Oral Health JSNA

Evidence base

This section provides links and a brief summary of a robust evidence base. For example, peer-reviewd studies, systematic revies, evaluations of interventions and best practice guidelines from national sources.

Issue number 1 = highest priority
1	Source	Public Health England
	Title incl. web link	Inequalities in oral health in England: summary Inequalities in oral health in England: summary - GOV.UK
	Summary	Oral health inequalities are strongly linked to socioeconomic status for both children and adults. Dental caries in 5-year-olds show a clear social gradient (higher prevalence in more deprived communities). Access to dental services is unequal with barriers including cost, availability and services not tailored to local need. Vulnerable groups (e.g. looked after children, homeless people, prisoners) face particularly poor oral health and access challenges. Recommendations: Supervised toothbrushing programmes in early years settings. Water fluoridation as a population-level intervention has been shown to reduce inequalities. Community-based education and outreach to improve health literacy and engagement.
	Source	Medscape
	Title incl. web link	NHS Dental Crisis Worsening in England, MPs Warn NHS Dental Crisis Worsening in England, MPs Warn
	Summary	Key Findings from the Commons Public Accounts Committee (PAC) Report: NHS Dental Access Crisis: Government and NHS England efforts to improve access have “comprehensively failed.” Vulnerable Patients Most Affected: Some Britons have resorted to removing their own teeth due to lack of care. Declining Access: Only 40% of adults saw an NHS dentist in the two years leading up to March 2024, down from 49% pre-pandemic. Unfit Contract: The current NHS dental contract is not fit for purpose and discourages dentists from providing NHS care.
2	Source	Office for Health Improvement and Disparities, Department of Health and Social Care, NHS England and NHS Improvement
	Title incl. web link	Delivering better oral health: an evidence-based toolkit for prevention Delivering better oral health: an evidence-based toolkit for prevention - GOV.UK
	Summary	Prevention strategies for Oral Cancer: Tobacco cessation – tobacco is strongly linked to oral cancer risk, support for quitting is essential. Alcohol reduction – excessive alcohol use is a major risk factor, especially when combined with smoking. Diet and nutrition – a healthy, balanced diet rich in fruits and vegetables may reduce risk. HPV awareness – HPV is an emerging risk factor, vaccination and education are important. Early detection – encouraging regular dental check-ups and awareness of symptoms (e.g. ulcers, lumps, red/white patches) can aid early diagnosis.
	Source	NHS
	Title incl. web link	Mouth cancer Mouth cancer - NHS
	Summary	Prevention Advice: Avoid tobacco and limit alcohol. Maintain good oral hygiene and attend regular dental check-ups. HPV vaccination: HPV infection is a growing cause of oral cancers, especially in younger people. Be aware of symptoms: Persistent ulcers, lumps, or red/white patches in the mouth should be checked promptly.
3	Source	NHS
	Title incl. web link	Health Literacy Toolkit Health-Literacy-Toolkit.pdf
	Summary	The Health Literacy Toolkit developed by NHS England and partners outlines how low health literacy affects: Understanding of oral hygiene practices Ability to navigate dental services Engagement with preventive care Improving health literacy is key to: Reducing inequalities in oral health Supporting behaviour change (e.g. smoking cessation, healthy eating) Empowering communities to take control of their health
	Source	NHS England
	Title incl. web link	Health Survey for England 2019 Main Findings - NHS England Digital
	Summary	Smoking is a major risk factor for: Oral cancer Periodontal (gum) disease Tooth loss NHS guidance emphasises the importance of smoking cessation as a key oral health intervention, especially in deprived areas where smoking rates are higher. Smoking also reduces the effectiveness of oral treatments and impairs healing after dental procedures. Obesity is more prevalent in deprived communities, especially among women Poor diet, particularly high sugar intake, contributes to both obesity and dental caries. Obesity is associated with inflammatory conditions, including periodontal disease, and may reflect broader lifestyle risks that affect oral health.