Contemporary perspective on the role of community pharmacists in oral health promotion.

Abstract

Our oral health is an important part of our general health and wellbeing, and requires a range of providers to work in partnership to effectively provide oral health promotion. Cheryl Else, from Manchester Metropolitan University, explores the role community pharmacies can play in reducing oral health inequalities.[Image omitted: See PDF.]According to a recent report by Public Health England (PHE)[1] for local authorities, it was acknowledged that oral health is an important part of general health and wellbeing, and that both share common risk factors such as smoking, alcohol misuse and unhealthy diets.Since 2012, local authorities have been statutorily required to provide or commission oral health promotion programmes to improve the oral health of their local population to a standard appropriate for their area.[1] They can integrate these programmes into existing services or tender for new partnerships.[1] A range of providers already deliver oral health programmes that have been developed from evidence-based research.[1]To be effective, oral health promotion requires a range of providers who can work in partnership, and community pharmacists could play a specific role in this area.According to a review by Mann et al.,[2] community pharmacists already provide essential services in general health promotion and are frequently asked questions on oral health issues. Furthermore, pharmacists are willing to incorporate oral health promotion into their existing role as long as the right support is in place.[2] This support would need to include further training in understanding contemporary evidence-based dental public health interventions and incorporation of oral health promotion into their existing NHS contract.[2]The Royal Society for Public Health (RSPH) and PHE[3] researched the role community pharmacies currently play in health promotion and the future role they could play with the right support in place. This would enable them to reach their full potential in health-promoting activities.[3] Through the 'community pharmacy contractual framework', some health-promoting activities are already an integral part of the community pharmacies role including prescription-linked healthy lifestyle advice, smoking cessation and signposting to other health services.[3] In addition, many pharmacies are commissioned by local authorities to deliver other public health services such as weight management programmes or NHS health checks, but as the report highlighted, there are challenges that still need to be overcome to make 'healthy living pharmacies' a truly viable option across the UK.[3] These challenges include financial, infrastructure and training issues.[3] However, policies and structures could be put in place to address these issues allowing all community pharmacies on our high streets to play an important part in reducing health and oral health inequalities.Oral Health InequalitiesWhile there has been a general decline in dental decay, it remains a disease that has become increasingly concentrated in high-risk groups and closely linked with social and economic deprivation.[4]In 2016, PHE published their epidemiology report on the prevalence and severity of dental decay,[5] which revealed huge variations at local and regional authority levels and confirmed previous studies which found that most of the dental decay is found in children of poor economic and social backgrounds, with ethnicity also a factor.The results of that epidemiology survey found that the overall percentage of 5-year-old children in England free from visually obvious dental decay was 75.2% and the national average overall for England with regard to number of teeth affected by dental decay was 0.8 decayed, missing or filled teeth (DMFT); but this number increases to 3. …