From Volume 41, Issue 1, January 2014 | Pages 7-18
This article looks at the background to the current changes in primary care dentistry being piloted in England. It looks at the structure of the different elements being piloted, such as the oral health assessment, interim care appointments and care pathways. It also examines advanced care pathways and how complex care will be provided when clinically feasible and beneficial to the patient.
The authors have worked in a Type 1 pilot practice since September 2010.
The NHS was created in 1948 to provide a health service available to all and financed entirely through taxation. When first established, the oral health needs of the population were very different from today – with high decay rates, routine multiple extractions and denture placement.1 Over the last 60 years, extensive research has helped to determine the aetiology of many dental diseases,2 allowing a large proportion of dental disease to be preventable now. The use of fluoride, coupled with this increased knowledge, has changed the dental needs of today's population – decreasing levels of dental disease have been reported by the Adult Dental Health Survey (2009)3 and the Child Dental Health Survey (2003).4 We now need to move away from simply addressing the problems present, to preventing their occurrence and finding an NHS system which rewards a preventive focus from dental teams rather than one based on activity (ie treatment).1
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