Putting the Mouth Back in the Body

Putting the Mouth Back in the Body

The former CDO England was fond of catchphrases, and ‘putting the mouth back into the body’ was a telling example. Now a study at Loughborough University has focussed on how dental teams might influence what passes through the mouth and into the body.

One of the criticisms levelled at introducing discussions about tobacco and smoking into dental appointments was that patients might not take kindly to being ‘told off’ about their smoking and drinking excesses. However, the Loughborough study has concluded that patients would welcome support from their dentist on weight management.

With 39 million children under five years of age and 1.9 billion adults worldwide living with excess weight, obesity is a global public health crisis. Methods for tackling increasing levels of obesity have shifted in recent years, with surgeries and, more recently weight loss drugs, making less demands of patients, and promising faster results than diet changes and exercise.

National guidance in the UK already recommends collaboration across healthcare services, including dental teams, to support people living with obesity to make healthy lifestyle changes, during their appointments.

The study, which was conducted by researchers within the University’s Centre for Lifestyle Medicine and Behaviour (CLiMB) found that involvement of dental teams is low, and not routine practice at present. The views of teams already providing weight management support though was positive, both in respect to the integration of the service into patient assessment and the receptiveness of the families receiving their services.

The public also appeared in favour of weight screening and discussion, if it is performed sensitively and consistently for all patients regardless of their weight status.

The study was led by paediatric dentist, Jessica Large, and Amanda Daley, Professor of Behavioural Medicine and Director of CLiMB.

Speaking about the project, Jessica said: “It is positive to see that both the public and those within the profession, are supportive of weight screening, discussion and signposting to support, becoming more routine during dental appointments.

“All health professionals have the opportunity to contribute to reducing obesity and improving health, and these results suggest that with the right support and training, dentists could help in a positive way to achieve this.”

Professor Daley, said: “Dentists consult with most of the population at least once a year, providing an ideal opportunity to screen and intervene to reduce obesity. They also engage in other behaviour change interventions such as stopping smoking and dietary advice in connection to reducing sugary snacks and drinks. This puts them in a strong position to address weight concerns.

“The initial assessment has shown that members of the public would like to see support from their dentist in relation to weight loss and with obesity levels continuing to grow, an ‘all hands-on deck’ approach is now increasingly necessary.”

The study did identify some barriers reported by dental teams about raising the topic of weight and offering interventions, such as weight stigma, lack of time and fear of offending. There was a need for suitable training and support to be in place if this holistic approach to dental care was to be successful. Looking ahead to enforcement, the team added: “guidance and advocacy from stakeholders, including professional regulatory bodies, is also required.”

However, following the trail from Loughborough University’s enthusiastic press release, it transpires that the study in question is a systematic review and meta analysis. Published in an international journal, its analysis was based on numerous original papers, many of which would have been produced in very different healthcare systems and cultures to that in the UK.

This is not proving to be a barrier to its promotion as a UK solution. The research has been funded via the National Institute for Health Research (NIHR). Professor Daley has published an opinion piece on the role dentists have to play in tackling obesity in the British Dental Journal and worked on a study that looked at obesity, cholesterol, and diabetes screening, in primary care practices.

‘Putting the mouth back into the body’, momentarily sounded profound, though on further examination it questioned the most basic anatomy. Rolled out, it led to suggestions that dental teams provide more general health advice and screening within the current NHS service, a reasonable suggestion to anyone ignorant of the UDA system, NHS economics and the workforce situation. That ambition has not departed with the former CDO.

Public and dental teams’ views about weight management interventions in dental health settings: Systematic review and meta‐analysis - Large - Obesity Reviews - Wiley Online Library


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