Oral health is an important part of general health and wellbeing. A healthy mouth enables us to communicate, eat and enjoy a variety of foods, socialise, attend school or work, and contributes to self-esteem, confidence and readiness to learn. There is also increasing evidence that good oral health can positively affect employment opportunities through increasing social acceptance, confidence and self-esteem.
Poor oral health causes pain, distress and sleepless nights. It can also worsen long-term conditions such as diabetes and glaucoma, and can contribute towards malnutrition, poor hydration, and aspiration pneumonia in older adults. Dental practitioners have a key role in supporting behaviour change around the common risk factors which impact on both oral and general health – poor diet, smoking and alcohol.
Dental teams can contribute towards improving the quality of life, wellbeing and economic prosperity of Greater Manchester population. We can have a greater impact on the wellbeing of individuals and communities through the integration and transformation of dental care within the wider public sector offer.
The challenge is to engage communities to value good oral health, understand how they can maintain and protect oral health and contribute to the design and utilisation of more responsive, effective dental services within the devolution framework. Primary care general dental practitioners will play an essential part in delivering the transformation required.
The commissioning of all NHS dental services became the responsibility of NHS England on 1 April 2013. Internal delegation arrangements for Greater Manchester include dental commissioning responsibilities, which are discharged on behalf of NHS England by the dental commissioning team within NHS Greater Manchester Integrated Care.
The commissioning of dentistry covers the full pathway of treatment and care, including the commissioning, contracting and service development for primary, community and specialist / secondary dental care services, in addition to dental urgent care services. Commissioning responsibilities are delivered at a Greater Manchester level, seeking to ensure responsiveness and accountability within localities and neighbourhoods for the local population.
Dental care is not a single specialty, in addition to general primary care services, commissioned services also provide care across:
- Oral surgery and oral and maxillofacial surgery
- Paediatric dentistry
- Special care dentistry
- Oral medicine
- Restorative dentistry, including endodontics, periodontics and prosthodontics
- Several supporting specialties, including dental and maxillofacial radiology, oral and maxillofacial pathology and oral microbiology
The specialty of dental public health supports commissioning and redesign of clinical dental services, as well as providing specialist advice and support to local authorities in the delivery of their statutory responsibility to improve the oral health of their populations. Approximately 38 per cent of people use private dentistry (according to GP Patient Survey results in January 2020) – some driven by choice, others by poor access experience and culture of symptomatic attendance. Access to NHS dentistry remains at around 58 per cent of the population.