Oral Health Foundation

Karen Liesching-Schroder’s mouth cancer journey

Karen, 47, was ‘shocked beyond belief’ to be told that a seemingly harmless mouth ulcer on her tongue was actually mouth cancer

Having appeared during the school holidays of 2016 it was not until early February that Karen finally got a biopsy done and her worst fears were realised; it was cancer of the tongue. When asked if she had any idea that it would be cancer, she replied, “I had no idea, I’m a healthy person, I run, don’t smoke, don’t drink much and I eat healthy food.”

A treatment plan for the mother-of-two from Rochford, Essex, was drawn up. She endured what she describes as ‘unbearable agony’ during her course of treatment for the disease and claims going for runs kept her ‘sane.’ Radiotherapy, a neck dissection and gruelling surgery to have the side of her tongue removed simply weren’t enough to keep her from continuing to run with her local club.

Speaking of her determination to remain mentally and physically healthy in the thick of her battle with cancer, Mrs Liesching-Schroder said: “I just needed to run. Control was being taken away from me by cancer and this was one way of getting control back. When it came to the end of radiotherapy, I had the goal that I wanted to run the Southend half-marathon. I was told by clinicians that I wouldn’t be allowed to do it. But nobody could stop me. It’s what’s keeping me going and I have to do this. Running was my way of being free from it all.”

Despite being told that for immediately after her course of radiotherapy finished the side effects of the treatment would be worse, Karen still completed what she claims to be her ‘best run ever.’

“It was all about celebrating life. Being able to do that was really important to me. My running club were all there at the end with high-fives, a massive line of them. It was brilliant. I had unbelievable support all the way through from so many people. I was very lucky.”

Mrs Liesching-Schroder’s life has never been the same following her treatment. Complications including “an aggressive form of oral thrush,” learning to speak properly again and concerns about cancer returning are just some of the obstacles she has faced over the last few years, but nothing has stopped her from running regularly.

“After you’ve had cancer, you see life a bit differently and you feel a bit more alive afterwards. There’s a lot of things out there to enjoy and now I feel I have a second chance at doing just that.”

Years on from her initial diagnosis, she is determined to use her story to help raise awareness of the disease.

“A lot of people think that mouth cancer only happens to smokers, but my story shows that isn’t always the case. If you have worried about an unusual change in your mouth then get it checked out. Don’t be frightened but it’s important that you don’t suffer in silence and to remember that the sooner it’s checked out, the sooner it can be sorted. Chances are it’ll be fine but in the rare case it is not, it could be a life saver.”

For more information about mouth cancer, including how to spot the disease early, how to reduce your risk and what to do if you notice any of the early warning signs, visit www.mouthcancer.org.

Mouth cancer in young people: Charlotte’s story

As part of November’s Mouth Cancer Action Month, Charlotte Webster, who lives in Peters field, Hampshire, tells us her experience of mouth cancer.  Charlotte hopes her story will raise awareness of the disease and encourage more people to check themselves for signs of mouth cancer

At 26 years old, Charlotte was given the life-changing news that she had mouth cancer. The ex-cabin crew member now training to be a midwife from Hampshire does not fit the typical mouth cancer patient – being a young woman who’s a non-smoker and an active gym-goer.  But Charlotte represents a growing number of younger people who are being diagnosed with mouth cancer and also is just one of thousands of people who have been diagnosed with mouth cancer and had to face their treatments with the added struggle of COVID regulations and isolation.

Ahead of November’s Mouth Cancer Action Month, Charlotte talks about her own journey, opens up about what led her to getting checked out, the disbelief of a diagnosis, and reveals how mouth cancer continues to change her life. 

“I had some ulcers for about three to four years before I had my [mouth cancer] operation, but I wasn’t worried about them at first because I do get run down and I was jet-lagged and flying all the time with my job and often ulcers are sign of celiac disease, which I have, so I put it down to that. They came and went but always in the same area, they never fully went but they used to flare up like if I was run down.

“About a year before I had my operation I went to the dentist and they said ‘well, I don’t really know what it is, might be because your teeth are rubbing so we would advise maybe getting your teeth straightened and have your wisdom teeth taken out’. So, I did that. I paid for braces, got my wisdom tooth taken out and had really great teeth, but still had the ulcers.”

After these initial early signs of mouth cancer were missed by her dentist and other professionals, Charlotte went on to have a biopsy in April 2021 after her ulcers got significantly worse.

“They felt like ulcers do, but just a bigger patch and they started to turn white, and they had like red around them as well, so they looked quite like inflamed. I thought maybe it was a bit of an infection or something. My mum kept telling me to go and get it checked so I went to my doctor in January and he said he wanted to send me for a biopsy which I got around April.

“I went in for the results, and he said, ‘have you got anyone with you today?’ And I was thinking yeah my other half is in the car with the dog. And he said, ‘Do you want to bring him in?’ and I just looked him and I said ‘it’s not good is it?’ and he was like ‘no, it’s not. I’m really sorry, you’ve got cancer’ and I was like, ‘What do you mean? Surely not.’ and I think I almost laughed. It was such a shock because I’m otherwise a healthy person.”

