Oral Health

Healthy Lives

Behavioural Risk Factors

Dental Care

Oral Hygiene

Tooth Decay Prevention

Fluoridation

Oral Health Promotion

Introduction

Oral health involves the state of the mouth, teeth, gums, and related facial structures. Oral health impacts the entire population. It is essential for everyday functions including speech, chewing, socialising, and breathing, as well as psychological factors including confidence, self-esteem, and being free from discomfort and embarrassment.

Oral diseases and conditions include dental caries (decay), periodontal (gum) disease, oral cancer, tooth wear, tooth loss and birth defects such as cleft lip and palate¹. Oral health impacts from infanthood to older adulthood and childhood experiences can significantly impact the individual’s oral health later in life. Oral health is a key contributor to overall health.

The main risk factors for poor oral health include poor oral hygiene and plaque control, diet particularly sugar consumption, lifestyle factors such as smoking and alcohol, and some health conditions.

Despite some being almost entirely preventable, oral diseases and conditions remain at the highest rates of non-communicable disease across the population².

Why is it important to Population Health?

Oral health is important to population health for several reasons:

High Prevalence and Impact: Poor oral health is largely preventable, yet oral diseases remain some of the most common non-communicable diseases worldwide³. Poor oral health can cause pain, discomfort, and embarrassment to individuals. It can also impact on school attendance, missed days of work and social isolation. There are many overall health issues that contribute or link with oral diseases for example periodontitis (gum disease) can indicate diabetes in an individual, and how well one condition is managed can impact on the other.

Population Health and Ageing: Poor oral health can impact those of all ages and backgrounds. There are increasing inequalities in oral health with the most deprived communities experiencing poorer oral health outcomes.

Good oral health from a young age is essential for life-long oral health. All age groups are at risk of poor oral health without effective prevention in place. The ageing population means more older adults are suffering from the consequences of poor oral health including tooth loss and chewing difficulty leading to poor hydration and nutrition. Many older adults struggle to maintain preventative hygiene measures due to age-related changes, chronic conditions, and other risk factors.

Economic Implications: The cost of dental care to individuals can be a barrier to accessing care or cause financial worries to families. Additionally, the consequences of poor oral health cause a substantial cost to the NHS. With growing and ageing populations, the cost to society is increasing. Access to NHS dental care is a challenge which can increase inequalities and the gap within the population. Preventing poor oral health and promoting self-care can help alleviate the costs to society and individuals.

Quality of Life: Poor oral health can have significant consequences for an individual’s quality of life. Chronic pain and discomfort can lead to low mood and depression. Tooth loss can result in difficulty with speech and chewing. Individuals struggling to socialise or with low self-esteem may experience social isolation. Oral cancer can lead to death and its treatment can be highly debilitating. Education and career potential can also be affected by missed days of school and work, which can also lead to financial loss for families.

Prevention and Promotion: Establishing self-care and prevention is essential to good oral health. Poor oral health is largely preventable. Good oral hygiene, access to fluoride, a healthy diet low in sugar, avoiding smoking and high alcohol consumption, and regular professional dental care reduces the risk of oral diseases. Improving population understanding and knowledge of prevention can enable behaviour change to improve oral health outcomes.

The Derbyshire Population Health Approach

The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.

When considering the topic of oral health within The Derbyshire Population Health Approach:

Prevention is paramount to achieve good oral health. To achieve this, education is key from a young age. Oral health is now included in the National Curriculum from the Early Years Foundation Stage up to Key Stage 4⁴.

Evidence-informed interventions such as provision of toothbrushes to children and supervised toothbrushing programmes help to instil good habits from a young age. In Derbyshire, the Derbyshire Community Health Services (DCHS) Oral Health Promotion team⁵ provide supervised toothbrushing to targeted Early Years settings around Derbyshire. This intervention encourages toothbrushing as part of the daily routine. Health visiting advice includes oral health and the provision of toothbrush packs.

