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Prevention in practice – an initiative between BASCD and Department of Health. Sue Gregory Consultant in Dental Public Health. The task. DH want to focus on prevention - How can prevention be built into the new contract? What help can be given to PCTs to help them commission more effectively?
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Prevention in practice –an initiative between BASCD and Department of Health Sue Gregory Consultant in Dental Public Health
The task • DH want to focus on prevention - How can prevention be built into the new contract? • What help can be given to PCTs to help them commission more effectively? • Can we maximise the yield from the preventive tools we have and the knowledge on how they work?
Following the publication of Choosing Better Oral Health - 3 supporting documents: • ‘Smokefree and Smiling’ - Guidance to PCTs on smoking cessation and how it fits in with dental practice – Richard Watts, May 2007 • Guidance on improving oral health among adults and children with disabilities – Colette Bridgman, to be launched soon • ‘Delivering Better Oral Health’ - Provision of evidence-based information to support the commissioning of preventive services –Sue Gregory, Sept 2007
Contents • Reference cards - Summary guidance • Supporting chapters: • Principles of toothbrushing for oral health • Increasing fluoride availability • Healthy eating advice • Identifying sugar-free medicines • Improving periodontal health • Stop smoking guidance • Accessing alcohol misuse support • Prevention of erosion • Supporting references
Distribution • General practices • Salaried services • Consultants in Dental Public Health • Also available online
The Team • Chair – Sue Gregory (BASCD president) • Secretary – Semina Makhani • Derek Richards (BASCD) • Gill Davies (BASCD) • Keith Milsom (National Oral Health Unit) • Rowena Pennycate (BDA) • Baldeesh Chana (FGDP) • Nigel Carter (BDHF) • Richard Watt (OHPRG) • Tom Dyer (GDP) • Tony Jenner / Jerry Read (DH) • Rosemary Khan, Jan Clarkson
The Principles • Statements must be supported by evidence – the stronger the better • The potential benefits of prevention have not been maximised • Not doing enough • Prevention not evidence based • Challenges the ‘high risk’ approach in favour of a practice ‘population’ approach
ThePrinciples • Messages would be in line with wider health messages • The common risk factor approach • Providing information for • The whole dental team • Dental care at primary, secondary and tertiary level • Primary Care Organisations to assist with commissioning
Prevention of caries in children aged from 7 years and young adults
Prevention of periodontal disease – to be used in addition to caries prevention
Erosion • Currently the evidence is based upon laboratory studies or observational studies. No evidence could be found which measured the effectiveness of providing preventive advice in a clinical setting. • Until such evidence emerges guidance will be provided in the Appendix 8 in the Supporting Information With acknowledgement of the original work carried out by: Mrs J T Duxbury Miss M A Catleugh Prof R M Davies Dr G M Davies
Commissioning Implications • Fluoride varnish costs 30 pence per application • 3 x per year, yields 3 UDAs • Skill mix (hygienists & therapists) • Effective Prevention better than Cure