Charlotte also told us about her time in intensive care.

“It was hard, and I remember I couldn’t see mum which was really hard too. I couldn’t wait to get out of hospital, as amazing as the staff were, my goal was ‘right, just get home’. To get discharged you need to show the staff you can drink, swallow, keep stuff down, you know, all the rest of it. So, they listen to your swallow for a while and then they’ll test it.

“My tracheostomy was fitted for seven days so my body hadn’t swallowed or breathed through my mouth in so long that often your muscles take a while to get back to that. And I had to have my tracheostomy taken out, and I remember the first time they tried to take it out. They covered this hole so I could then breathe through here and it wouldn’t, it just couldn’t, I think my body wasn’t ready because it was like being suffocated because I couldn’t breathe through my mouth. it was so like, it’s just like I had a mouth full of like straw or hay. It was just so hard, so husky, so stuck. And I remember the panic, I was like no, I can’t, so they tried again the next day and then every day it just got a bit better and better.”

After getting home from the hospital Charlotte continued to get support from different professionals including counsellors, dieticians, and speech therapists, but also emphasised how important she found the support she got on social media from other mouth cancer sufferers.

“It’s a different kind of like support that you get because you know that they feel the same, like one guy said to me ‘I saw your video of you sipping the water for the first time. I laughed my head off because I felt exactly the same!’ and before my operation there was one lady who said she would chat to me, but I chose to speak to her after my op because I just wanted to, not really know much, I just wanted to get it done and out the way. But afterwards I messaged her about one of the things I was most worried about – I asked her to send me a voice note because I wanted to know that I wasn’t going to sound like you couldn’t understand me that was the only thing I was worried about. Because I know unfortunately it does happen some people, but she reassured me.”

Charlotte also shared some thoughts about mouth cancer in young people.

“There is a stigma against mouth cancer, I was told ‘oh, you’re too young’, ‘God it won’t be that’, ‘no it won’t be that’, and it does happen. It really can happen to anyone not just smokers because that’s such a stigma – it really annoys me. People think you have to be like a really old man that smokes 50 a day, but you don’t. It took this tiny little poster in the clinic for me to, to be like, ‘oh my God, that’s mouth cancer’ and by then it was too late anyway.”

Learn more about mouth cancer by visiting www.mouthcancer.org.

New NHS dentistry reforms receive a mixed response from oral health charity

A new package of proposals to reform NHS dentistry in England has received a mixed response from the Oral Health Foundation

In a letter penned to dental practices, NHS England outlined the first significant changes to the delivery of NHS dental care in 16 years.

Dr Nigel Carter, chief executive of the Oral Health Foundation, says: “The new reforms to NHS dentistry are welcome changes in the right direction.  The long-awaited adjustments to UDAs should make it easier to treat high-need patients and go some way in reducing inequalities.  The dental profession has been calling for such changes for over a decade, so they are long overdue.

“We are also supporting the move of allowing dental therapists to start courses of treatment, although even more must be done to fully utilise the skills of the entire dental team.

“Unfortunately, the new reforms stop well short of addressing urgent issues within NHS dentistry, such as the diminishing workforce and access to NHS dentistry.

“A move towards extending recall intervals will only scratch the surface of current access problems and a plan to address manpower shortages is needed immediately.  It is also extremely disappointing that the new reforms do not in any way tackle the postcode lottery of dental access in England.

“Fundamental reform is still needed.  Whether it is increasing the NHS dental workforce, or improving access across England, there must be a greater commitment toward additional funding for NHS dentistry.  Despite servicing an ever-increasing population, government investment in NHS dentistry continues to decline in the UK.  Ultimately, reforms without the necessary financial investment will only have a limited and short-term effect.”  

A summary of changes to NHS dentistry, which will take effect from this Autumn, include:

  • A minimum UDA (Units of Dental Activity) value. The payment dentists receive for hitting a target is now set at a minimum of £23.00.
  • A higher reward for treating 3 or more teeth. Dentists will now receive 5 UDAs for treating 3 or more teeth. This is an increase on the current level of 3 UDAs which are applied to any number of teeth treated.
  • A new payment rate for complex treatment. Root canal treatment on molar teeth will now be rewarded with 7 UDAs.
  • A greater role for dental therapists. This means that other members of the dental team can start treatments for patients with the hope of reducing access issues.

Oral Health Foundation: Cost of living crisis contributing to deterioration of oral health

The rise in cost of living could lead to a deterioration in the nation’s oral health, according to the Oral Health Foundation. 

New research by the charity shows more than nine-in-ten (94%) UK adults have been affected in some way by the rising cost of living, with nearly two-in-three (62%) experiencing a significant increase in their outgoings. 

Data reveals around four-in-five (82%) are being forced into making sacrifices into their spending habits, with one-in-four (25%) cutting back on oral health products like toothpaste, mouthwash and interdental brushes. 