For all ages, dental care professionals provide preventative messages in line with the Delivering Better Oral Health Toolkit (DBOH)⁶. Targeted advice on lifestyle factors such as smoking and alcohol should be delivered by all health care professionals as part of Making Every Contact Count (MECC)⁷. Live Life Better Derbyshire⁸ offer smoking and alcohol support. Regular dental examinations ensure regular oral cancer screening.

Education to professionals is essential for those working with vulnerable populations. The DCHS Oral Health Promotion team⁹ deliver training to professionals to increase awareness and importance of good oral health.

There are clear inequalities in the population across all age groups. Public Health England found marked inequalities by socioeconomic position, geographic area, protected characteristics and vulnerable groups. It was also found that “the impacts of poor oral health disproportionally affect vulnerable and socially disadvantaged individuals and groups in society”¹⁰. Those in low-income groups suffer the financial barrier of access to oral hygiene aids, dental care, and healthier food choices.

Targeted oral health interventions focusing on vulnerable population groups can promote equitable outcomes.

The Delivering Better Oral Health Toolkit¹¹ provides guidance for dental care professionals, this evidence-based toolkit can be used to update guidance and tailor training to all professionals and develop any intervention programmes.

Evidence-informed toolkits are followed by the local authority to improve oral health including the Commissioning better oral health for children and young people toolkit¹² and Supporting Oral Health Improvement toolkit¹³.

The Healthy Child Programme Schedule of Interventions¹⁴ for health visitors includes oral and dental health as a universal intervention to support families.

National policy for educational settings includes the Early Years Foundation Stages (EYFS) Statutory Framework¹⁵. As part of Personal, Health and Social Education (PHSE), oral health is in the curriculum to increase awareness of oral hygiene and how to maintain oral health.

The National Institute for Health and Care Excellence (NICE) provides guidance for oral health of adults in care homes¹⁶.

The main causes of poor oral health include poor oral hygiene, high sugar diet, tobacco use, and alcohol use. There are much wider causes contributing to these risk factors.

Social determinants of health influence, such as education, health status, and lifestyle factors influence how well these risk factors can be controlled. Economic determinants affect the ability to buy oral hygiene aids or pay for dental care whilst environmental determinants influence access to healthy food and dental services, and support with smoking cessation. Focusing on the wider determinants is essential to support the population to reduce these causes.

Collaboration and working with communities and stakeholders is essential for a joint approach to prevention.

The Derby and Derbyshire Oral Health Steering Group regularly meet to promote joined-up working and agree interventions to improve oral health across the City and County. This includes both Derby City and Derbyshire County Council, Community Dental Services, Commissioning managers, the Derbyshire Oral Health Promotion Team, Healthwatch Derbyshire and representatives from General Dental Practice and Derby Royal Hospital.

We are working to improve collaboration working amongst wider partners including Children’s Services and Adult Care.

Latest Derbyshire Data

Trend Data

Prevalence Maps of Derbyshire

The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.

LSOA
MSOA

In the top right of the map, you’ll find the ‘Layer Control’ icon. This is an easy way to customise what you see on the map visualisation. Click the ‘Layer Control’ to choose which information is displayed on the map. Pick the indicator that interests you the most, and the map will transform accordingly.

Slope Index

This chart illustrates the differences in health and lifestyle factors across areas in Derbyshire, from the most deprived (decile 1, red) to the least deprived (decile 10, green). As you move from left to right on the chart (from more deprived to less deprived areas), the line shows whether these factors are becoming more or less common. Essentially, it’s a way to see how living in wealthier or poorer areas affects the prevalence of these factors.

Further Analysis & Assessments

Derbyshire Joint Strategic Needs Assessment (JSNA) involves a thorough examination of a specific health problem, exploring its causes, consequences, and underlying factors. It combines various data sources, collaboration with stakeholders, and rigorous analysis to generate insights for evidence-informed interventions and policy changes.

Coming soon…

More Information & Resources

Here is a list of useful resources and information with regard to oral health. These materials are meant to provide individuals, healthcare professionals, and communities with the knowledge and tools they need as part of efforts to address oral health as a population health topic.

Contributors

Emily Januszewski, Healthcare Public Health Practitioner (Oral Health)