The State of the Dental Nation

1
The State of the Dental Nation

• Margie Taylor
• Chief Dental Officer
• Scotland

2
The Dental State of the Nation

• Margie Taylor
• Chief Dental Officer
• Scotland

3
Improve oral health

• Education
• Health promotion
• Appropriate services

4
The Dental State of the Children of the Nation
5
Scotland the nation
6
United Kingdom
7
5 year olds 2000 dmft
lt1.00
1.01-1.5
1.51-2.00
2.01-2.5
2.51-3.00 No survey
8
Dental Health of P1 Children in the UK

2000
2004
2006
Level of d3mft
lt 1.00
1.01 1.50
1.51 2.00
2.01 2.50
2.51 3.00
no survey
9
Dental health of P1 children by Board/PCT in UK
2006
2006
2006
Level of d3mft
lt1.00
1.01 1.50
1.51 2.00
2.01 2.50
2.51 3.00
gt 3.01
10
Worst dental disease in P1 children across the UK
2005/2006
BASCD 2006
11
Proportion of P1 children in UK with no obvious
decay experience

BASCD 2005/6 All Ireland Survey 2003
12
Trends over time in the proportion of P1 children
with no obvious decay experience
National target for P1 children by 2010
SHBDEP (Scottish Health Boards Dental
Epidemiological Programme)
NDIP (National Dental Inspection Programme)
13
with no obvious decay by deprivation category
at age 5 years

SourceNDIP 2006
DEPCAT
14
with no obvious decay by deprivation category
at age 5 years

SourceNDIP 2006
DEPCAT
15
Proportion of P1 children by DepCatwith no
obvious decay experience 1994 - 2006
16
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
17
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
18
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
19
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
20
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
A
B
C
D
E
21
What do we know?

• The people who are most affected
• Where they live
• What causes decay
• Which teeth are most likely to be affected

22
What we should be doing about it

• Prevention
• Early detection
• Treatment

23
What we should be doing about it

• Prevention

24
Care Pathway
Birth
Health Visitor Assessment
25
Care Pathway
Birth
Health Visitor Assessment
Low Risk
26
Care Pathway
Birth
Health Visitor Assessment
Low Risk
Increased Risk
27
Care Pathway
Birth
Health Visitor Assessment
Low Risk
Increased Risk
28
Increased Risk

• Referred to Dental Health Support Worker
• Visit family
• Family to identify dental practice

29
Increased Risk

• Referred to Dental Health Support Worker
• Visit family
• Family to identify dental practice

Dental practice appointment arranged
30
Regular check up patterns by social class 1998
Source ADHS 1998
31
Increased Risk

• Referred to Dental Health Support Worker
• Visit family
• Family to identify dental practice

Dental practice appointment arranged
Child attends
Child fails to attend
32
Child fails to attend

• Dental Health Support Worker to arrange follow up
• Encourage attendance
• Support family as required
• Liase with Dental Nurse
• Try a group session (max 3)

33
What we should be doing about it

• Prevention
• Early detection
• Treatment

34
Percentage registered in Scotland children

35
Number of decayed, missing and filled teeth in
P1 children in Scotland 2006
S C O T L A N D
NDIP 2006
36
Top 10 main diagnoses in children admitted to
hospital electively March 2007
Source ISD February 2008
37
Care Index
38
Mean d3mft of P1 children across the UK 2005/2006
d3mft
BASCD 2005/6 All Ireland Survey 2003
39
The Dental State of the Adults of the Nation
40
Edentate Adults by year

Source ADHS 1998
41
with no teeth by age group
Source ADHS 1998
42
of adults registered in Scotland by age at June
08
Source ISD
43
Attendance for regular check ups
Source ADHS 1998
44
Use of public and private dental services
45
Denplan patients

• Number of patients registered with Denplan has
  increased
• Fastest growth in patients with good oral health
  and low future dental care needs

46
Utilisation of Denplan and GDS in Scotland

• Total number of claims delivered in the GDS is
  approximately constant

47
Utilisation of Denplan and GDS in selected
postcode areas
48
Oral cancer
49
Age standardised rate per 100,000 (2005)
Cancer research UK
50
UK age standardised incidence rates by sex
Cancer research UK
51
Oral cancer registrations and deaths by
deprivation category
Number
SIMD
Source ISD
52
Oral cancer
53
Workforce
54
Population projections

• Demand forecasts are increasing because of the
  population projections
• Uncertainty in the population projection
  generates uncertainty in the demand forecast

55
Access to NHS dental services in Scotland
56
GIS access to NHS dental services in Dundee East
57
GIS linking workforce and spatial data
58
The End