The increase in living costs is also labelled as a factor for one-in-three (31%) who have not visited a dentist in over two years while one-in-four (25%) parents have had to spend less money on their oral health to look after their children’s teeth. 

Since the beginning of the pandemic, around one-in-ten (12%) say their oral health has declined. 

The Oral Health Foundation is concerned that rising costs could lead to a widening of oral health inequalities and calls for more support to help those in the greatest need. 

Dr Nigel Carter, chief executive of the Oral Health Foundation, says: “Rising costs have hit the poorest families hardest and now we are seeing this impact on the health of the mouth. It is an unjust and unfair travesty that some people are having to make choices between putting food on the table and heating their home, and buying toothpaste, deodorant and shampoo. 

“Buying habits are linked to behavioural habits and we’re concerned that many people feel like they have little choice but to give up twice daily brushing just to make their toothpaste last a little longer.  Absolutely nobody should be put in the position where they have to make sacrifices to the health of their mouth.  

“Government is rightly under increasing pressure to end the cost of living crisis.  They must now commit to a levelling up agenda that prevents a widening of oral health inequalities so that everybody can achieve the standards of oral health that they deserve.” 

More data from the Oral Health Foundation suggests oral health products are some of the last essentials people are willing to go without.  Luxuries like holidays (53%) and tv subscriptions (43%) come top of the list of items the UK public has given up over the last year.

Oral health was also deemed a greater priority than hair products, skin care products, and make-up.  

On average, UK households spend £4.70 per week on oral health products, however, the majority (38%) spend as little as £2 a week.  Worryingly, twice as many households (22%) are now cutting back on how much they spend on their oral health compared to those who are choosing to spend more (11%). 

The rise in the cost of living has led over half (55%) of UK adults to feel like they have neglected their teeth over the last two years.  As a result, more than one-in-five (28%) now regularly feel self-conscious or anxious because of their smile.

“Many people view good oral health as an important factor in their overall appearance, and in most cases, the health of the mouth can play a significant role in a person’s confidence to smile,” adds Dr Carter.

“This is most likely because a healthy smile often translates to an attractive smile, and this will make a person feel better about themselves.  A smile communicates a sign of friendship, trust and acceptability.  As these are things most people strive towards, it means that taking good care of the mouth is incredibly important.”

For a healthy mouth, the Oral Health Foundation advises brushing teeth last thing at night and at one other time during the day with a fluoride toothpaste.

The charity is also keen to highlight the importance of cutting down on sugary foods and drinks you have and keeping to regular dental visits.  Health experts also advise cleaning between your teeth with an interdental brush once a day while chewing sugar free gum can also be helpful to neutralise plaque acid build-up throughout the day.

Dr Carter says: “Look after the mouth is very easy and does not take a lot of time.  Government must do more to allow people the means and opportunity to care for their own mouths and support those in financial difficulties with the basic tools that are needed to do this.”

Oral Health Foundation: Dental teams can be ‘vital link’ in caring for patients with eating disorders

Dental teams are in the ideal position to identify and act on early signs of eating disorders, says the Oral Health Foundation

Around 1.25 million people in the UK are affected by an eating disorder and many can be recognised by a range of common problems in the mouth.

Around nine-in-ten (90%) patients with bulimia and one-in-five (20%) with anorexia suffer from enamel erosion.  Tooth decay, sensitive teeth, dry mouth and enlarged salivary glands are also frequent.

The Oral Health Foundation believes that thousands of undiagnosed eating disorder can be picked up during regular dental check-ups by dentists, dental hygienists, therapists, and dental nurses.

Chief executive of the Oral Health Foundation, Dr Nigel Carter, says: “During the routine dental examination, dental teams carry out checks on the hard and soft tissues of the mouth and look for signs of tooth erosion.  They will also look for possible injuries to the mouth which could have been induced by inserting foreign objects that cause a person to vomit.

“The UK needs a far better strategy for diagnosing eating disorders early.  The sooner an eating disorder is suspected or recognised, then the more effective treatment will be.  This treatment extends far beyond any damage caused to the mouth.  It is also necessary to instigate wider medical referrals to those who specialise in treating eating disorders.”

In the UK, around 275,000 people suffer from binge eating disorders, 235,000 have bulimia and 100,000 are diagnosed with anorexia.

Those who purge through vomiting often suffer from enamel erosion and those with binge eating disorders may have an increased risk of tooth decay and tooth loss through excessive sugar consumption.

The lack of vitamins and nutrient deficiencies associated with eating disorders can also cause the body to shut down and not function properly.  This will also be reflected by signs in the mouth.

“As well as erosion through stomach acid, dental teams will also be able to detect conditions such as tooth decay, from excessive sugar consumption and signs of nutrient deficiencies,” adds Dr Carter.

“If they suspect that a person might be suffering from an eating disorder, they will be able to talk calmly through the clinical signs they are seeing in the mouth.  They might also speak about prescribing a high fluoride toothpaste or varnish to protect your teeth from decay.

“The more open and honest patients can be with their dental team, the better they will be able to help.  Your dental team can be trusted to help you and will not judge you over any symptoms you are having.”

