Over 45s need ‘targeted dental treatment’

Older patients will require better-targeted treatment than promised by the planned new contracts for dentists, MPs have been told.

Those aged over 45 – who grew up before significant improvements to dentistry practices – will continue to need ‘rehabilitation’ work, as well as a new focus on preventive treatment, a meeting heard.

The comments were particularly significant because they came from Professor Jimmy Steele, Head of the School of Dental Sciences at Newcastle University – and the author of the 2009 dental review.

‘The good news is that under-45s have healthier teeth than ever before and they have much better prospects than those who came before them’

Professor Steele told the Westminster meeting that the proposed ‘capitation’ system – to tackle criticism that the current deal lacks rewards for high quality care, or for delivering prevention – still made sense for all patients.

But he said 25% of work on over-45s would be rehabilitation, adding: ‘It will take more than a deftly-applied fluoride varnish, useful though that maybe.

‘In the future, rehabilitation will be just as important as how we stop disease happening, if we want to ensure all of our patients get what they want.’

In September, the Department of Health (DoH) announced trial changes to the current contract at 68 dental practices – but there is no date for introducing a new contract across the board.

Professor Steele also called for better information about what’s available on the NHS, as well as consideration of the controversial issue of charges, ‘to make sure we use scarce resources well’.

The speech was made to a meeting of the all-party parliamentary group for dentistry, chaired by Conservative MP Sir Paul Beresford, a dentist himself.

Professor Steele also suggested the evidence to explain why most people visited a dentist every year was ‘sparse’, saying: ‘That’s not a question that is asked often enough.’

And he urged caution on the ‘fantastic’ progress made in dentistry over the last decade, arguing that disease was on the rise in Australia, so dentists ‘shouldn’t be complacent’.

Furthermore, while gum disease also down, serious cases were up slightly – and patients with disease were as badly affected as 10 years ago.

On a positive note, Professor Steele said: ‘The good news is that under-45s have healthier teeth than ever before and they have much better prospects than those who came before them.’

And he poured scorn on the suggestion that patients should visit every six months, saying: ‘That derives from something somebody published in the United States in the 1940s. There is no evidence for that.’

The meeting also heard from Mike Browne, director of policy and communication at the General Dental Council, who presented the results of the GDC’s most recent survey of patients’ attitudes.

It found that 65% of people had been dental patients in the last 12 months, varying from 74% in social classes AB to just 65% in classes DE.

More than 60% said they were ‘very satisfied’ with their treatment and a further 30% were ‘fairly satisfied’.

However, a researcher from Which magazine said the conclusions were more encouraging than its own undercover research, saying: ‘You are painting a rosier picture than our research.’

‘Out of 20 visits across England made by Which experts, 11 were rated poor, with evidence of poor case history-taking, clinical examination and a ‘hotch-potch of inappropriate treatment offered to our undercover researchers’.

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