A quick glance at the national news headlines paints a gloomy picture of oral health in the UK. You don’t have to look hard to see how the lack of access to dental care impacts the general population and what it could mean for the nation's health.
As such, it’s never been more important to enhance patient education and ensure that people understand how to reduce their risk of dental disease and protect their health. A big part of this is nutrition and appreciating how the food and drink consumed can impact dental and systemic health.
Beyond the basics
Thankfully, most people today know the obvious foods and drinks that should only be consumed in moderation. It’s commonly accepted that fruits and vegetables are good, while sticky sweets, crisps and fizzy drinks are bad. Of course, it’s not actually as clear-cut as this in real life, but we often simplify the messages to ensure as many people as possible understand the basics.
The messages are going beyond the obvious now, though. The focus has generally turned to spreading awareness about the hidden horrors in certain foods or drinks, including added sugars, salt and trans-fat. Few would have missed what became a highly successful campaign, Change4Life, whereby the sugar in all manner of food items was presented as sugar cubes for clarity.
When it comes to oral health, there are various potential culprits that can cause less-than-ideal outcomes. For example, foods high in starch can be just as dangerous for dental wellbeing as sugar. In particular, rapidly digestible starches (RDSs) – more highly processed starches – have been shown to increase the risk of dental caries. Research also links the intake of saturated fatty acids with the development of periodontal disease. Patients should be encouraged, therefore, to do a little more research when trying to make healthier choices for themselves and their families.
A wider issue
Unfortunately, simply educating the general public about maintaining a healthy diet may not be enough. That’s because there are many factors that can influence a person’s decisions about food and drink beyond their knowledge or understanding of how their health will be affected.
It has been postulated, for example, that how food production and distribution are managed could impact the population's oral health. There is evidence to suggest that government policies restricting access to unhealthy food and drink could have a positive impact on oral health. The same systematic review found that food security for the consumer is important too, as people with the necessary financial means tend to choose healthier food options.
People’s level of understanding regarding nutrition will also impact their dietary choices. One study from 2000 found that 70 per cent of people surveyed in England did not know the recommended daily intake of fruit and vegetables. Almost a third of respondents also struggled to correctly categorise foods as high or low in sugar, fat, starch, salt, protein or fibre.
Of course, this was some time ago, and several campaigns (including the aforementioned Change4Life) have been designed to educate the general public on healthier diets since then, so we would expect the numbers to have improved. There are, however, still areas that are lacking. For instance, only 43 per cent of women and 36 per cent of men knew the recommended daily calorie intake in the 2019 Eating Well Choosing Better programme in Northern Ireland.
Driving nutritional education
All healthcare providers have a duty to support patients’ health in any way that they can. The importance of a holistic approach to care is being recognised by various professional bodies, who are encouraging care providers to adapt their patient services accordingly.
The 2019 ‘NHS Long-term Plan’, for example, highlights the responsibility of all dental and healthcare professionals to be able to talk about nutrition with patients. It’s not about working as a dietician, but rather, steering individuals in a positive direction along their nutritional education journey.
Of course, this applies to dentists and dental professionals outside the NHS system as well. We all have a responsibility to support patients wherever possible, and part of the profession-wide shift towards integrated dental care means providing basic advice and additional resources in everything from diet to exercise. Improving these areas will boost our patients’ oral health and enhance their overall wellbeing. No matter what area of dentistry or healthcare you work within, this will always be the ultimate goal.
References available on request.