hot topics Flashcards
sugar tax
- Banded volumetric tax of added sugar into carbonated drinks
- introduced w aims of curbing the childhood obesity epidemic
- Implemented in 2018
- Introduced to incentivise soft drink companies into reducing added sugar
- Manufacturers have to increase prices to reflect extra tax
- Which discourages consumer from buying
- Or manufacturers reduce sugar so they don’t have to pay the extra tax
For:
* Reduction in caries rate
* Other countries saw favourable outcomes
* Mexico
* Tax revenue collected is used to promote physical education in primary schools
* 44% reduction in sugar content in mid and high sugar drinks across UK
Against:
* Poorer people
* Tax prevents them from buying drinks they want
* Removes their autonomous right
* Type 1 diabetic patients
* Rely on purchasing high sugar drinks
* Safeguard against hypoglycaemic episodes
* Doesn’t take into account frequency of sugar consumption
* Drinking a can of coke in one go causes one acid attack
* Sipping on it through the day results in constant acid attack
* Doesn’t take into account acidity
* Tooth erosion- erodes enamel
* Susceptibility to caries
* Increased sensitivity
amalgam
- Alloy containing mercury
- Used for fillings
- NHS implemented guidelines to minimise use of dental amalgam
- Encourage use of alternative materials
- Particularly for children, preggos, ppl w specific health conditions, ppl likely to have allergic reaction
- NHS emphasised importance of informed consent
- Providing patients w info ab benefits and risks of diff filling mats
- BDA support phasedown rather than ban
- Dentists can adapt to change and discover alternative mats
For
* Durable
* Can withstand forces of chewing and grinding
* Appropriate in teeth w high occlusal forces when eating eg molars
* Last years (cost effective)
* Cost effective
* Cheaper than composite resin
* More affordable for patients
* Ease of use
* Easy to handle and manipulate for dentists
* Short setting time
* Beneficial for NHS dentists w short appt times
* Long standing evidence for safety
* Mercury bound within alloy so minimal release of mercury vapour
* Safe for most patients- not preggos
* Accesible
* Widely available in dental practices worldwide
* Long history of use so dentists familiar w properties and techniques for placement and removal
Against
* Contributes to mercury environmental pollution
* Doesn’t decompose
* Patients prefer composite resin(white) fillings
* Concerned ab mercury/ aesthetics
* Improved in durability and longevity
* Minimally invasive dentistry
* Preventing dental disease while removing minimal tooth structure
* Amalgam fillings require more tooth structure to be removed than composite
* Rely on mechanical retention
* Predesigned cavities must be cut in tooth
* EU countries have to ban amalgam use by 2025
* England imports most amalgam from EU countries
* Close by, cheaper
* Cant if they stop using it, have to import from far away countries
* More expense for NHS
the environment
- If healthcare industry was a country it wld be 5th most carbon emitting country in the world
- Examinations are most carbon emitting procedure
- So many a year
- Amalgam
- Doesn’t decompose when u die
- Hard to make healthcare sustainable
- Linear economy
- Cant be circular cos patient safety so cant recycle
- Landfill
How to make dentistry more sustainable
* Can create more sustainable dental equipment
* Wooden toothbrush
* Water pick
* Make dentistry more preventative
* More education so less procedures
water fluoridation
- Fluoride is a naturally occurring mineral
- Acids produced when eat unhealthy food causes tooth decay
- Fluoride seeps into tooth tissues and makes enamel chemically stronger
- Reverse tooth decay in its early stages- remineralise enamel
- Make tooth stronger for future acid attack
- World health organisation
- Recommends max 1.5mg per litre
- Optimal balance between maximising oral health benefits and protecting from potential side effects
- Recommends max 1.5mg per litre
For
* 1960s ab 1ppm fluoride added to water supply
* Combat tooth decay
* Government figures showed that ppl who lived in places w fluoridated water supplies 63% less likely to be admitted to hospital for tooth pain
* Save 35£ for every 1£ spent on water fluoridation
* Less ppl need fillings extraction checkups
* Widespread access to dental care
* All members of society, regardless of socioeconomic status
* Prevent need for invasive treatment
* Beneficial cos dental deserts
* Passive dental care
* Ppl dont attend dentist for many reasons
* Time constraints
* Hard to access
* Anxiety
* Ensures consistent protection against tooth decay without regular appts
Against
* Water fluoridation only in 10% of UK water supply
* Cant get consent from everyone- GDC principle obtain valid consent
* More conspiracy theories on social media
* Some water in UK is hard water
* Has more minerals, react w fluoride
* Form ppt that blocks sewage pipes
* Fluorosis
* Disease caused by high fluoride ingestion
* White mottling of teeth
* Ppl who live in water fluoridated areas more likely to get it
NHS vs private
Price
* NHS
* Exempt ppl dont pay
* Others pay according to bands system
* Private
* All have diff pricing
* Some cheaper to outcompete other private clinics
* Prices set by clinic owner
* Much more expensive than NHS
Pay
* NHS
* UDA system
* Private
* Diff for every practice
* Usually a %, can sometimes be negotiated
* Earn a lot more
Treatment available
* NHS
* restorative
