Could retaining the dental recall interval save NHS dentistry?

• Published in: British dental journal Vol. 236; no. 7; pp. 525 - 527
• Main Authors: Mossey, Peter A., Preshaw, Philip M.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 12.04.2024; Nature Publishing Group
• Subjects: Cardiovascular Diseases; Dentistry; Dentists; Diabetes mellitus; Disease prevention; Health care; Health Personnel; Holistic Health; Humans; Inflammatory diseases; Medical personnel; Metabolic syndrome; Opinion; Oral diseases; Oral hygiene; Public health; Respiratory diseases; Risk factors; State Medicine; United Kingdom > UK
• ISSN: 0007-0610; 1476-5373; 1476-5373
• DOI: 10.1038/s41415-024-7233-y

The World Health Assembly in May 2021 was a watershed moment in oral health, with the landmark resolution that designated oral diseases as non-communicable diseases (NCDs). This was strongly supported by a host of other NCDs in recognition of the common risk factor principle and acknowledgement of the fact that oral diseases do not occur in isolation from other NCDs, but are commonly associated with cardiovascular disease, diabetes/obesity, respiratory diseases, metabolic syndrome, a range of other inflammatory disorders and cancers. Regular monitoring and early detection would potentially intercept these NCDs and this could form a central plank of a revamped holistic ‘health'- as opposed to ‘disease'-oriented health care system. Consultation with patients and dentists reveals strong support for maintaining regular recall intervals, which maintains trust and optimises motivation and compliance. In-person visits could be minimised by using technology, such as remote consultations and longitudinal monitoring systems, making it adaptable to different health care settings and equitable, affordable, cost-effective and sustainable. A new paradigm with dentists as oral health professionals, and the mainstreaming of oral health and population-level prevention, means the future of health care can be guided by integration and workforce modification producing a surveillance-based, early interceptive, preventive model of care. Key points With oral disease on the increase and the participation in NHS dentistry on the decline, the current approach in the UK to managing oral disease in terms of both treatment and prevention is not working. Stimulated by the landmark resolution at the World Health Assembly in May 2021 that has included oral diseases among non-communicable diseases, dentistry has a unique opportunity to integrate in the quest for prevention of oral and other non-communicable diseases. Exemplary models of oral care, which involve integration and workforce modifications, are currently being adopted in the UK and other parts of the world and are worthy of consideration or roll out; one of which is the Scottish Government-supported Childsmile model. The global momentum in public health, driven by the Non-communicable Diseases Alliance, is aimed towards social determinants of health and aligns with the principles of FDI Vision 2030 and the preventative agenda advocated in the WHO Global oral health action plan 2023.