The Oral Health Foundation is currently running National Smile Month – a campaign that champions the importance of having good oral health.  During the campaign, the charity is keen to support those with severe oral health needs and improve awareness and information about the health of the mouth.  

Brooke Sharp is a Clinical Advice Coordinator at Beat, the UK’s eating disorder charity.

She says: “Eating disorders impact around 1.25 million people in the UK of all ages, genders and backgrounds and you cannot tell if someone has an eating disorder by looking at them. This means that eating disorders can go undetected for a long time. However, physical signs of an eating disorder, such as dental erosion or sensitivity can occur, mean that dentists may be among the first to observe the signs and symptoms.

At Beat, we are currently working on a webinar series to educate different health sectors about health, which includes dentists, dieticians, and pharmacists. The aim of this training will be to help professionals identify the signs of an eating disorder and understand how to support their patients. However, whilst it’s important to increase awareness of eating disorders, it is never the role of dentists to diagnose or treat the eating disorder, and patients must always be signposted to specialist support.”

Tina McGuff  is a mother of four children and struggled most of her life with anorexia and obsessional exercise behaviours. She has fully recovered and lives a healthy life, even writing a book to help other people who are going through the same struggles. Currently, she is helping to educate others on mental health and how to cope with different needs. It can be hard for dental teams to broach the subject with those who are suffering from eating disorders.

Tina says: “I could see the impact it was having on my oral health, and I was eventually hospitalized in a psychiatric ward as a teenager. There were a lot of problems with my teeth even at that time because I was sick all the time.”

Constant stomach acid on teeth can erode the tooth’s enamel.  As the teeth are weakened, it is also important not to brush straight after being sick as this could further damage the teeth. Instead, simply rinse with water or use a safe fluoride mouthwash recommended by your dentist.

Tina explained that she assumed the dentist would simply be able to fix everything at the end of her struggle and that it would not impact her dental health going forward.  “It is so good that awareness is now being raised as to how eating disorders can impact your mouth,” Tina adds.  “All the sugary things I was taking to try to get back into normal eating meant that my teeth were always being attacked.

“I was aware of oral hygiene. I did brush and floss my teeth. I also wasn’t probably using the right products with the correct amount of fluoride. It felt almost futile, but I did it because it was the only right thing I could do.

“The most interesting thing is that when I did go to the dentist, which I did a lot when I was younger, was that not one dentist ever said anything to me. It was only this last year that the dentist sat me down and said I have some concerns with the pattern in your mouth – do you have an eating disorder? It was so sad he was the first one to ever ask. Someone must have spotted and seen, but no one person ever said anything, and it would have been a great opportunity to have that discussion.”

Tina is currently pushing for more research into how best to help patients with eating disorders. This could be a great step forward for the wellness of those who struggle with eating disorders.

Rhian Lovell has a long history of eating disorders. She is 39 years old and living currently in South Wales. Rhian says: “The longest-lasting legacy of my eating disorder is my teeth. I have spent probably the best part of £6,000 and lost five or six teeth. I am going to get dental implants for the teeth which are missing. While I was unwell, I did try to take care of my teeth but when you are vomiting multiple times a day that is going to have a long-term impact.

“When you have an eating disorder, self-care is not very high on your priorities. I probably didn’t brush all the times when I should have.

“The dentist I registered within Cardiff when I was eighteen is still my dentist to this day. The worst part before I had my treatments was having constant infections in my mouth, I was lucky because he was always at the end of the phone for me. Even now it is over an hour’s drive away, but he understands what I’ve been through, and he understands how to encourage me and what advice to give me.

“My advice for dental teams is to try to approach it sensibly and sensitively. If there is a decline in dental health there is, of course, a reason for it and I don’t think it is unreasonable to have the conversation like that. It was a bit of a relief for me for my dentist to know why my teeth were a mess. I knew I wasn’t taking care of my teeth, it almost made it easier for me to deal with. My teeth still frustrate me, but they look okay now, and they work.”

The Oral Health Foundation urges anyone with an eating disorder, or family and friends with eating disorders, to get help reach out for support.  Both Tina and Rhian volunteer for Beat, the UK’s an eating disorder charity that strives to help people overcome their problems supports people affected by eating disorders.  Beat’s helpline is open 365 days a year on 0808 801 0677 or via beateatingdisorders.org.uk. You can find more help here at https://www.nhs.uk/nhs-services/mental-health-services/ for information and support.

Charity head calls for urgent need to ‘level up’ the UK’s oral health

The UK’s oral health is a postcode lottery and is in dire need of levelling up, says Dr Nigel Carter

Speaking on Monday at the launch of this year’s National Smile Month, the Oral Health Foundation’s chief executive, Dr Nigel Carter called for the government to put an end to the vast inequalities in oral health that are causing tens of thousands of people to suffer in pain.

Dr Carter has urged the government to focus on addressing critical problems with access to NHS dentistry and the need to train more dentists.

