Rachael Leslie explained that oral health did not just concern teeth but also the health of gums, mouth and throat. Oral disease had a wide impact on an individual’s health and well-being, but it was preventable and Public Health had a prevention duty to work to improve the health of the whole population and reducing health inequalities. The Public Health Ring Fenced Grant paid for the fluoridation of water supplies where it was fluoridated; around half of Worcestershire had fluoridated water.
An Action Plan had recently been written following the Oral health Needs Assessment which had been completed in 2017. Evidence showed that fluoridation was the number one way to protect teeth and there was strong evidence that teeth brushing schemes and promoting healthy food for young children was effective as well as raising awareness with domiciliary and nursing home staff regarding helping elderly people to maintain their oral health. Usually a combination of factors such as diet, stress, smoking and alcohol contributed to poor oral health.
Overall Worcestershire had low levels of poor oral health compared to other areas of the Country but within the County the areas which were fluoridated had generally better oral health. In areas with greatest deprivation people were more likely to have poor oral health. The Malvern Hills area was not fluoridated but still had good levels of oral health probably because good oral health routines had been taught by parents and maintained. Poor oral health in children could result in extractions which would be traumatic for children and makes anaesthetic and operations necessary.
The Oral Health Action Plan concentrated on three populations: children, older people and those with learning disabilities. Actions were focussed on prevention, looking at what interventions should be invested in and organising a pilot of a supervised toothbrushing programme and reducing waiting times for children who needed teeth extracted.
In the following discussion various points were clarified:
· Maintaining oral health was important as periodontal disease can affect other systems in the body.
· It was acknowledged that it was very complicated picture as to why not all areas were fluoridated and was affected by decisions made when Herefordshire and Worcestershire were one County; various technical reasons and policies in different water companies, counties and countries.
· The process to introduce fluoridation could take several years and would involve consultation with the population.
· One of the arguments against fluoridation was that it was considered mass medication and it was a chemical, even though it was only at 1 part per million and there was evidence that it was not harmful.
· If instructions on toothpaste were followed and the correct amounts uses Fluorosis would not occur.
· The focus was on Children in order to help with prevention. The Director of Children’s Services supported fluoridation and said they would want to do anything which was evidenced based which would help children.
· There were complicated reasons why people in deprived areas suffered poorer oral health. Oral health could be affected by having a stable home environment with clean and available areas and equipment, consistent messages and good diets.
· There was a concern that teaching about good oral health was done in a sensitive manner and it was felt that easy read information should be available for people with learning disabilities.
· Homeless people were identified as being at high risk of poor oral health but there were no explicit instructions for how that should be addressed. Board Members were assured that the Strategic Oral Health Promotion Group met regularly and were supportin vulnerable groups.
· It was confirmed that sugar and fizzy drinks were bad for teeth, especially if combined with a poor teeth cleaning regime.
RESOLVED that the Health and Well-being Board noted the findings of the Oral Health Needs Assessment and the action plan for Worcestershire.