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Published: Sunday, 29 November -0001 23:58

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Retired dentist, Baroness Gardner of Parkes raised the issue of peri-implantitis, which she described as an important and growing health problem in the House of Lords.  in replying, Minister of Health Earl Howe said that a working group had been set up to develop ‘clear and consistent’ guidance on treatment planning prior to the placement of implants.

In her speech introducing the debate, Baroness Gardner of Parkes, said that  peri-implantitis was an important and growing health problem and ‘there needs to be an awareness and a degree of understanding of the present position and the growing risks associated with this increasingly popular form of dental treatment’.  She reported that the European Association for Osseointegration emphasises the importance of appropriate patient selection. They said it was important to indicate for the patient, particularly in complex cases, that implant dentistry should be seen as a multidisciplinary treatment. Some experts, she said, who were studying the condition of peri-implantitis believe that there should be formal national registration of implants, National Health and private, in the UK.

Baroness Gardner told fellow peers that it must be made clear to patients that an implant is not a treatment you just have and forget. Regular follow-up visits are required to ensure that a periodontal condition does not develop. Ten years ago, she said, the disease was almost unknown, but it is now ‘a serious possible consequence of implantation, particularly when the implant patient has not continued to have regular periodontal checks, with treatment if nnecessary, following an implant.

She concluded her speech by mentioning the report that 26,000 children in England aged between five and nine have been hospitalised to have multiple tooth extractions in 2013-14, which is nearly 500 children a week, at a huge cost to the NHS and a great disturbance and upset for the children and their families.

Replying to the debate health minister Earl Howe said that the NHS had a duty to commission services which are both clinically appropriate and cost effective. It was important when discussing the replacement of missing teeth that all options are discussed. He also said that it was important when people travelled abroad for this sort of treatment they realised that, ‘without the ongoing clinical care and support that this type of treatment requires, what looks like a low-cost option initially might ultimately turn out to be high-cost—both financially and from a health outcome perspective’.

There had been a significant increase in the placement of intra-oral implants in the last 20 years, he noted.  Although the immediate result can be instantly impressive, it is vital that patients received good aftercare, including periodontal checks my noble and instruction on how to maintain a healthy interface between the implants and natural tissue. The Department of Health would expect clinicians to carry out procedures ‘only where oral health is good enough to support the treatment being provided’.

Earl Howe also reported that a UK-wide working group, which includes representation from the dental faculties, has been established. Chaired by the Chief Dental Officer, it will look at developing clear and consistent cross-system guidance relating to treatment planning prior to the placement of implants, the education and training required by the clinicians and best practice for aftercare. It will also look at how appropriate, easily understood information can be made available to members of the public considering this form of treatment.

Finally referring to recent data regarding the admission of young children for the administration of a general anaesthetic for removal of teeth, he described this as ‘unacceptable’ as dental caries is a preventable disease, which can be almost eliminated by the combination of good diet and correct tooth-brushing, backed up by regular examination by a dentist. The minister said that NHS England was working with colleagues within and outside the profession to educate and inform the parents of these young children so that they are not subject to this extremely unpleasant experience at such an early age.

The debate can be found in Hansard at: http://www.publications.parliament.uk/pa/ld201415/ldhansrd/text/140723-gc0002.htm#14072390000015

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