Saturday 25 May 2013

Oral health – the silver lining of economic clouds?

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It is not necessary to see the catwalks in Paris, New York, Milan and London to see what the next global style trend will be – it is tight belts, all round.

There is no escaping the fact that we are in a worldwide economic downturn, the like of which has not been experienced for generations. Two consecutive reports from the Institute of Fiscal Studies (1) have warned that UK household budgets could be squeezed for the next 10 years and there is likely to be a significant increase in the number of people living in poverty (2).

‘There is a glimmer of optimism in noting that people regard oral healthcare as important with only 12% reducing their visits to the dentist’

There is absolutely no escaping the impact of the recession that is already hitting jobs, pensions and every sector from construction and clothing to food and healthcare. We know that people are curtailing their non-essential spending and in fact a recent survey  identified eating out, foreign holidays and visits to the pub as the top three activities being cut by cost conscious consumers (3).

Belt-tightening all round – except when it come to oral health perhaps?

There is a glimmer of optimism in noting that people regard oral healthcare as important with only 12% reducing their visits to the dentist. Another survey focusing specifically on oral healthcare and carried out in the early part of 2011 posed the question; ‘Attending the dentist regularly is widely acknowledged as an important part of a balanced healthy lifestyle; in these tougher economic times, does this still remain a matter of priority for people?’

The researchers found that in fact there had been a slight increase (2%) since 2009 with 77% of UK adults saying they visit the dentist at least once every two years, and similarly 47% of respondents say they go every six months – up from 43% in 2009 (4).

While these snapshots present encouraging evidence that suggests even in these tough economic times, people are still prioritising their oral health, there is no room for complacency as regular dental attendance has not returned to the 80% peak of 2006.

‘Interest in oral healthcare is growing and dental practitioners are certainly aware of increasingly well informed patients who take responsibility for their oral health care between comprehensive and regular oral examinations’

Therefore the challenge facing dental healthcare professionals is to encourage and support effective and regular oral hygiene at home that includes interproximal cleaning. Adopting such a habit is likely to prove beneficial for both health and wallet as good oral healthcare protects against periodontal disease, caries, plaque and bad breath, thus contributing to preventive and cost effective healthcare.

New data released by the British Dental Health Foundation (5)  based on analysis of over 150,000 public enquiries over the past five years suggests that oral hygiene is increasingly important to people and accounted for 7% of calls for advice (by comparison, queries about NHS dental charges have fallen by 8%.)

Interest in oral healthcare is growing and dental practitioners are certainly aware of increasingly well informed patients who take responsibility for their oral health care between comprehensive and regular oral examinations.

However, there is still much to be done to educate people about the importance of beginning and maintaining a regular oral hygiene regime from an early age that will serve them throughout their lives. When household incomes and personal finances are under pressure, it is important that patients appreciate oral hygiene – not as a cosmetic luxury, but rather an essential part of one’s personal healthcare and as vital as a sensible diet, exercise and avoidance of tobacco and alcohol.

Although there is a growing body of worldwide academic and clinical research that incontrovertibly links poor oral health with heart disease, strokes, diabetes, lung disease Alzheimer’s and many other chronic conditions, a study for the British Dental Journal  by researchers from Warwick Medical School (6) found that there was very poor awareness among diabetes sufferers of any association between dental health and their medical condition.  Of significant concern is the researchers’ comments: ‘Dental and oral self-care tasks were rated as less important than other diabetes self-care tasks, such as taking prescribed medication or having regular eye checks. around one-third of patients rated daily flossing as the least important health related activity.”’

Raising awareness
Clearly, there is a need for continually raising awareness and reinforcing the importance of daily flossing as part of a strict and regular home oral hygiene routine – and not just among diabetics. While the importance of brushing at least twice a day can never be under emphasised , brushing alone is not sufficient to remove biofilm which is why interproximal cleaning is so essential.

