Annual Oral Health Survey shows up to three million could be putting their dental health in danger as fear of the dentist and money worries lead to dental avoidance.

Britain could be reclaiming its reputation as the nation of bad teeth as a new survey from dental payment plan specialists Denplan by Simplyhealth Professionals reveals over one in 20 admit to never visiting the dentist. Even more shockingly, 1% even admit they NEVER brush their teeth, which could represent over 500,000* of us!

For those who avoided the dental chair and visit the dentist less often than once every two years, 39% said they were too scared of the dentist or pain, and the same number claimed they couldn’t afford check-ups.

In a worrying socio-economic trend, over half of UK adults (52%) said they’d cancel a routine dental appointment if they had financial worries, despite check-ups costing as little as £20. Young people aged 18-24 were the age group most likely to cancel.

14% of those that don’t regularly visit the dentist said they couldn’t access an NHS dentist, while one in five were worried they’d uncover further issues that needed treatment. In contrast, 91% of those with a dental payment plan went to the dentist every six months. 

Despite rumours from across the pond that Britain’s teeth are some of the worst in the world, according to University College London and Harvard University, Britons dental health is no worse than our American counterparts, in fact, the average person in Britain is missing 6.97 teeth, while in America the average is 7.31[2].

But these emerging bad habits could spell bad news for future generations, with almost one in 20 (4%) parents of children aged 18 or under saying their child never brushed their teeth and 7% admitting they never took their child to the dentist. [3]

Shockingly, 43% of parents of children with a filling said their child had their first one aged seven younger. Almost a quarter of parents of children aged 18 or under whose child had a filling (23%) said  they had been given their first filling at five years or younger. 

The findings from Denplan by Simplyhealth Professionals correspond with a report by the Royal College of Surgeons which showed record numbers of under-fives having rotten teeth removed. Findings also revealed that hospital extractions among pre-school children have soared by 24 per cent in just ten years[4].

Even babies are affected — last year alone, 47 children under the age of one had newly grown milk teeth taken out.

Commenting on the figures, Henry Clover, Director of Dental Policy, Simplyhealth Professionals said “It’s clear from these findings that more work needs to be done to properly educate the British public on the importance of good dental health. Seeing your dentist regularly means that any potential dental problems can be spotted early on, reducing the need for invasive or expensive treatment. If you are worried about the cost of dental care, it is always worth talking to your practice to find out if they have options available, such as a dental payment plan or subscription plan, which can help you budget or spread the cost throughout the year.”

For more information on the survey results or Denplan by Simplyhealth Professionals please contact Hannah Mepham This email address is being protected from spambots. You need JavaScript enabled to view it. or Beth Heard This email address is being protected from spambots. You need JavaScript enabled to view it. or call 01273 712 000

The survey data

All figures, unless otherwise stated, are from YouGov Plc.  Total sample size was 5,068 adults. Fieldwork was undertaken between 24th January - 2nd February 2017.  The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).

For the children’s oral health section:

Parents of children aged 18 years old and under took part in this survey; and if there was more than one child in the family, we asked parents to answer based on the child whose birthday fell next.

All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 4353 adults. Fieldwork was undertaken from 25th January to 2nd February 2017. The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).

About Simplyhealth

In the world of healthcare, more than anywhere, experience counts. Since 1872 – long before the existence of the NHS – Simplyhealth has been helping people to make the most of life, by managing their everyday health needs.  That’s why today we ensure over 3 million people in the UK have access to the health products, services and support that they need, when they need them and at a price they can afford.

We’re the kind of people who live by our purpose: we’re here to help people make the most of life through better everyday health. We’re proud to be the leading provider of everyday health cash plans, dental payment and pet health plans. And whilst we may be 144 years old, we’re not afraid to innovate. Whereas once we were known purely for cash plans, we now offer a wide range of products and services with one thing in common: an unflinching desire to cater for peoples’ everyday health needs – now and into the future.

We exist to help people make the most of life through better everyday health. That’s our purpose. We use charitable partnerships to also deliver that purpose, going beyond our products and services, but very much aligned to our business strategy. As a result of our success, in 2016 we were able to donate £1.7m to our charitable causes, supporting 23 different charities including Revitalise, Music in Hospitals, Brainwave Centre and Auditory Verbal, touching the lives of thousands of people across the UK.

Our future success and performance will enable us to deliver our ongoing pledge to donate 10% of our profits to charity every year, supporting health-related charities that share a similar outlook to us and a dedication to helping people with everyday health challenges make the most of life.

Simplyhealth is a trading name of Simplyhealth Access, which is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.

For further information:

This email address is being protected from spambots. You need JavaScript enabled to view it.

http://newsroom.simplyhealth.co.uk/

@SimplyhealthUK

Facebook.com/SimplyhealthUK

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Patient Plan Direct is offering to help practices undertake a simple process, which could significantly improve your practice’s profitability and success.

