Sugar – a long-term battle

Sugar – a long-term battle

In dentistry, we understand the dangers of high sugar consumption. The challenge is to spread the word among the general population, which involves members of the dental team, not just the dentists and dental hygienists/therapists.

Increased awareness

Dr Simon Harrison from Kyrle Street Dental Practice considers how he thinks awareness of sugar has changed over the years.

“In my experience, general awareness about the dangers of sugar remains variable. Many more people seem to understand the issue now compared to 25 years ago, but there are still pockets of patients who don’t quite have the right message. Unfortunately, some people think it’s OK to consume lots of sugar as long as they clean their teeth. Others don’t realise the extent of hidden sugars in certain foods.

“In addition, I think awareness of the correct level of fluoride in toothpaste is still an issue. Many people aren’t sure how much fluoride to use or what toothpaste their children should be using.”

Challenges to overcome

As Simon mentions, we are heading in the right direction with increased awareness across the population. However, we still have some way to go.

“Encouraging patients to change entrenched habits is very difficult. It doesn’t always happen after the first time of giving advice. We therefore need to repeat the message – and even then, we can’t force patients to change. Another challenge is finding the time to deliver dietary guidance in a busy clinical environment.”

With increased involvement of the whole dental team, including dental nurses, practice managers and reception staff, a more collaborative effort into patient education and support can be achieved. Should we consider how non-clinical members of staff might add value to the patient experience in this way?

A structured approach

Simon believes the new NHS contract may help the dental team to support their patients in this area.

“We are a prototype practice and the software we use provides a structured assessment process, including questions about social habits. This calculates a risk status, which is very helpful in knowing what to suggest to patients.

“In Herefordshire, we have a high caries rate among children under 5-years-old. We are a non-fluoridated area, but we experience higher caries rates compared to other regions in the same position. Helping young patients and their parents understand the impact of sugar is one way in which we can help to address this. Similarly, the structured assessment helps us identify elderly patients who could benefit from high fluoride toothpastes as well. We can then tailor our dietary and oral hygiene advice for the individual patient. This enables us to help people make small, specific changes.

“It is important for each member of the dental team to understand that we need to be constructive and non-judgemental. If patients feel like they’re being told off, they are far less likely to be receptive to our recommendations. Further still, I find it useful to talk about the involvement of all family members when it comes to child patients. Grandparents may enjoy spoiling their grandkids, but they should be reminded that moderation is key!”

Spreading the message about sugar

Improving awareness of the dangers of sugar requires repetition of the right messages. Designed to help are Nationwide campaigns like Change4Life and its Sugar Smart App, as well as the sugar tax. Health visitors are also providing relevant information to new parents and encouraging them to register their children early on. For dental professionals, reiterating advice at every appointment and following up to see if recommended changes have been made is essential. In addition, professional guidelines like the Delivering better oral health document are useful references and support.

“In my opinion, the sugar tax doesn’t do any harm, but it only addresses one part of the problem,” Simon adds. “The repetition of messages through dental professionals and health visitors is what will really help to make a difference. It’s a long-term project and there are no quick fixes.”


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