Inequality and the future of dental care

Health inequalities across the UK are well documented and are represented in oral health, where there has been a long-standing disparity between people with good and poor dental health


Inequalities in oral health are often unjust, related to social status, wealth and education. While, as a population, it has steadily improved over the last generation, we still have a subset of those who display significantly higher levels of disease than others.

With the evidence suggesting that dental health is strongly linked to areas of deprivation, we are at a critical point whereby the government’s wider public health policy must address all key factors which could lead to poor oral health.

While potentially avoidable, however, these inequalities are far larger than general health strategy, instead expressive of our broader society as a whole. The task of government agencies, associations and other health bodies must be to work collaboratively to produce and integrate a series of cohesive messages, focusing on prevention, which feeds into the education and health and social care sectors.

The unacceptable factor here is that dental disease is entirely preventable. Adopting a simple daily oral health and hygiene routine should be sufficient to develop and maintain good oral health. Brushing last thing at night and at one other time during the day with a fluoride toothpaste, cutting down on how often we have sugary foods and drinks, and visiting our dentist regularly, as often as they recommend, are three effective ways to protect our oral health.

But it is clear that not enough of the population are following these guidelines. Communication and motivational methods from the health professional to the patient must also improve in order to engage and encourage that change.

Despite the burdens in dental disease, which still exist throughout some areas of the country, there has been much to applaud over recent years. The commitment to drive up standards of care show that we’re moving in the right direction, while the introduction of Direct Access has meant that more people than ever before can see an NHS dental professional, meaning the days of overstrained waiting lists are far behind us.

Educational methods have also evolved, but there has been another change, an even more significant one, which has had a hugely positive effect on the nation’s oral health.

The change has come from within ourselves. The most important aspect to recognise is that it is us, the people, who can make the biggest contribution towards improving our own oral health. As a population we are more health conscious than ever before and this has fed through into our oral health. While policy and investment are critical to outcomes of health, particularly in addressing inequalities, it is our own mindset that is most likely to determine whether the nation’s oral health improves.

The social and financial burden of oral diseases, and the barriers that create inequalities need major investment, initiatives and actions

So far the signs are positive. The first Adult Dental Health Survey in 1978 showed that one in three Brits had none of their natural teeth. From today’s standards that’s a truly staggering thought and, despite today’s ageing population, that figure has now reduced to around one in twenty.

The oral health of children in the UK tells a similar story. The amount of decayed, missing or filled teeth in 12 year olds averaged 4.8 a generation ago – an unthinkable scenario for today’s standards. Latest figures have shown this average has reduced to as little as 0.7 and, alongside Germany, is the best in Europe.

Both of these examples, and there are plenty more, demonstrate that evolving policy, standards of care and public attitudes towards oral health are changing for the better. What needs to happen now, as we work towards a brighter future, is that the entire population benefits from these changes.

The social and financial burden of oral diseases, and the barriers that create inequalities need major investment, initiatives and actions, which focus on a consistent approach and ensuring all our population receive the right care, in the right place and at the right time.

Dentistry is not always reflected in the most positive light but, alongside the other organisations and people working within it, I am fully committed to building a bright and successful future. By delivering oral health care to those that need it most, supporting an increasingly polarised society with added financial struggles and ensuring that prevention is at the forefront of our dental care system, we can work towards building a network which ultimately stamps out these inequalities.