| Targets |
1. Dental
and oral health was adopted as one of the key priorities
in "Health Education in Scotland - a National Policy
Statement" in 1991. Dental targets were set for 2
age groups for the year 2000:
- that 60% of 5 year
old school entrants should have no cavities,
fillings or extractions
- that less than 10% of
45-54 year olds should be without their own
teeth.
|
| |
| The
Strategy |
| 2. In 1992
"Scotland's Health - A Challenge to Us All"
outlined a series of initiatives in the priority areas to
facilitate progress towards the national targets. This
included a commitment to draw up a national dental
strategy for Scotland. The strategy has been widened to
encompass the whole spectrum of oral health, and is the
result of wide consultation with the dental profession. |
| |
| Multi-agency
Action |
| 3.
"Scotland's Health - A Challenge to Us All"
recognised that improving the health of the Scottish
population could only be achieved by key organisations
working together at national and local level. While the
NHS has the leading role to play in improving health,
other agencies must also contribute. The strategy adopts
this multi-agency approach for oral health with health
boards taking the lead responsibility. It sets out for
each key stakeholder what they need to do to make the
strategy work and achieve the national dental targets.
Key areas for action are identified - diet; health
promotion; fluoridation; the role of the individual; and
prevention. Emphasis is also placed on the development of
a national framework within which local partnerships and
local initiatives can flourish and promote good dental
health and ensure well-targeted dental services. |
| |
| The
Role of the Individual |
| 4. The key
to oral health lies in simple preventive measures adopted
by individuals. Individuals need to take charge of their
own destiny and it is one of the challenges of health
promoters to help people undertake this responsibility.
Against this background, the strategy emphasises the
ability of the individual to influence his or her oral
health, or his or her children's oral health. |
| |
| Focus
on the Young |
5. The
prevalence of dental decay in Scotland is much higher
than in England and Wales. The adult target may be
achievable, with the 1993-94 data showing:
- 15% of 45-54 year
olds without their own teeth
but the prospect of achieving the target for
young children is less promising, with 1993-94
data showing:
- 38% of 5 year olds
without any decay.
|
| 6. Indeed,
there is some evidence that the extent of dental decay
has worsened for young children. To improve this
situation, the strategy recommends the concentration of
efforts on pre-school children and their parents to bring
about a positive attitude to oral health. |
| |
| Toothbrushing |
| 7. The only
substance that can have a substantial positive effect on
resistance to decay is fluoride. A major plank of the
strategy therefore is the encouragement of regular
toothbrushing with a fluoride toothpaste. This practice
is made more important by the continuing lack of
fluoridation of water supplies. There is at present no
reliable data on the use of fluoride toothpaste within
the Scottish population, but there is sufficient evidence
to show that a significant proportion of children do not
brush their teeth at all. The strategy stresses the need
to ensure that all children learn to brush their teeth
and the need to limit the consumption of sugary foods,
snacks and drinks in their diet. The importance of
regular visits to the dentist for check-ups and
preventive dental and oral health advice is also
highlighted. |
| |
| New
Objectives |
8. The
national dental targets set in 1991 reflected the
knowledge and emerging priorities at that time. To
reflect the tracking of progress which is taking place
across all of Scotland's Health initiatives and targets,
and the wide age gap between the 2 present dental target
groups, the strategy extends the current targets by
incorporating three new objectives:
by 2005:
- children aged 12 to
have (on average) no more than 1.5 teeth decayed,
missing or filled
by 2008:
- 90% of 18 year olds
to have all their own teeth
- at least 80% of
dentate adults aged 35-44 to have at least 21 or
more teeth
|
| 9.
Monitoring of these new objectives and the national
targets will take place through the Scottish Health
Board's Dental Epidemiological Programme; the recently
established Scottish Health Survey; and the Office of
Population Censuses and Surveys. |
| |
| Service
Implications |
| 10. The strategy
underlines the need for clear and comprehensive action by
health boards to assess the dental needs of their
population, to set local targets related to the national
targets and the new objecives, to plan and purchase
dental services in line with the strategy, and to
initiate, monitor and evaluate oral health programmes and
their outcomes. |
| 11. The vital role of the
dental profession in achieving oral health is recognised.
The Government's long term aim is to develop the way
dental services are provided so that health board
contracts with dentists could increasingly take account
of the health status of the population served, and
dentists could be encouraged to provide services in
particular areas, and to emphasise certain kinds of care
and treatment. In the meantime, the strategy encourages
dentists to give priority particularly to the oral health
of children through early registration, regular
attendance, and providing appropriate care and treatment. |
| |
| Ownership |
| 12. The promotion and
improvement of oral health in Scotland, and the
achievement of the national targets, will require the
adoption of the strategy by a wide range of organisations
and the public. This is a stragegy for acton, focused on
oral health for the young where the need for improvement
is the greatest, and where long-lasting success is most
likely to be achieved. Implementation of the strategy is
a challenging task but there is much that can be done to
help improve Scotland's poor dental health record, and
the contribution each individual or organisation makes is
important. |
