Website of the Department of Health

Improvements to oral health in England

Adult oral health has improved dramatically since the 1960s when surveys began. The most recent national Adult Dental Health Survey, in 1998, shows that adults now enjoy the best dental health for 30 years and the percentage of adults with no teeth has fallen from 37% in 1968 to 12% in 1998.

Dental health in children is better than it has been since records began. There has also been a dramatic improvement in dental health in primary teeth over the last 30 years but there is still a long way to go (Figure 1). Currently some six out of 10 children starting school have never known decay but we still rank seventh best in Europe when it comes to dental health among five year olds. The greater part of this fall in dental decay occurred between 1973 and 1993 largely due to the widespread introduction of fluoride toothpaste and over the last 20 years the improvement has been at a slower rate. In 1983, 48% of five year olds had no tooth decay and this increased to 54% in 1993 and 56% in 2003.

However not everyone has benefited from general improvements and poor oral health is still closely linked to economic deprivation, social exclusion and cultural differences. There are still unacceptable variations across and within the English regions (Figure 2). Improving oral health and reducing oral health inequalities across England is a key objective for the Chief Dental Officer and his team.

• Download Figure 1: Improving oral health in England since 1973 (PDF, 94K)
• Download Figure 2: Regional differences in child oral health in England (PDF, 94K)
• Appraisal of Brushing for Life scheme - March 2005

Choosing better oral health: an oral health plan for England

Since April 2006, primary care trusts have for the first time been given an explicit responsibility for dental public health and they are now required to work with dental professionals to deliver improvements. This will enable oral health to become an integral part of local health services, delivered not only through the dental surgery, but also through health visitors and other parts of primary health care.

In support of this in November 2005, the Government published Choosing Better Oral Health–An Oral Health Plan for England. This plan supports primary care trusts (as they commission dental services to improve oral health) and dental professional teams (by outlining what preventive programmes work at a practice level).

• Choosing better oral health: An oral health plan for England

Guidance on water fluoridation

There is strong evidence for the benefits of water fluoridation in improving oral health and reducing health inequalities. There is a new legislative framework governing the consultations and assessment of public opinion that strategic health authorities need to undertake where they propose to make arrangements with a water company to increase the fluoride content of a water supply.

The Department updated this guidance in February 2008.

• Guidance on fluoridation

Other news on dental public health

• 25 May 2007: Smokefree and smiling: helping dental patients to quit tobacco
• 19 January 2007: Guidance to PCTS on dental screening (inspection) in schools and consent for undertaking screening and epidemiological surveys
• 28 April 2006: The final report on the Oral Health Assessment project undertaken by the University of Dundee has been published
• 26 May 2006: The Department has issued revised guidance on the issue of consent for both school dental inspections and dental surveys