Regular dental attendance is recommended for patients of all ages from the first year of life, with the interval between appointments, up to an exceptional maximum of two years, being determined by an individual’s oral health and past dental needs. Regular oral health assessments are required to check for both common forms of dental disease – dental decay, gum disease and tooth wear, and other diseases of the jaws, jaw joints and oral-facial soft tissue, including a check for any signs of oral cancers of which there are more than 12,000 new cases each year. Also, oral health assessments provide opportunity for dental healthcare professionals to advise patients on their oral health maintenance.
Regrettably only about 60% of the population seek regular dental attendances. Most forms of dental disease do not give rise to any significant symptoms until well advanced, limiting options and possible outcomes when treatment is eventually sought.
Oral Health and wellbeing
Oral health, an essential element of wellbeing, is the third most expensive health condition to manage after diabetes and cardiovascular disease.
There is strong evidence of associations between poor oral health and conditions including diabetes, obesity, cancer, HPV and sexual health, cardiovascular disease and older people’s general health. There is also evidence of associations with arthritis and kidney disease, with the list of such associations continuing to expand.
Inter-professional working, i.e. different healthcare professional working together to provide integrated, holistic care for individual patients, has been shown to be beneficial and effective, with opportunities for cost savings. To date, it has been the rare exception to have general dentists included in, let alone consulted by healthcare teams looking after patients with conditions with proven associations with poor oral health.
Dental teams may also enhance oral health and wellbeing through smoking cessation and dietary advice, including alcohol consumption. In some cases, dentists may be the first to identify and help address conditions such as eating disorders which tend to be associated with erosion of the teeth.
Dental attractiveness, a large element of facial attractiveness, can be compromised by missing, diseased and malaligned teeth, aesthetically poor fillings, crowns and veneers (restorations), staining and discolouration of teeth, both intact and filled, problems with dentures, and diseased gums which may be swollen and red or receding exposing the roots of the teeth and margins of restorations. Through measures, many linked to establishing good oral health, dental teams in general practices can greatly improve, if not transform dental attractiveness and in the process wellbeing and personal confidence, often helping to address low esteem and other emotional and mental health conditions, including depression.
Emergency dental care
Emergency dental care may be required following a number of events including, trauma, the sudden, catastrophic failure of a tooth, loss of a filling, crown or veneer, damage to a denture, or, mot commonly, untreated dental decay (dental caries) affecting the nerve of the tooth causing severe pain, possibly followed by the formation of a dental abscess. Emergency dental care may also be required when, for example, an erupting wisdom tooth becomes infected. Invariably, the effective treatment of these conditions requires dental expertise and the availability of specialist dental equipment, devices and instruments which are not available to general medical practitioners and pharmacists and medical staff in Accident and Emergency departments in general hospitals. Pain killers ( analgesics) may help control any pain but will not treat the underlying problem. Antibiotics are only indicated if a patient has clear evidence of an infection which cannot be fully managed by some form of dental treatment.
Dentistry following the COVID-19 pandemic
Dental practices reopened after ‘lockdown’ on Monday 8 June 2020. Visits to the dentist are now different, with various new measures being taken to protect patients and the dental team. Ahead of an appointment, patients, who will be suitably briefed by their dental team, will be asked to fill in a number of forms. On the day of the appointment, patients will be asked to attend alone and to arrive promptly. They will be screened for COVID prior to being allowed to enter the practice, which will have been cleaned and specially prepared for you following the previous patient. In the practice, especially during treatment, there will be a number of measures to minimise the risk of any transmission of the virus. These measures, including, for example, hand sanitisation, should not give rise to any anxiety. The appointment may be longer than experienced previously. Once the treatment has been completed, there will be a procedure to be followed to allow you to exit the practice safely, with social distancing being respected. Further details may be found on the website of your dental practice or available on request from your dental team.