Oral Health in Adults

Headlines

  • Fewer adults in Wakefield visited a dentist in the last two years (75% compared to the regional average 80%).
  • One in four (27%) adults in Wakefield describe their oral health as fair, poor or very poor, slightly more than the regional average (25%).
  • In Wakefield, a third of adults (33%) report occasional or more frequent discomfort when eating because of problems with their teeth, mouth or dentures.
  • Those living in more deprived areas are likely to experience poorer oral health than those living in the least deprived areas.
  • The main sources of information for parents for their child’s dental health were dentists, health visitors and the internet.

The population

Oral health has improved over the last forty years in England, however many people continue to experience pain and discomfort associated with oral diseases. Oral health has an impact on the way people eat, speak and socialise; it is an important part of a person’s health and wellbeing.

Information on oral health in adults generally comes from a dental survey completed by the Office for National Statistics every 10 years (decennial), the most recent survey was completed in 2009. Approximately 6% of  adults were estimated to have no natural teeth in 2009, a sharp decline from the 28% estimated in 1978. The prevalence of tooth decay has also fallen, from 46% (1998) to 29% (2009).

Studies have demonstrated that young adults, the elderly and those of a lower socioeconomic status are more likely to experience dental caries.

All adults are at risk of poor oral health even though it is highly preventable. Oral health disease is closely linked to the following risk factors that are modifiable

Smoking and alcohol have also been associated with oral cancers. There is also evidence of links between Human Papilloma Virus (HPV) infection and oral cancer.

The Burden

Information on oral health is not routinely or readily available.  The national decennial survey provides an overview of oral health in adults at a national level, however this information is not available for Wakefield.  In 2008 a postal survey of adult oral health was carried out across Yorkshire and Humber, providing information on the self-reported oral health of adults living in Wakefield.

  • Fewer adults in Wakefield visited a dentist in the last two years (75% compared to the regional average 80%).
  • One in four (27%) adults in Wakefield describe their oral health as fair, poor or very poor, slightly more than the regional average (25%).
  • 29% of adults in Wakefield described painful aching in the mouth, occasionally, fairly often or very often, the same proportion as the regional average.
  • In Wakefield, a third of adults (33%) report occasional or more frequent discomfort when eating because of problems with their teeth, mouth or dentures.
  • Almost 30% (29.7%) of adults stated they have been self-conscious because of their teeth occasionally or more often, slightly more than the regional average (29.1%).
  • More adults in Wakefield reported that they felt they would need treatment if they went to the dentist; 28.6% compared to 25.4% regionally.

The Inequality

Some communities and groups are more vulnerable to poor oral health and less likely to receive dental care for a number of reasons. It is difficult to quantify the level of dental disease due to the lack of local and national data.  The groups most affected are:

  • Adults with learning disabilities,
  • Adults in residential care,
  • Prisoners,
  • Homeless people,
  • People from black and minority ethnic communities,
  • People with a mental illness,
  • People on low income,
  • Older due to the ageing process,
  • Women during pregnancy.

The 2008 postal survey provides further information on inequalities:

  • More women than men have no teeth (9.2% females, 6.8% males), this may in part be because there are more older women in the population and proportion of the population with no teeth increases with age.
  • Those living in the most deprived areas are more likely to have no teeth, 10.8% compared to 4.8% of those living in the least deprived areas,
  • More adults in deprived areas describe their oral health as fair, poor or very poor, 36.3% in the most deprived areas compared to 18.3% in the least deprived areas,
  • More adults in deprived areas stated they had a painful aching in their mouth in the last 12 months, 37.7% compared to 23.8% in the least deprived areas.

Service Provision

Access to NHS contracted general dental practices (GDP) is available across the district. This includes 32 primary dental practices, a community dental service; advanced mandatory services and unplanned dental care for emergencies.

Wakefield Community dental service is the main provider of the community dental services and provides special care dentistry and primary care for groups of people who cannot be treated in the general dental service. Priority groups may include:

  • Adults with mental health problems,
  • Adults who are severely physically and/or medically compromise who cannot receive care in general dental practice,
  • Homeless people.

The domiciliary oral healthcare service reaches out to those people who cannot visit a dentist. Wakefield community dental service provides domiciliary care within their core contract.

Sedation services – Wakefield Community Dental service provide inhalation sedation services.

Bariatric people are often unable to visit conventional dental practices because of lack of disabled access and normal dental chairs will not support their weight or facilitate their size. Bariatric dental services are provided by the Wakefield Community Dental Service.

Community Assets

There are approximately 32 NHS Dental Practices in the district.

Mid Yorkshire Hospitals NHS Trust provides the Community Dental Service which has clinics in various parts of the district.

Mid Yorkshire Hospitals NHS Trust also provides a wide range of medical and surgical treatments for patients with problems related to the mouth, jaw. face and related structures.

There is a Smoking Cessation Service which dentists can refer into to improve the general and oral health of patients.

There are drugs and alcohol Services that dental patients can access.

Community pharmacies are able to provide oral health promotion information and advice.

The interactive map below can be used to show the location of different community assets.

Resources

Interventions and messages to prevent dental caries and improve the oral health of adults and older adults include:

  • Brush at least twice daily, with a fluoridated toothpaste,
  • Brush last thing at night and at least on one other occasion,
  • Use fluoridated toothpaste with at least 1,350 ppm fluoride,
  • Spit out after brushing and do not rinse, to maintain fluoride concentration,
  • The frequency and amount of sugary food and drinks should be reduced,
  • Encourage dentists to carry out opportunistic screening for oral cancer for adults who are at high risk.

PHE, 2014 Delivering Better Oral Health – an evidence-based toolkit for prevention

NICE 2014, Oral Health –Oral health improvement for local authorities and their partners

NICE 2015 Oral health promotion: general dental practice  

NICE 2016 Oral health for adults in care homes

PHE 2014 Smokefree and smiling – Helping dental patients to quit tobacco

The dental health of adults in Yorkshire & the Humber 2008

West Yorkshire oral health needs assessment 2015

Adult Dental Health Survey 2009 – Summary report and thematic series

 

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