In Practice Prevention – the future of skills mix?

Chris Groombridge explains what’s involved in the In Practice Prevention (IPP) pilot programme. 

The greater and more flexible use of skill mix is steadily becoming one of the most efficient and effective ways of improving treatment outcomes in the dental practice. Some of the dental practices making the most of this approach are ADG members (Association of Dental Groups) 543 Dental Centre, Alpha Dental Care and Mydentist, who are currently involved in the first wave of the In Practice Prevention (IPP) pilot programme. Oasis will also be taking part when the second wave commences in October.

Part of a regional programme developed by the Local Dental Network for North Yorkshire and the Humber, in partnership with Local Dental Committees, Public Health England and Health Education England on behalf of NHSE, IPP’s aim is to help reduce dental decay in children aged between three and 16. So how does it work?

What’s involved?

The programme requires general dental practitioners (GDPs) to signpost children identified as having decay or requiring a GA extraction to dental care professional-led prevention clinics, where evidence based prevention is delivered over a defined number of appointments with prescribed evidence based interventions and messages. All pathways are delivered in parallel with the restorative work undertaken by the signposting of GDPs and the GA extractions provided by the community dental services, and uses flexible commissioning targeting existing contract value to deliver the programme in primary care.

Once a dentist has identified dental decay in a child aged three to 16, the patient is referred via one of four care pathways. These are divided into:

  • Children aged three to six with dental decay
  • Children aged seven to 16 with dental decay
  • Children aged three to six requiring a general anaesthetic
  • Children aged seven to 16 requiring a general anaesthetic.

Through their participation in this pilot, 543 Dental Centre, Alpha Dental Care and Mydentist (along with other dental practices and groups) will have the opportunity to maximise their full skills mix potential, helping to reduce the prevalence of dental decay at the same time. Oral health sessions include providing sugar and diet information in line with the ‘eat well plate’, offering healthy swap alternatives, as well as giving oral care advice and relevant oral hygiene instructions to both child and parent. The programme also involves the issuing of fluoride mouthwash to children over eight years and the prescribing of high fluoride toothpaste to children over 10 years, with fluoride varnish applied every three months in high-risk cases.

Early days

It’s early days yet, but if implemented well there is no doubt that there is huge potential for the IPP to alter the behaviour and cooperation of children and improve the state of children’s oral health in Yorkshire and the Humber. As for dental teams, the initiative presents an unmissable opportunity to capitalise on the benefits of a multidisciplinary approach and effective use of skills mix.

The feedback has already been very positive from participating groups, particularly from nurses who have undergone additional training via Health Education England and Local Dental Network organised courses to deliver this evidence based prevention pathway to patients. ‘The IPP initiative is a team effort that gives dental nurses like me more responsibility,’ says Julie Fountain, head nurse and lead oral health educator for 543 Dental Centre. ‘This has enabled me to extend my scope of practice and help even more patients.’

For the ADG and its members, this is good news – the association has, after all, keenly championed the use of skills mix in the dental practice for some time now.

To find out more about the programme visit

For more information about the ADG visit

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