* Eg Fillings crowns examinations
* Orthodontic is under 18
*dont have as advanced tech eg most use amalgam
* Private
* This plus cosmetic treatment
* Eg composite veneers
* composite not amalgam
Appt length
* NHS
* 10-15 min
* Stress
* Private
* Longer
* Easier to form rapport
* Less stress
Availability
* NHS
* Waiting list
* Dental deserts
* Private
* Accessible
although there are many differences, the level of patient care administered is the same, which is the most important factor imo
social media
- As tech progresses, social media has more impact on healthcare
- Making ppl more impressionable
- More likely to believe things they see scrolling
- Not likely to fact check it
- Many ppl think fluoride is poisonous
- Its acc one of most important things in decreasing rates of tooth decay
- Ppl avoid using it, opt for non fluoride toothpaste
- Ppl have worse oral health, are resistant to recieving help
- Ppl thing mercury in amalgam is toxic
- Hatred toward dentists
- Right wing
- Placebo effects become more popular
- Resist listening to dentists advice that they’re not good for them
- Eg hismile toothpaste, smile direct club
- Smile direct club is like Invisalign but all from the internet
- Take ur own impression and send it
- Dangerous for oral health to do this all without any dentists inmput
- Ppl become more insecure
- Unrealistic standards set- ai and photo editing
- Covid 19 increased tooth insecurity
- On zoom and social media a lot to stay connected to the world
- Looking at ur face all day
- Teeth whitening rose sm
- Dentists using to getting a solid patient base- private
- Tell ab services offering
- Posting pics of before and after- show off their work
- Confidentiality, data protection issues
- Can also provide education
- Make dent more preventative
- Save money for the NHS as less procedures needed
- Although there are negs, social media can be used valuably for the dental profession
effects of covid
- COVID-19 is a highly contagious respiratory illness that led to a global pandemic
Service disruption
* Routine services suspended
* Practices limited to urgent and emergency care
* Remote management of patients
* Increased antibiotic prescribing
* Leads to antibiotic resistance
* Patient expectation that antibiotics are suitable for toothache increased
Financial challenges
* Less patients so less income
* Led to practices shifting their focus to private care
* Led to NHS dent becoming less accessible
* Dental deserts
* Costs of ppe and stricter hygiene protocols
* NHS dent already severely underfunded
Dental anxiety
* Patients avoided dental visits, concerned ab exposure to the virus
* More in high risk groups eg elderly and immunocompromised
* Pre existing dental anxiety increased
* Added stress of infection risk
* Caused progression of dental issues cos no frequent checkups to identify problemts
* More need for complex treatments
* Fuels more anxiety
Long term implications
* Still working thru backlogs of deferred care
* Delayed treatments led to worsened oral health
Positives
* Innovations in patient treatment
* Teledentistry
* Improved safety measures
In conclusion
Moving forward, addressing the backlog and supporting the mental health of both patients and professionals will be essential to ensure that dentistry can recover and continue to provide high-quality care.
the elderly
The elderly face several unique challenges when it comes to dental care, which can significantly impact their oral health and overall well-being
Age related oral health problems
* Dry mouth
* Reduced saliva production
* Leads to dry mouth
* Increases risk of cavities, periodontal disease, discomfort
* Cavities
* More susceptible
* Especially in roots of teeth which become more exposed as gums recede w age
Physical and cognitive limitations
* Mobility issues
* Challenging to attend regular dental appts
* Harder to come across issues at early stages
* They develop and become more complex
* Arthritis
* Diff to brush/ floss
* Poor oral hygeine
* Cognitive decline
* Eg dementia
* Hinder ability to care for teeth, remember to brush, follow treatment plans
* neglect in care homes
In conclusion Addressing the dental needs of the elderly requires ensuring accessibility, affordability, and education
Regular dental check-ups, preventative care, and tailored treatment options can help manage and mitigate these challenges, improving the oral health and overall quality of life for older adult
What are they key social issues affecting dental healthcare practice in the UK
- Inaccessibility
- Patients struggle to find appt
- Funding shortages
- Workforce shortages
- Dentists going private- covid 19 contributed
- Brexit- fewer overseas dentists entering UK workforce
- Rural areas have shortage of NHS services
- Cost
- Low income families and those not eligible for free care
- Oral health inequalities- socioeconomic status
- Poorer- higher rates of decay, gum disease, tooth loss
- Lack of access to preventative care, diet
- Ageing population
- Complex dental needs
- Mobility issues- access more difficult
- Dental anxiety, mental health issues
- Avoid treatment
- Neglect oral hygiene practices
- Language and cultural barriers
- Diff perceptions of oral health and treatment needs
- Lack of education
- Ab oral hygiene practices and importance of regular checkups
- Social media spreading misconceptions
Several key social issues impact dental healthcare practice in the UK, affecting both access to care and oral health outcomes.