Dr Carter said: “Oral health varies around the UK – it is a postcode lottery.  This isn’t going to go away overnight as the dentists just aren’t there.  It does seem that there isn’t a wish to address the problem and train more dentists.

“Whether that dentistry is being delivered on the NHS, or the private sector, it is not possible without an adequate workforce.

“You really can’t achieve good health and wellbeing without good oral health.  That’s why during National Smile Month, we are calling for a levelling up agenda so that everybody can achieve the standards of oral health that they really deserve.”

National Smile Month 2022 is all about tackling inequalities within oral health in the UK.

Under the theme of ‘Everyone deserves a healthy smile’, the charity’s campaign will be helping more people achieve a healthier life through better oral health.

The Oral Health Foundation will be providing information and support for thousands of children and families, the elderly and vulnerable, people with disabilities and those living in deprivation or isolation.

Mhari Coxon

Mhari Coxon, President of the Oral Health Foundation said: “This year is about shining a light on the millions of people that are affected by oral health problems such as tooth decay and gum disease.

“We want to support those who are vulnerable, elderly, disabled or those who, for whatever reason, can’t access education, the right dietary advice and because of social economic reasons don’t have access to oral care.

“Everyone deserves a healthy smile, and these diseases are completely preventable.”

Tooth decay is one of the most common diseases in the UK.  One-in-three (33%) adults have signs of tooth decay, as well as around one-in-four (24%) five-year-olds.

Those from disadvantaged backgrounds are more likely to suffer from tooth decay and be admitted to hospital because of it.  Last week, it was revealed that 14,615 children in England had rotten teeth removed in hospital between 2020-21. 

The Oral Health Foundation is campaigning to make healthier food and drink, that contains less sugar, more affordable for families on lower incomes.  It is tragic to see the government decision this week to delay the ban on cheap offers on unhealthy foods.  Far from helping in these times of inflation the move is likely to store up greater problems with both oral and general health and to cost both individuals and the country more in the future.

The charity also believes a nationwide water fluoridation programme will drastically cut rates of tooth decay, especially in children.  Currently, only 11% of the population benefit from fluoride being added to their water supply.  Research shows that in fluoridated areas, the number of hospital admissions (for tooth decay) falls by between 45% and 68%.

Tooth decay and other oral diseases can have a negative impact throughout life and can cause pain, infection and lead to difficulties with eating, sleeping, socialising and wellbeing.  Campaigners are extremely concerned that oral health has declined during the pandemic.

The charity has found over half (55%) of UK adults feel they have neglected their teeth during the various lockdowns.  Around one-in-seven (15%) admit to not brushing their teeth as much as before the pandemic.  One-in-five (20%) are eating unhealthier foods, and more than one-in-ten (11%) have been drinking more alcohol.

Professor Avijit Banerjee

Professor Avijit Banerjee from Kings College London, speaking on behalf of the Wrigley Oral Healthcare Programme, one of the National Smile Month sponsors said: “The pandemic has highlighted the key issues in both oral and dental health care that we see daily in the news.

“We have access issues, social and demographic inequalities and of course, these impact on the quality of dental health which has declined over the past two years.

“We need to move away from just treating diseases to preventing them.  We need to bring back the national health service, as opposed to a national illness service or a national treatment service.  We need to innovate in the way we change behaviour and engage with the public on prevention.

“Behaviour change is available if we are willing to think outside the box. I was privileged to lead a fantastic research team at Kings College London over the last four years looking at the health benefits of chewing gum. We found that chewing sugar-free gum reduces the level of plaque and decay.”  

Health leaders are also keen to raise awareness about how the health of your mouth has a direct link to the health of your body.

Studies have shown that poor oral health, specifically severe gum disease, can lead to increased risk of heart disease, strokes, diabetes, dementia and poor pregnancy outcomes.

Professor Iain Chapple

Professor Iain Chapple from Birmingham University, speaking on behalf of Johnson&Johnson, the makers of LISTERINE® Ltd and sponsors of the Month said: “Both tooth decay and periodontitis (severe gum disease) are the most common human diseases responsible for more years lost to disability than any other human condition, and the links to systemic diseases are well established.

“There is a desperate need for public health campaigns to raise awareness of this. It’s really tough to get public health messages in oral care funded nationally.  We all need to start investing and getting those messages out there.

“Healthy gums don’t bleed.  Effective toothbrushing and interdental cleaning is essential for keeping gums healthy.  Mouthwashes containing fluoride (with more than 100ppm fluoride) that are clinically proven to reduce plaque/germs offer additional benefit.

Research shows that the single biggest reduction in gum disease occurs through the measures that patients can take at home.”

National Smile Month runs until 16 June and is supported by some of the most well-known household brands in the UK, including Invisalign, Oral-B, GSK, Johnson&Johnson, the makers of LISTERINE® and Wrigley Oral Healthcare Programme.

For more information about the charity campaign and to discover great tips about how to care for your mouth, visit www.smilemonth.org.

Fall in children’s tooth extractions labelled a ‘smokescreen’ by Oral Health Foundation

The Oral Health Foundation warns that thousands of children have been left to suffer in pain for more than one year, as the number of tooth extractions for young people in England falls by more than half during the pandemic.

