conditions and promote treatments. Either handing these to individual patients, or making them available in the reception and waiting room areas, will ensure patients have the correct information. • Easy to understand question and answer format • Written and verified by qualified dental staff • Approved for plain English by the Word Centre • Regularly reviewed and updated
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British Dental Health Foundation/ International Dental Health Foundation Smile House 2 East Union Street Rugby Warwickshire CV22 6AJ United Kingdom Tel: 01788 546 365 Fax: 01788 541 982 Email: pr@dentalhealth.org Website: www.dentalhealth.org