The oral health consumer survey previously referenced highlights the contradiction between knowledge and action  with an overwhelming  majority (85%) of respondents agreeing that good oral health supports overall well being, while only a minority are using interdental brushes (14%) or floss daily (12%), suggesting that simple and effective oral hygiene routines are not being adopted.

There are a number of reasons why people fail to floss that basically come down to lack of proper information; some people find string flossing difficult to manage while others are alarmed at the gingival bleeding and tenderness that often occurs at the start of a flossing regime and simply give up. Others erroneously believe it is not possible to floss if they have had implants or other restorative or aesthetic treatments.

Many clinicians, and indeed patients, recommend Water Flossers as a preferred alternative to string floss. In fact , Waterpik® Water Flossers are clinically proven (7) to be twice as effective as traditional string floss at improving gum health, are easy to use and with a range of settings, are gentle yet effective enough for all, including implant and orthodontic patients. The new compact Waterpik Nanoä Water Flosser can be powered from a shaver socket, making it an ideal travel companion and perfect for every family bathroom.

With little sign of a break in the dark economic clouds, it is even more important to invest in maintaining good health, particularly oral health that is so essential to overall wellbeing.

For more information on Waterpik Water Flossers, speak to your wholesaler or visit www.waterpik.co.uk.
Waterpik products are widely available in Boots stores and selected Lloyds Pharmacies.

 Reference

1. Institute for Fiscal Studies; ‘ The Effect of the Great Recession on Household Income Distribution’ , Joyce et al September 2011 http://www.ifs.org.uk/publications/5671

2.Institute for Fiscal Studies ; ’Child & Working Age Poverty 2010-2020’, Brewer, Browne et al October 2011 http://www.ifs.org.uk/publications/5711

3.Sept 2011 http://www.charitytimes.com/ct/recession_change_in_spending_habits

4.Consumer Attitudes Towards Dentistry Survey 2011 – Denplan  http://www.denplan.co.uk/~/media/Files/pdfs/news/article/consumer-survey-2011.ashx

5. British Dental Health Foundation survey Sept 2011-11-10 http://www.dentalhealth.org/news/details/523

6. Oral health awareness in adult patients with diabetes: a questionnaire study, September 2011 British Dental Journal (BDJ). V Bowyer et al Health Sciences Research Institute, Warwick Medical School.

http://www.bda.org/news-centre/press-releases/33628-diabetics-told-to-brush-their-teeth-to-reduce-the-risk-of-developing-heart-disease-and-cancer.aspx

7. Rosema NAM et al. The effect of different interdental cleaning devices on gingival bleeding.  J Int Acad Periodontol 2011; 13(1):2-10. (using the Waterpik Ultra WP100 model).

About the author
Deborah Lyle received her Bachelor of Science degree in Dental Hygiene and Psychology from the University of Bridgeport and her Master of Science degree from the University of Missouri – Kansas City. She has 18 years clinical experience in dental hygiene in the United States and Saudi Arabia with an emphasis in periodontal therapy.  Along with her clinical experience, Deborah has been a full time faculty member at the University of Medicine & Dentistry of New Jersey, Forsyth School for Dental Hygienists and Western Kentucky University.  She has contributed to Dr Esther M. Wilkins’ 7th, 8th, 9th and 10th editions of Clinical Practice of the Dental Hygienist and the 2nd and 3rd edition of Dental Hygiene Theory and Practice by Darby & Walsh.  She has written numerous evidence-based articles on the incorporation of pharmacotherapeutics into practice, risk factors, diabetes, systemic disease and therapeutic devices.  Deborah has presented numerous continuing education programs to dental and dental hygiene practitioners and students and is an editorial board member for the Journal of Dental Hygiene, Modern Hygienist, RDH, and Journal of Practical Hygiene and conducted several studies that have been published in peer-reviewed journals. Currently, Deborah is the Director of Professional and Clinical Affairs for Waterpik, Inc.

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