The number of extractions performed on decayed teeth in children aged 19 and under decreased from 35,190 in 2019-20 to 14,615 in 2020-21, data from the Office for Health Improvement and Disparities shows.

However, the oral health charity says the fall in the number of procedures, which take place in hospital under general anaesthetic, do not reflect any change in demand.

Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation says: “To report that childhood tooth extractions in England have shrunk is a smokescreen towards the reality of what is happening. Tooth decay in children has not simply disappeared over the last year which means that thousands of young people are going without the treatment they need.

“It is unfair and unjust for just one child, let alone thousands, to be put in pain because they are unable to access the care they deserve.”     

More than 12.5m NHS dental appointments for children had been lost in England since lockdown, while tooth extractions had been the most common reason for hospital admissions among young children for a generation.

“There now needs to be an urgent and decisive plan from government about how they plan to tackle the backlog in dentistry,” adds Dr Carter.  “We also need open and transparent clarity about the scale of the backlog and which NHS dental practices are able to take new patients.

“NHS dentistry is in dire needs of a new contract.  We also need to be training far more dentists.  All in all, the provision and funding for NHS dentistry falls well below the threshold that is needed for the needs of the population.”

In addition to the Oral Health Foundation seeking clarity on access to NHS dentistry, they are urging government to move forward with plans that can drastically improve rates of childhood tooth decay.

The charity is calling for the widescale implementation of a national water fluoridation scheme. Currently, as little as 11% of the UK’s water supply has fluoride added to it.

Dr Carter says: “Water fluoridation is one of the single most credible and impactful polices that can have a significant impact on tooth decay.  The data on children’s hospital extractions and community water fluoridation is staggering – in fluoridated areas, hospital admissions fall by as much as 68%.”

The charity also believes there should be further extensions to the sugar tax.

“Since it was introduced, the sugar tax has done a remarkable job at removing sugar from soft drinks,” adds Dr Carter. “It is now time this was widening to include other sugary foods and drinks. These measures would be highly effective alongside junk food advertising bans.”

The Oral Health Foundation and Denplan launch Mouth Cancer Action Charter to Parliament

The Oral Health Foundation and Denplan launched their Mouth Cancer Action Charter at a face-to-face event in the Houses of Parliament earlier this week. Members of Parliament, ministers and dental and health professionals were invited along to sign the Charter and demonstrate their support for its policy recommendations.

The Mouth Cancer Charter has been created to coincide with November’s Mouth Cancer Action Month – the UK’s biggest charity campaign for mouth cancer awareness. The campaign calls for more people to be mouthaware by being able to recognise and act on any unusual changes to the mouth.

The Oral Health Foundation and Denplan are concerned that mouth cancer referrals have significantly fallen over the pandemic period, while awareness of the major signs and symptoms of mouth cancer is very low. According to results from a recent MP survey, only 27% of MPs felt they were as well informed of the causes and symptoms of mouth cancer as they are of other leading cancers.[1]

Dr Catherine Rutland, Clinical Director at Denplan, part of Simplyhealth said: “We’ve worked together with the Oral Health Foundation for over 20 years on the Mouth Cancer Action Campaign, but we wanted to go one step further this year by spreading the mouth cancer awareness messages further and wider into the corridors of Westminster.”

“Mouth cancer referrals will have been significantly reduced due to the Covid pandemic restrictions last year and delays have been incurred by the dental backlog and access to NHS dentistry remaining difficult in certain areas. We urge the Government to consider these mouth cancer policy interventions. The longer the delay to implement these changes, the more lives could be lost to mouth cancer as possible cases go undetected. Top of the policy recommendation list is that we are calling on the Government to fund a public health awareness campaign on the signs and symptoms of mouth cancer.”

Recent research conducted by the Oral Health Foundation and Denplan shows that four-in-five UK adults have never been exposed to public health messaging around mouth cancer, leading to poor awareness of the early warning signs and risk factors[2].

Dr Rutland said: “If people can easily recognise the risk factors and what to look out for in terms of changes in their mouth, health professionals will also be able to catch cases earlier. Late diagnosis of mouth cancer is becoming all too common and this will have a severe effect on a person’s quality of life and their chances of survival.”

The Charter proposes that GP’s, pharmacists, care home and nursing staff should all be given enhanced training or further information about how to look out for signs and symptoms of mouth cancer to further improve early detection. Spotting signs early can increase someone’s chances of survival from 50% to 90%.

Sir Paul Beresford and Dr Nigel Carter OBE

Commenting on the policy recommendations proposed in the Charter, Dr Nigel Carter, Chief Executive of the Oral Health Foundation said: “If these mouth cancer policy changes were put into action we could drive down case numbers and save the government a significant amount of money in oral cancer treatment costs.  In England, the cost of head and neck cancer treatment was £309m in 2010-11[3] and since then case numbers of mouth cancer have grown by around 67%.” 

