Under Freedom of Information please can you provide me with the following information:
Based on what evidence and risk assessments was the NHS contract reformed by the Chief Dental Officer to include the following:
"Fluoride varnish
In order to be entitled to the payment for this metric:
· At least 80%* of all Adult FP17Ws that indicate a caries risk of red or amber support the
application of fluoride varnish as part of the treatment provided; and
· At least 80%* of all FP17Ws for Child patients aged 3 and over as well as for Child patients
aged under the age of 3 with a risk of caries (caries risk of red or amber) support the
application of fluoride varnish as part of the treatment provided
*A 5% tolerance is allowed i.e. the target is 75%.
5% of the maximum contract value (£8,500) earned if fluoride is applied to 75% or more of all of
the patient groups above. No payment will be made if there is a failure to reach that level."
Why in Wales only? And why is there a requirement for high strength fluoride on already healthy teeth when we have fluoride in our water supply? Where is the evidence to support this?
How many NHS dentists have left the NHS since these reforms were brought in?
What are the most recent statistics regarding access to dentistry as a result of so many going private?
Does the dentist have to obtain parental consent and clarify what they are adding to the mouth before administering to child/children?
Why is 95 percent compliance required by NHS dentists? What is the reason for this requirement?
What statistics do you hold to date that confirm that the administration of oral fluoride varnish prevents tooth decay in children?
What evidence do you hold on fluoride as a neurotoxin? Why did you reform a dental contract to include the administering of a neurotoxin to children?
Where is the long term safety data for using this varnish?
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Thank you for your recent request dated 8th June 2023. For information requested we have provided links throughout this response which are underlined in blue.
Question - Why in Wales only? And why is there a requirement for high strength fluoride on already healthy teeth when we have fluoride in our water supply? Where is the evidence to support this? Answer - Wales does not have any water fluoridation scheme. Evidence base for application of fluoride varnish can be found at Delivering Better Oral Health: An evidence based toolkit.
Question - How many NHS dentists have left the NHS since these reforms were brought in? Answer – Public Health Wales does not hold this information but previous years information is available from StatsWales. Each Health Board should have information on NHS dentists in their own areas. Welsh Government may hold some information on this also. I have provided the contact details for the health boards and Welsh government at the end of this response. You will need to contact them individually for this information.
Question - What are the most recent statistics regarding access to dentistry as a result of so many going private? Answer – Public Health Wales does not hold this information. Welsh Government publishes these statistics on StatWales. Access rate up to 31st of Dec 2022 is available on StatsWales. Dental access rates in each health board area can be obtained from the respective Health Boards or from the NHS Business Services Authority (NHSBSA). I have provided the contact details for the Health Boards and NHSBSA at the end of this response. You will need to contact them for further information.
Question - Does the dentist have to obtain parental consent and clarify what they are adding to the mouth before administering to child/children? Answer - Yes, parental consent is needed for dental interventions on children. Consent can be verbal or written or both.
Question - Why is 95 percent compliance required by NHS dentists? What is the reason for this requirement? Answer - Contractual terms and conditions agreed between dental practices and Health Boards mentions the tolerance level on delivery of Key performance measures.
Question - What statistics do you hold to date that confirm that the administration of oral fluoride varnish prevents tooth decay in children? Answer - All general dental practice data including statistics on fluoride varnish applications is held by the NHSBSA. Evidence base that fluoride varnish prevents tooth decay comes from the Delivering Better Oral Health: An evidence based toolkit. I have provided the contact details for the NHSBSA at the end of this response. For further information you will need to contact them.
Question - What evidence do you hold on fluoride as a neurotoxin? Why did you reform a dental contract to include the administering of a neurotoxin to children? Answer - Possible health impacts of fluoride in water is monitored in England where they have water fluoridation schemes. A report is available. This report contains references of similar reports from other countries.
Question - Where is the long term safety data for using this varnish? Answer – Public Health Wales does not hold this information. The Medicines and Healthcare Products Regulatory Agency (MHRA) is the regulatory agency that considers safety of the licenced product used in the UK. You will need to contact them for this information. I have provided the contact details below.
Aneurin Bevan University Health Board: http://www.wales.nhs.uk/sitesplus/866/page/39187 Betsi Cadwaladr University Health Board: http://www.wales.nhs.uk/sitesplus/861/page/39134 Cardiff and Vale University Health Board: http://www.cardiffandvaleuhb.wales.nhs.uk/freedom-of-information-new Cwm Taf Morgannwg University Health Board: https://cwmtafmorgannwg.wales/foi/ Swansea Bay University Health Board: https://sbuhb.nhs.wales/about-us1/foia/ Hywel Dda University Health Board: http://www.wales.nhs.uk/sitesplus/862/page/52085 Powys Teaching Health Board: http://www.powysthb.wales.nhs.uk/freedom-of-information Welsh Government: Requesting information from the Welsh Government (FOI requests) | GOV.WALES NHS Business Services Authority: Freedom of Information | NHSBSA – Medicines and Healthcare products Regulatory Agency: |
Medicines and Healthcare products Regulatory Agency - GOV.UK (www.gov.uk)
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