06 June 2023

• The Oral Health Foundation is backing a new report which calls for a package of new preventative policies to improve the nation’s oral health.

• Research from Frontier Economics for the Wrigley Oral Healthcare Programme outlines three urgent interventions that can prevent and reduce incidences of tooth decay.

• The new set of recommendations has the potential to save NHS dentistry £51m and NHS dental patients almost £100m annually.

A leading national charity is backing the release of a landmark new report that aims to reduce the number of people suffering from tooth decay while also saving the NHS millions.

The Oral Health Foundation is calling for the immediate roll out of three oral health policies outlined in the review and believes they have the potential to reduce unnecessary trips to the dentist, save people and the NHS millions of pounds, and free up capacity to deliver up to 8.3m more check-ups.

The report, Economic Value of Good Oral Health, was undertaken by Frontier Economics and has been launched to coincide with National Smile Month.

It shows that water fluoridation programmes, sugar-free chewing gum and supervised toothbrushing could result in 1.43m fewer tooth extractions, 1.6m fewer fillings and 265,000 fewer root canal treatments carried out on the NHS every year. The associated savings to NHS dental services could reach over £51m.

The Oral Health Foundation believe that with more people finding it difficult to access NHS dentistry, along with the significant cost of treatments for oral health problems, the immediate roll out of preventive interventions is essential.

Dr Nigel Carter, chief executive of the Oral Health Foundation, says: “The current model of NHS dentistry is broken and not fit for purpose. Treating oral health problems requires an endless pit of money and a workforce that matches population growth. Both resources are becoming increasing scarce.

“With this in mind, we must shift our approach from treating oral health problems, to preventing them from happening at all. Oral health diseases are almost entirely preventable with the correct daily care and supportive policies.”

Dr Ben Atkins, a dentist and trustee of the Oral Health Foundation, adds: “Water fluoridation programmes, sugar-free chewing gum and supervised toothbrushing all have the potential to reduce the amount and severity of oral disease. Nobody deserves to suffer from pain and discomfort because of their oral health, yet this is what faces millions of people every year.

“Politicians and policymakers now must step-up and make radical changes to how oral health care is managed in the UK. This report highlights the positive impact just a few new interventions can make towards reducing oral disease, lowering the pressure on a dwindling NHS workforce, as well as releasing the financial burden of an NHS dental budget that has been stagnating for years.”   

Water fluoridation

Fluoride can be added to public drinking water to improve oral health by protecting people from tooth decay.

Water fluoridation has been used in various parts of the world for almost 80 years and was introduced in the UK around 60 years ago. Currently, only 10% of the population in England have fluoride added to their water supply.

“We believe that water fluoridation is the single most effective public health measure there is for reducing oral health inequalities and tooth decay rates, especially amongst children,” says Dr Carter.

The report suggested that rolling out water fluoridation to the 90% of the population who are not already covered in England and Wales could lead 1.2m fewer tooth extractions each year.

Last year, the Office for Health Improvement and Disparities reported that water fluoridation reduced the number of children admitted to hospital for tooth extractions by up to 63%.

Sugar-free chewing gum

The report also highlights how sugar-free chewing gum can support good oral health by encouraging saliva production, which contributes to neutralising plaque acids, maintaining tooth mineralisation and removing harmful micro-organisms.

Evidence suggests that chewing sugar-free gum (containing sorbitol or xylitol) twice or three times a day can reduce the risk of tooth decay.

Dr Mike Dodds, BDS PhD, Senior Principal Scientist with the Wrigley Oral Healthcare Program, says: “We know that dental services are under real strain right now, with a backlog from the pandemic still being worked through. So the role of preventative policies, that can help reduce demand on services, is more important than ever.

“The evidence has long shown that sugar-free chewing gum can promote good oral health. Chewing sugar-free gum is one simple, effective and enjoyable thing people can do to prevent tooth decay and support good oral health.”

The report suggests that if most people chewed sugar-free chewing gum three times a day, there could be an estimated 109,430 fewer tooth extractions, 182,383 fewer fillings and 36,477 fewer root canals carried out on the NHS every year.

Supervised toothbrushing

The final recommendation from the report suggested that supervised toothbrushing programmes should be used in schools or nurseries, to improve the oral health of younger children.

Dr Atkins says: “By supervising a child when brushing, you are making sure they are cleaning their teeth effectively. This means that they are brushing for the full two minutes and covering every surface of each tooth.

“The other benefit of supervised brushing programmes is that they help children to establish good habits. They help to instil the importance of brushing twice a day with fluoride toothpaste – a behaviour they are more likely to carry through into adulthood.”

According to the report, a supervised toothbrushing programme targeted at children aged between three and six living in the poorest 20% of areas, would save the NHS £8m a year.

The Oral Health Foundation is now calling for the Office for Health Improvement and Disparities, Department of Health and Social Care, NHS England, local authorities, and dental practitioners across the country, to consider placing a greater focus on preventative oral health interventions as part of a wider strategy to tackle the challenges in dentistry.

You can read the full report here