The offer is to let one of Patient Plan Direct’s highly experienced business development managers to undertake a Dental Plan Health-check at your practice, reviewing the strategy and objectives associated with the dental plans you offer patients – checking you’re doing all you can to maximise the potential of your dental plan.

Irrespective of the current plan provider you’re working with (e.g. Denplan, Practice Plan, DPAS), this Health-check is completely free of charge and will leave you fully informed as to the best options of running your plan moving forward. At the very least you’ll come away with some fresh ideas and have a benchmark to assess the value your current plan provider represents.

For more details, Patient Plan Direct invite you to watch this short video:

To book your Dental Plan Health-check, simply email: This email address is being protected from spambots. You need JavaScript enabled to view it. or Call 0844 848 6888

It has been a little while since I last wrote this blog. Various things have taken over as they tend to do in life, and the blog unfortunately was something that seemed to never quite get done. However, I’ve now found myself back in the writing frame of mind, and I still seem to have opinions that some will agree with and no doubt others will disagree with, so here we go with some more ramblings of a Yorkshireman.

I have still been keenly observing what has been going on with regards to the profession over the last few months, and there still seem to be the same old problems surfaces that always have. I shall be writing about all of these issues in the near future.

The GDC seems to still be a problem to many, and personally whilst it seems to be to have become more aware of its previous problems, I don’t think it can truly move on whilst the current chair is still at the helm. It is time for a registrant to be in charge again, and for Dr Moyes to be moved to some other Quango where he can’t oversee damage to the morale of an entire profession.

Social media is also still a hot topic, and the GDC have now issued a case study on this. Some of the profession are obviously of the opinion that social media is the real world, and seemingly lack the ability to see it in its true context. There is a lack of humility in the profession where social media is concerned, and huge damage can occur to people when they believe that all they see on their iPhone is the unadulterated truth. It isn’t.

The lack of a new NHS contract, or anything really concrete is also concerning. However, I have a fairly simple view on this. We must be deluded as a profession if we think for one moment that there is suddenly going to be a fantastic new contract that will give the patients and us everything we ask for. I will guarantee that any new contract will primarily be worded to the benefit of the DoH so that the dentists can be held responsible for whatever goes wrong with it.

I’ll write more on these subjects in the coming weeks. But for this blog I though I would concentrate on something that has seemed to be brewing for quite a time, and might actually be reaching a tipping point.

Indemnity.

Now, I can remember when my indemnity was about £1200 a year, and didn’t particularly change by much annually. But now, as a principal dentist working full time, it is £5800. This increase is over the period of about 10 years. We have seen an increase in both the activity of the GDC and especially negligence solicitors in this time, which it is claimed to account for the increase in our costs.

Indemnity is a little bit like car insurance in that you hope you will never need it, but it is a necessary evil to have. With the costs of legal representation being what they are, and the increase in the amount of cases being brought, it is not really surprising that costs rise year on year.

But how do we know how these costs are calculated individually? If you are a young driver with a fast car (which you will no doubt be flaunting on Facebook!) then you are likely to be a higher risk than an older person in a more sedate family saloon. This doesn’t necessarily translate to your dental indemnity though. It seems that the longer you are in the profession, the more likelihood you are to be sued and thus have higher premiums. Perhaps the reason for this is that when these practitioners retire, often the patients are found to have large amounts of remedial dentistry to be done. This may be the case, and I am aware of some dentists who have built up a good practice on rectifying this type of problem, especially when they perhaps encourage the patient to take some form of action against the previous dentist.

I’m not saying a wrong shouldn’t be corrected in that situation, but there do seem to be some dentists who are quite happy to throw colleagues under the bus in order to ensure they get the benefit of the patient charges to rectify the problems. Perhaps ‘There but for the grace of god go I’ would be an apt phrase to remind those considering this course of action. In addition, they will also find that their indemnity is going to increase also when this happens.

Because that’s how this kind of indemnity really works; the current members are paying for the claims that are currently being made and are going to be made in the future. In much the same way as the state pension works.  We can’t have an indemnity company suddenly have empty coffers, so they have a duty to ensure they assess the needs of the society to actively have the funds to cover their expenses. All of this is paid for by the membership.

However, this is where I spot a problem. There are some dentists who for what ever reason have higher indemnity costs. Whilst it always seems unclear why this is (as there is no apparent transparency in the fee structure when applied to an individual member), it is not unreasonable to consider that there might be an increased risk identified by the indemnifier. So they are basically saying there may be claims likely to be made against this person in the future. I have no problem with that in principle, but the issue comes when this person then leaves the society because the costs of indemnity have risen so high it is fundamentally unaffordable for them to keep paying.