The Mouth Cancer Action Charter highlights the following policy areas for change:

  1. Conduct a government funded public health awareness campaign of the signs and symptoms of mouth cancer.
  2. Improve access to routine dentistry to detect mouth cancers earlier and save lives.
  3. Enable enhanced training of GPs to identify suspected mouth cancers and change the NICE guidelines so that more cases can be referred to secondary care.
  4. Improve training programmes for healthcare staff to look for signs of mouth cancer.
  5. Introduce free dental check-ups and treatment for mouth cancer patients to end the unfair financial burden placed on them.
  6. Support the development of better technology to diagnose mouth cancers.

One of the key points in the mouth cancer charter is about the development of better technology to diagnose mouth cancers. During the pandemic, it has become more evident that innovation, data and technology are helping to make dentistry safer, faster and more accessible.

The use of technology in diagnostics is also becoming more important. Denplan and the Oral Health Foundation are proposing that with the support from NHSX a mobile app could be developed that would enable patients to share photographs of their mouth lesions which would then be reviewed within a short space of time by a consultant.

In addition to politicians and ministers, the Oral Health Foundation and Denplan are also asking dental professionals and other healthcare professionals to show their support and sign the Charter at www.dentalhealth.org/mouth-cancer-action-charter. More information on mouth cancer can be found on the website and by following the campaign on social media via #MouthCancerAction.

References:

[1] YouGov completed online interviews with a representative sample of 103 MPs.   The survey was completed between 6th and 28th September 2021;

[2] The research was carried out online by Research Without Barriers – RWB. All surveys were conducted between 6th October 2021 and 8th October 2021. The sample comprised 2,008 UK adults

[3] https://pubmed.ncbi.nlm.nih.gov/28734109/

Safe Smiles: new campaign set to champion the benefits of safe dentistry

The British Orthodontic Society and The Oral Health Foundation are launching a new campaign to help patients make safer choices when it comes to their dental treatment

The public awareness campaign, named Safe Smiles, will highlight the benefits of safe dentistry and treatment when carried out in dental practices by trained and registered professionals.

Safe Smiles is a dental sector response to concerns about the growth of direct-to-consumer alternatives, with the campaign’s two organisers worried about patients performing treatments at home – potentially putting themselves in danger.

The campaign was announced at this year’s British Orthodontic Society’s annual conference (16 September) in Manchester, in a joint press conference between the Oral Health Foundation and the British Orthodontic Society.

Recent research by the Oral Health Foundation reveals one-in-four (25%) UK households have opted for some form of DIY dentistry during lockdown.

The nationwide study also shows over half (55%) of adults feel they have neglected their teeth during lockdown. Around one-in-seven (15%) admit to not brushing their teeth as much as before the pandemic.  One-in-five (20%) are eating unhealthier foods, and more than one-in-ten (11%) have been drinking more alcohol. 1

Dr Nigel Carter, Chief Executive of the Oral Health Foundation is worried the potential decline in oral health status may lead to poor consumer choices, with many favouring shortcuts and attracted by direct-to-consumer alternatives.

Dr Carter says: “We are really concerned by evidence suggesting the UK’s oral health habits have declined during the pandemic. Symptoms associated with dental disease – mainly pain and changes in visual appearance – are leading patients to seek quick and cheap home cosmetic treatments advertised online. This is a great cause for concern and one of the key driving forces behind Safe Smiles.

“Dental treatment of any kind must involve face-to-face contact with a trained clinical professional inside the dental practice. This is to ensure patient safety and the most effective treatment.  It is important that the profession continues to champion safe dentistry and advise patients against direct-to-consumer treatments and alternatives shared on social media.

“When carried out correctly, cosmetic dental treatment can give patients the white, straight and confident smile they have always dreamed about. Safe Smiles will make sure patients are given the very best advice about the safest and most effective way to have dental treatment.”

Further findings from The British Orthodontic Society suggest that adults have become more conscious of their smile during lockdown. Over half of orthodontists (60%) say they have seen a larger than expected demand for treatment during the pandemic. It is suspected those affected could be looking for solutions to treat dental problems and improve the appearance of their smile.  

Speaking at the launch of the campaign, Anshu Sood, Director of Clinical Practice at the British Orthodontic Society, says: “We’re delighted to be extending our long-standing campaign with the Oral Health Foundation. It’s heartening to see overwhelming endorsement from the dental sector. This couldn’t be more timely. Our recent stats revealed the pandemic has seen a rise in the number of people seeking orthodontic treatment. With this demand comes a growth in online companies offering treatments.

“Embarking on treatment without seeing a suitably trained clinician could result in serious conditions being missed or dangerous treatment carried out. We want to ensure patients have the very best advice about the safest and most effective way to have treatment. We know that, when carried out correctly, orthodontic treatment can have a positive and life-changing impact.”  

Data shows that more than four-in-five (84%) UK adults want to change something about their smile. Over the next year, more than one-in-three (35%) are thinking about having their teeth whitened while around one-in-six (16%) are considering orthodontic treatment. 1

Safe Smiles will be asking all patients considering treatments to visit dental practices in the UK and have treatment carried out by clinicians registered with the GDC.

