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Oral health

Leicester Joint Strategic Needs Assessment (JSNA). Health and social care needs associated with oral health, 2018.

Who’s at risk and why?

All age groups and populations are at risk of poor oral health even though it is largely preventable. The main modifiable risk factors for oral disease include having a diet high in sugar, smoking or chewing of tobacco, excessive consumption of alcohol, poor oral hygiene, trauma and irregular use of dental care services. 

Oral diseases are not uniformly distributed but are increasingly concentrated in vulnerable and socially disadvantaged groups. Certain communities are more likely to have poor oral health and are less likely to use dental services. These can include young adults, the elderly, the more deprived, socially excluded population along with those with learning disabilities and those in long-term and short-term residential and institutional care.

The level of need in the population

According to a local dental survey (2015), two thirds of respondents visit a dentist once a year, which is lower than the England average. 

Overall, oral cancer rates are significantly higher in Leicester compared to England. Rates are also significantly higher in males compared to females and those aged 55-64 and 65-74 years in Leicester compared to England.

Current services in relation to need

Although Leicester has a young population base, the older population is increasingly retaining a high number of teeth for life. This means that the need for dental services to be accessible to the older population groups, and those medically compromised, at a time when they may be less able to cope with treatment, will only increase. It also means that any dental treatment required may be more complex due to a higher need for advanced restorative dental treatment.

Projected services use and outcomes in 3-5 years and 5-10 years

Although Leicester has a young population base, the older population is increasingly retaining a high number of teeth for life. This means that the need for dental services to be accessible to the older population groups, and those medically compromised, at a time when they may be less able to cope with treatment, will only increase. It also means that any dental treatment required may be more complex due to a higher need for advanced restorative dental treatment.

Unmet needs and service gaps

Availability

Although there are 57 dental practices providing NHS dental care in Leicester, only 40% of practices are accepting new NHS adult dental patients. 38% of Leicester residents who reported difficulty in obtaining an NHS dental appointment had found it difficult because the dentist they wanted to visit did not have availability.

Affordability

Although NHS dental care is free for those claiming certain benefits, 33% of those who pay for NHS dental care and reported difficulty in obtaining an NHS dental appointment had found it difficult because treatment was too expensive, with 23% reporting having to delay NHS dental care/treatment due to cost.

Acceptability

Although 40% of dental practices in Leicester are currently accepting new NHS adult dental patients, 13% of Leicester residents who reported difficulty in obtaining an NHS dental appointment had found it difficult in making the journey to the practice.

Accessibility

Respondents (from NHS Dental Survey 2015) aged 18-64 years were more likely not to have been to the dentist because they ‘could not find an NHS dentist’ and because they ‘cannot afford NHS charges’. Respondents aged 65 and over and respondents from more deprived areas were more likely to have found it difficult because of the ‘difficulties in making the journey to the dentist’ and because their ‘dentist is only treating privately’

Recommendations for consideration by commissioners

  • Ensure that oral health promotion activities include raising awareness of the links between oral cancer and excessive alcohol use and tobacco as well as non-communicable diseases such as diabetes and oral health.
  • Although access is an absolute priority, there should be additional initiatives to help people improve their oral health through education, better diet, and awareness of self-care. This is especially relevant in the priority locations where greater levels of inequalities have been identified.

Onward journeys