What happens then? The costs of these future claims will be potentially met by the rest of the members who are maybe NOT doing the same sort of high risk dentistry as the member who has left. One can argue that this is a socially responsible and indeed professional manner in which a wronged patient can claim recompense. The problem occurs when there are more of the lower risk members paying for the expenses of the higher risk. Add into this situation that the societies offer ‘discretionary cover’, meaning that your claim only has the right to be considered by the society (and not actually guaranteed to be supported), then some people feel that they are paying an increasing amount of money for less than guaranteed and continued support in their time of need.

It seems to me that many of the members of the traditional membership societies are becoming increasingly worried about the inexorable rise in costs, and the discretionary nature of the support offered. I am aware of much conversation about the pros and cons of moving between the societies, and I’m also aware of the increase in membership of the Insurance based companies as a result of the concerns about this. One of the advantages of insurance based cover is the presence of a written contract, and the ability to make a complaint to the Insurance Ombudsman, which doesn’t exist with the discretionary membership. In addition, the insurance companies are also heavily regulated by the likes of the Financial Services Authority; the traditional indemnifiers however seem to have no regulator at all. The counter to this argument is that with discretionary cover the traditional indemnifiers can cover those who are not indeed members at the time of a claim, and for the benefit of the profession. I can recall this publically happening at some point in the past, and if I am not mistaken it was a human rights issue that became clarified as a result. However, just how many times has the discretionary cover been used in that manner, and not just to refuse cover?

The way I see it, we will reach a tipping point if something is not done soon to clarify more robustly the stance of the traditional indemnifiers, especially where their discretionary powers are concerned. I want to know that I have the support of the indemnifier in assisting me in my time of need, and not that at some point they decide to pull the plug due to a disagreement or just because it is easier and cheaper to settle (despite it being morally, ethically, and clinically wrong to do so). Does writing a blog of this nature give them grounds to refuse cover? Your guess is as good as mine since there is no real published criteria to know where you actually stand.

I can see there becoming a tipping point at some time in the future where all the good clients of the protection societies are no longer willing to put up with the uncertainty and the lack of transparency about the decisions made about any individuals’ costs and especially the discretionary element of support. These clients will leave, and since it is a requirement to have appropriate indemnity, there will be no shortage of new style companies happy to disrupt the market place and offer an alternative.

For example, what if the indemnifier needed a million pounds to cover its expenses and it had 10,000 clients? The cost per client is obviously £100 per client. But what if this indemnifier then starts to haemorrhage clients until it only has 1000? The cost per client is then £1000. These remaining clients are not necessarily going to be the high risk ones either, as it’s probably the case that those higher risk clients will have changed society much sooner in order to keep their costs down.

This is probably a gross oversimplification, and I’d actually welcome someone putting me right over this, especially from any of the defence societies. However, fundamentally what I see is an ever increasing demand on the resources of these societies, with a potentially decreasing number of members footing the bill, and those members not actually knowing if they will be fully supported by the society due to the discretionary nature of the membership. This is a prime situation for a tipping point to occur that changes significantly the whole model this operates under. This might be practitioners leaving, or it might be a re-evaluation of the business model to take things into account. However it is not something that can remain the unchanged as it appears to me unsustainable in the long term.

Before anyone says this couldn’t happen as the societies are so big and have so many customers, all I have to remind you of is Kodak not identifying the digital camera revolution, Encyclopaedia Britannica not recognising the  threat of the internet, and finally the inexorable rise of Uber in its disruption of how we utilise taxis.

All indemnifiers are also reliant on the need for legal cases to continue. By this I mean there is a symbiotic relationship between the defence and prosecution of dental cases, as without one side the other cant really exist the in the same way. Once a case is begun, then costs accumulate on both sides, and the legal profession feeds from this accordingly. These adversarial sides become dependent on one another, and in particular the defence side of negligence does not necessarily work under a no-win, no-fee basis in my experience and gets paid regardless of winning or losing (by our indemnifiers). Cynically, one would say it is therefore in the financial interests of those in the legal profession to have the current highly litigious situation in dentistry to continue, because there appears to be no shortage of work for them. The practice of dentistry becomes the raison d’etre for the existence of both the societies and those legal firms feeding it until we do something to stop it.

There may be protests from the indemnifiers of the tome of this blog; certainly I have taken no account of some of the truly awful issues that result in harm befalling patients by some practitioners. I am definitely of the opinion that we as a profession most certainly still need to put our house in order, and there is probably no room within it for some of the practices that some of our colleagues routinely feel are acceptable. However, unless you are part of the solution, then you are actually part of the problem, and I feel that there should be much more clarity evident in the world of indemnity, so that the profession can practice with the confidence that our patients need us to have when caring from them.

Otherwise, what’s the point in us continuing to serve our patients? That may well create a further tipping point…..of no one in the profession left to care.

Image credit - Guiseppe Milo under CC licence - not modified.