Professor Iain Chapple shares invaluable insights into how dental professionals may be able to face the future, confident that they are following the most robust levels of evidence to support their patients’ oral care efforts.
It’s been 18 months since the publication of The Economist’s White Paper, Time to take gum disease seriously: the societal and economic impact of periodontitis (2021). In that time, a number of key stakeholders, including healthcare funders, the industry and public health bodies, have taken note.
It has also really raised the eyebrows of the profession, who I believe were quite shocked at the economic data. The challenge is for us as a profession to share these key messages. The Office of the Chief Dental Officer (OCDO) is very passionate about shifting dentistry’s focus to prevention from intervention and has lobbied hard to achieve this.
Field changing
There has been a contract modification to move in this direction and a growing recognition by NHS England that contract reform in NHS dentistry is critical to the future to address the inequality issue and to improve the oral and systemic health of the nation (NHS England, 2022).
Periodontal disease – what are the general health implications? If we focus on reducing inflammation and preventing periodontitis from developing, there will without doubt be substantial improvements in general health, wellbeing and quality of life. NICE demonstrated this in its 2022 guideline update on treating periodontitis in people with diabetes, where it showed significant economic and health benefits (NICE, 2022).
Treating periodontitis improves diabetes control and reduces complications, while similar data is emerging for rheumatoid arthritis (de Pablo et al, 2022). Therefore, preventing periodontitis by treating gingivitis early in the first place could be field changing.
The Dental Hygienist Roadshow
This year, Professor Iain Chapple, along with Benjamin Tighe, Laura Bailey and Simone Ruzario, will be discussing the importance of following the most robust levels of evidence to support patients’ oral care efforts at The Dental Hygienist Roadshow, brought to you by Johnson & Johnson Ltd, the makers of Listerine, and hosted at events across the UK.
‘I will be discussing The Economist White Paper, the recent WHO report and the vital importance of prevention,’ Professor Chapple explains. ‘I shall emphasise the importance of clinicians feeling empowered to be confident with policy, directives and their knowledge of evidence/data, so they can make personalised care a key part of their day-to-day practice.
‘I shall demonstrate how gingivitis can have systemic health consequences and reveal a little of the joint guidance from the EFP and the WONCA group representing family doctors.
‘And I shall focus on precision dental medicine and what collaborative working between medical teams and dental teams looks like, as called for by the White Paper, the NHS commissioning standard for dental care in diabetes, and the WHO (2023) and WONCA groups’ advice.
‘Finally, we shall take a glimpse at the future of bidirectional working between medical and dental teams, with the patient as the centre of all we do.’
Focus on prevention
What should dental professionals be looking out for? There is very clear guidance from the competent body on periodontal health in the UK – the British Society of Periodontology (BSP) – on examination, diagnosis and management of periodontal diseases.
It has also adopted the European Federation of Periodontology’s S3 Level Periodontal Treatment Guidelines for Stages I-IV periodontitis and produced fantastic resources for practitioners in the form of videos and infographics to explain the right thing to do.
The BSP and OCDO have jointly managed to get agreement from the BSA on ‘Phased Periodontal Care’. This focuses on prevention and engaging patients to provide significantly more funding to manage their periodontitis.
These are significant changes that have been achieved. However, it is imperative for dental professionals to keep up to date with the latest evidence-based recommendations, and they can do this by visiting the BSP website. BSP guidance is evidence-based, and it is the competent body providing guidance that is underpinned by that evidence.
No other UK authority has that track record, experience, expertise or credibility. Steps to manage gingivitis in patients as well as possible It is important to personalise care for each individual.
The education of the patient as to why they have the disease and the risk factors are key, as is coaching in mechanical plaque control procedures as the bedrock of care.
Risk factor control is critical and the most important step, whether it be stopping smoking, controlling blood glucose or improving plaque control/oral hygiene. Once the mechanical home care is established, many patients can benefit from chemical adjuncts in toothpastes and mouth rinses.
Not as a substitute for mechanical plaque control, but as an adjunct shown to reduce plaque to help prevent gingivitis.
For more information about The Dental Hygienist Roadshow, as well as an opportunity to sign up for an exclusive Q&A forum following the roadshow lectures and discuss with the speakers the latest research and recommendations in a private session, visit listerineprofessional.co.uk.
References:
De Pablo P and colleagues (2022) Outcomes of periodontal therapy in rheumatoid arthritis: the OPERA feasibility randomised trial. J Clin Periodontol 50(3): 295-306
Jain N and colleagues (2023) WHO’s global oral health status report 2022: actions, discussion and implementation. Oral Dis
National Institute for Health and Care Excellence (2022) Periodontal treatment to improve diabetic control in adults with type 1 or type 2 diabetes. NICE guideline NG17, NG28
NHS England (2022) Outcome of 2022/23 dental contract negotiations The Economist Intelligence Unit (2021) Time to take gum disease seriously: the societal and economic impact of periodontitis UK-LI-2300043.