The campaign will tackle the dangers associated with dental tourism, inappropriately fitting mouthguards bought online, as well as harmful aesthetic changes to the mouth like lip tattoos, oral piercings, tooth jewellery, modifications and grillz.

The new campaign is being supported by Align Technology and has gathered support from across the dental world. The campaign has already received endorsement from the British Dental Industry Association, British Academy of Cosmetic Dentistry, British Dental Bleaching Society, British Society of Dental Hygiene and Therapy, British Association of Dental Nurses, and British Association of Dental Therapists.

Edmund Proffitt, BDIA Chief Executive, says: “The British Dental Industry Association is delighted to be supporting Safe Smiles. With ever growing interest in cosmetic dental work, the dental industry feels that it is very important that patients can achieve a healthy smile in a safe environment. Be it orthodontic work, tooth whitening or any other aesthetic dental treatment, working with trained dental professionals within a dental practice is a great way to get safe and effective treatment.

“With some unsafe and unregulated online and ‘do-it-yourself’ treatments available, and unfortunately, a number of unregulated practitioners offering treatments, we thoroughly recommend that patients engage directly with dental professionals to get the best, safest healthy smile.”

Jacqui Elsden, BADN President: “We’re thrilled to be supporting safe smiles. With the rise in popularity of unsafe do it yourself treatments and unregulated providers, we hope that this campaign will help patients become more aware of these dangers and think twice before they purchase them. We recommend that patients engage in this initiative and take steps to safely pursue treatment options.”

Zaki Kanaan, Chairman of the British Dental Bleaching Society: “There is no doubt that one of the most common cosmetic dental procedures that is carried out routinely in dental practices is tooth whitening. Done properly, by a dental care professional, tooth whitening is one of the least invasive ways to improve one’s smile. This popularity has led to the growth of direct-to-consumer options that often get around the legality by using non-peroxide based products that not only have little to no efficacy in whitening one’s teeth but many OTC products are in fact harmful to teeth and their surrounding structures. Members of the public seeking OTC products are leaving themselves open to harm with virtually no recourse when things go wrong.  Over many years at The British Dental Bleaching Society we have been striving to highlight to the public this exact issue and we therefore fully support The Safe Smiles Campaign.”

A special toolkit has been created to help dental professionals support the campaign and share the importance of safe dentistry.

The toolkit is available on the campaign website at www.dentalhealth.org/safesmiles.

Reference:

  1. ORAL HEALTH FOUNDATION (2020) ‘National Dental Survey’ Atomik Research. UK. Sample 2,004.

Oral Health Foundation welcomes pre-watershed junk food advertising ban

In response to the government passing regulations on when junk food advertisements are allowed to play on television, the Oral Health Foundation welcomes these new restrictions and acknowledges that it is a step in the right direction, but worries that there is still a lot more work to do.

Dr Nigel Carter, chief executive of the Oral Health Foundation says: “Nutrition is a key part of taking care of not just our general health but also our oral health. The amount of sugar we consume has a devastating impact on the nation’s oral health. Cutting down on sugar consumption is the number one way to stop tooth decay, and junk food is often filled with sugar in order to make the taste more appealing.

“Tooth decay remains the number one reason for hospital admissions among young children.  The NHS carries out almost 900,000 tooth extractions on children under 18 every year and nine-in-ten of these are down to tooth decay. Tooth extractions takes a great physical and emotional toll on children and is often a source of trauma.  All measures we can take to prevent a child having to go through this [tooth extraction] are things we welcome wholeheartedly.
Dr Ben Atkins, President of the Oral Health Foundation, also welcomes these new regulations, sharing some heart-wrenching personal accounts of having to perform tooth extractions on young children.

Dr Atkins adds: “When you’re holding a parent’s hand because you’ve just had to take all of their child’s teeth out under general anaesthetic and the child’s looking you in the eye saying ‘why have you done this to me’ you will welcome any new rules brought in to help protect children and stop situations like this occurring.

“Performing tooth extractions on a child is risky, especially under general anaesthetic which comes with a lot of risks itself.  That child might not have woken up from anaesthetic. I could have put their life in danger over something which could have easily been managed with proper diet and proper oral healthcare.”

Despite being a move in the right direction, both Dr Carter and Dr Atkins believe the new regulations do not going far enough to protect children.

Dr Carter says: “The proposed ban on junk food television advertising is a great first step, however will still be allowed through audio media, such as podcasts and radio, and there will be no new restrictions for the out-of-home sector, which includes billboards, poster sites, on buses, and in locations such as railway stations and airports. 
“With many young children now also consuming more and more media online through things like Amazon Prime and YouTube, they may still be able to see junk food advertising through these channels.

“Extending these restrictions to cover all media types, especially streaming platforms, is the next natural progression.”

Dr Atkins adds: “Ultimately, the buying decision is still down to caregivers. They largely control what their children consume and while this advertising ban is welcomed, we all need to change our attitudes, and reduce our consumption of sugary foods, to effect change.”