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NHS oral health audit 'will fail without community pharmacy'

The NHS spent £35 million on extracting children's teeth in 2014/15

Pharmacies helped a scheme to improve children’s oral health and collect data on category sales

A project run by NHS England, Queen Mary University of London and Healthy London Partnerships is looking to “harness” the interactions between community pharmacies and parents of children and young people with oral health problems. But how could pharmacists benefit?

How good is oral health in the UK?

Pharmacists may be surprised to learn that tooth decay is the most prevalent – and preventable – oral disease affecting children in the UK. Some 63,000 children under 19 years were admitted to hospital for tooth extractions in England in 2014-15, at a cost of £35 million to the NHS.

What does the project involve?

The London project, which includes a public health campaign and an audit of pharmacy data, aims to understand what types of oral health problems prompt the parents of children and young people to consult community pharmacies.

The campaign will raise awareness of tooth decay in children and young people. Data from Public Health England (PHE) shows the extent of the problem: 25% of five-year-olds experience tooth decay in their primary (baby) teeth, and 21% of 12-year-olds have tooth decay in their adult teeth.

It makes sense to launch the campaign in London, as children in the capital have higher levels of tooth decay (27.2%) when compared to the national average (24.7%), according to PHE.

Why involve community pharmacists?

The health bosses and researchers behind the project say community pharmacists have a major role to play in improving oral health in children. “They may be the first point of contact for the parents and carers of children and young people who visit pharmacies seeking advice or analgesics to manage dental pain,” the researchers say.

These encounters also provide opportunities to encourage signposting to local dentists, so that children and young people can receive appropriate and timely dental treatment. 

How can community pharmacists prevent tooth decay?
  • Making every contact count: Families may have multiple contacts with pharmacies, and each of these encounters can be an opportunity to deliver advice and promote good oral health
  • Providing consistent evidence-based advice: Guidance exists, so the same oral health messages can be provided across the country
  • Acting holistically: Healthy lifestyles and healthy eating advice will not only protect children’s teeth, but also improve their general health and wellbeing.
What were pharmacists asked to do?

The campaign and audit were supported by local pharmaceutical committees (LPCs) in the capital, and their members participated in the design of the project.

Community pharmacies in London were contractually required to take part in the first phase of the project  the awareness campaign  and pharmacies displayed leaflets and information to signpost to local dentists.

The second phase involved a voluntary audit. Pharmacies encouraged all parents, carers, and young people (aged up to 19) who collected a prescription, bought an over-the counter medicine (OTC), or asked for advice about OTC pain medication, to complete an online survey.

Pharmacies were paid £75 for their participation in the audit, and were expected to make an average of 15 patient entries each.

What will the outcome be?

The project team will use the five-minute, eight-question surveys to collect data on the oral health needs of children and young people in London. The survey could “support commissioners in future service design”, and according to the research group, “provides an excellent opportunity for CPD for the pharmacy team”. It may also “provide valuable information [about the] training and development needs of community pharmacies in oral pain management”. 


The eight audit questions for pharmacy patients:
  1. Does the child have pain in their mouth and/or a tooth?
  2. Does the child have swelling around their throat or eye, signs of systemic disease (eg rash, high temperature (fever), loss of appetite), uncontrolled bleeding, or trauma to their teeth and jaws?
  3. Has the child already seen a dentist about their pain?
  4. Does the child have a regular dentist?
  5. Has the child seen another health professional or health service about their dental pain?
  6. Does the child have a toothache?
  7. Does the child have pain from a newly erupting tooth?
  8. Does the child have a painful ulcer?
What can pharmacists learn about oral pain medication sales?

The researchers say that approximately 90,000 paediatric analgesic items are processed every month across England. They chose to run the project in November as this “reflects the period when sales of over-the-counter analgesics and dispensing activity for analgesics are generally high”.

This project shows there's still plenty that pharmacists can learn about this common product category. 

Frador mouth ulcer medicine is available to order from Fenton Pharmaceuticals

The product seals the ulcer from saliva, which protects it from further infection, the manufacturer says.

Fenton Pharmaceuticals also say that the analgesia in Frador allows users to eat and drink, talk, and brush their teeth despite the ulcer, and relieves pain.

Frador retails at £2.99. Contact 0800 032 0579 or Alliance Healthcare for more information or to order.

What information do you need to improve your oral health sales?

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Wow - so now we're supposed to be taking the pressure off dentists as well?? Hows about I do a bit of joint cracking to ease the burdens on physiotherapists or shove my arm up a cows jacksie to make a vet's life easier??? How's about someone taking the pressure off US for a change?

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