Michael Watson looks at the latest guidance from NICE on children’s oral health
I don’t know what surprised me most last Wednesday – the BDA (British Dental Association) welcoming moving prevention from practice to schoolroom, or the BBC report that teachers would ‘check kids teeth’.
Of course the media reporting was a bit of an exaggeration.
What the National Institute for Health and Care Excellence (NICE) actually said was: ‘Carers, parents and children in many areas need support to stop tooth decay and diseases linked to poor oral hygiene.’
NICE also suggested that local authorities should consider ‘supervised tooth-brushing and fluoride varnishing programmes in nurseries and primary schools’ in areas where children are at high risk of poor oral health.
The BDA and many other dental organisations have welcomed this new guidance, and rightly if it addresses the need for prevention rather than tooth extraction.
The question that needs to be answered is who will do all this.
The BBC report I saw suggest that teachers should supervise daily toothbrushing.
This is where I part company with NICE.
Prevention needs to be carried out by properly trained and preferably registered dental professionals, though a proper national scheme.
Any programme needs to be centred around primary care dental services, whether general practice or community.
Local authorities should commission services from practices, not from schools, nurseries and care homes.
The NICE guidance gives no indication of how practices could be involved in delivering prevention within the community.
For that reason it should be criticised, not ‘welcomed’.