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Oral health: policy context

The main driver of policy concerning dentistry and oral health in Scotland is the 2005 Action plan for improving oral health and modernising NHS dental services in Scotland. This sets out the Scottish Executive's response to the two consultation documents Towards better oral health in children and Modernising NHS dental services in Scotland. Public health programmes have been developed to tackle the oral health problem, in keeping with Improving health in Scotland: the challenge. Dental services are being modernised through changes to the system for rewarding primary care dentistry in order to: promote prevention; improve access to services; and improve recruitment and retention in the workforce.

The Scottish Executive's national targets for oral health improvement set out in the action plan are:

a) by 2010

  • 5-year-olds (Primary 1)
    60% of children will have no signs of dental disease.
  • 11/12-year-olds (Primary 7)
    60% of children will have no signs of dental disease in permanent teeth.
  • Adults
    90% of adults will have some natural teeth.
    65% of adults aged 55-74 will have some natural teeth.

b) by 2015

  • Oral cancer
    Reverse current declining trends in oral cancer 5-year survival for males.

The governments' 2003 Health White Paper Partnership for care set out key proposals for primary care. A key development was the evolution of LHCCs (Local Health Care Cooperatives) into Community Health Partnerships (CHPs). CHPs have devolved responsibility for local health services and control of budgets as well as representation from frontline staff as an integral part of their management structure. Importantly, they have health improvement at the top of their agenda. This change gives oral health and dentistry an opportunity to become fully integrated into the primary care system (Scottish needs assessment report and guide to good practice: Oral health in primary care, May 2004).

Childsmile is a programme to improve the dental health of children in Scotland. Childsmile is split into three main elements:

  • the core programme - which involves nursery and school toothbrushing schemes, and distributes every child in Scotland with free toothbrushes and fluoride toothpaste in their first five years of life
  • the dental practice programme - based mainly in the West of Scotland, and involving clinical prevention activities
  • the east programme - involving the application of fluoride varnish to nursery school children's teeth.