NHS Yorkshire and the Humber is working with local NHS organisations on a range of oral health promotion initiatives, as outlined in the Department of Health’s publication ‘Choosing Better Oral Health’. We want to ensure dental services are commissioned to not only improve access to NHS dentistry but also include preventative dentistry as set out in the document ‘Delivering Better Oral Health’.
Dentists are able to identify patients who smoke who may not be in contact with other health professionals. Smoking is associated with a number of oral health problems including mouth cancer. Members of the dental team therefore have an important role in encouraging smokers to quit and signposting people to stop smoking services. The local NHS are encouraged to ensure that smoking cessation is a part of their oral health commissioning strategy (see ‘Smokefree and Smiling’).
Water Fluoridation
What is fluoridation?
The Department of Health published guidance in 2008 to help improve dental health and reduce health inequalities by considering the option of fluoridating the local water supply, alongside other options.
Fluoride is a mineral found naturally in all drinking water but the exact level varies between supplies. Where the level is approximately one part of fluoride in one million parts of water (1ppm) it has the optimum effect on dental health.
‘Fluoridation’ is the phrase used when the natural fluoride level in drinking water is topped up to 1ppm.
Fluoridation may not be appropriate or possible in some areas, and an extensive process would need to take place before it could be implemented.
The process
The Department of Health process is as follows:
A Primary Care Trust (PCT) believes that, in addition to other oral health improvement measures, fluoridation could be an effective way of helping to improve dental health and reduce health inequalities locally.
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The PCT requests that their local Strategic Health Authority (SHA) commissions a feasibility study, to determine whether fluoridation would be technically possible and what the costs would be.
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If the feasibility study determines that fluoridation would be a cost effective way of improving dental health locally, the PCT would then decide whether it wished to proceed and, if so, would ask the SHA to undertake a public consultation with the local population. Everyone who lives or works in the area would have the opportunity to respond to the consultation.
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If the public consultation supports fluoridation, the SHA will take steps to initiate the procedure.
The current position in Yorkshire and the Humber
NHS Yorkshire and the Humber received requests to commission a feasibility study from two Primary Care Trusts. The feasibility study is the first step in an extensive process and will establish if topping up the natural level of fluoride is technically feasible. The first phase of the feasibility study is currently underway with further work being undertaken to inform the second phase.
Documents
Link to Department of Health guidance on fluoridation of drinking water
