Presented by the Public Health Specialist, Torbay Council.

Mark Richards, Public Health Specialist, Torbay Council, explained that dental commissioning had recently been transferred to the Integrated Care Board (ICB).  This provided a good opportunity for Public Health and Local Authority Teams to work with the ICB to improve access to dental care and collaborative working was already underway to achieve that.  The new Peninsula Oral Health Steering Group had been established by Devon and Cornwall ICB’s to oversee dental reform work across the peninsula following the transition of dental commissioning functions and all three Devon Local Authorities, including Torbay, were represented.  There was a commitment to working with Health Inequality Leads, Local Authority Oral Health Improvement Leads, the Dental Teams and key partners to improve access to oral health improvement advice and interventions for those in greatest need together with increased access to dental services.

Members were informed that there was a lack of take up of the NHS Dental Contract nationally which was why a high number of dental practices were not taking on new NHS patients. In the South West 98% of dental practices were not accepting new NHS patients and as at September 2023, there were 3,656 Torbay residents on the NHS dental waiting list in total, consisting of 3,081 adults and 484 children and young people.

It was recognised that dental care providers were still working through a substantial backlog of work which had resulted from the impact of the Covid-19 pandemic and general population need and this also contributed to the current difficulty in accessing dental care.

The main areas of concern in Torbay were:

·         access to NHS dental care;

·         wait numbers (which were the highest they have been historically);

·         hospital admissions for tooth decay resulting in tooth extractions for the 0-19 years and 18+ age bracket and the impact of dental problems on children and young people; and

·         oral cancer registrations and mortality rate.

Members were informed of current and planned oral health improvement projects designed to help tackle these areas of concern which included:

·         First Dental Steps which was an initiative delivered by Health Visitors;

·         Supervised Toothbrushing Scheme which was delivered by At Home Dental;

·         incorporating advice on oral hygiene and dental access into Your Health Torbay (Lifestyles offer) for all triage appointments;

·         advice and guidance for Family Hubs, Early Years, 0-19 and Children’s Social Worker Teams regarding oral hygiene, registering for a dentist and what to do if in urgent dental need, including a staff training plan and accompanying advice regarding nutrition and hydration;

·         toothbrush and toothpaste packs for Family Hubs and looked after children and young people;

·         Fluoride Varnishing Programme;

·         Open Wide Step Inside – an initiative engaging with schools and Year 2 students to improve oral health and hygiene;

·         Homelessness Pathway which provided oral health support to the homeless;

·         establishing Oral Health Champions in Care Homes and Domiciliary Care settings; and

·         the Community Dentistry initiative which provided routine and emergency dentistry for adults and children with complex needs who find it difficult to access dental services.

Members heard that prevention as well as improvement was important and that the key was to focus on the early years sector and schools and this could be achieved through projects such as supervised brushing, fluoride varnishing, dental first steps, working with family hubs and the Open Wide Step Inside initiative.  It was suggested that outreach work in neighbourhoods would also help and that some funding was being provided by the ICB to help Public Health with initiatives, education and communication around prevention.

The Chair of Healthwatch Torbay explained to Members that since April 2023, Healthwatch in Devon, Plymouth and Torbay had collectively recorded 132 experiences about NHS Dental Services across the three localities and that 109 of those experiences related to access to dental services.  Healthwatch Torbay were keen to help in promoting key messages to the public around access to dental services.  It was as important to deal with prevention as well as the provision of emergency dental care, recognising the impact of the cost of living crisis, as individuals may have a poorer diet for example and may be reluctant to seek NHS dentistry help as there was also a cost element to that.