The Oral Health Foundation has highlighted the ‘critical’ relationship between local pharmacies and dentists, as patients continue to struggle to access dental treatment.

Dr Ben Atkins, Trustee of the Oral Health Foundation and general dental practitioner, told The Pharmacist that the relationship between a dentist and local pharmacists was ‘absolutely critical’, and that pharmacists have a key role in escalating concerns to local dentists.

This comes after a recent NHS Digital report revealed a 9.5% decrease in adults seen by NHS dentists within the recommended two-year period, while a BBC investigation last month found nine in ten NHS dental practices across the UK are not accepting new adult patients for treatment.

Dr Atkins said the public – especially the elderly – are ‘used to’ and ‘trust’ their local pharmacy. For example, if a patient comes in with a mouth ulcer lasting for six months, the pharmacists can let the local dentist know, as mouth cancer can first appear as a long-lasting ulcer.

He added: ‘If you can tell the dentist “They’ve got Bonjela, the ulcer is still there, would you mind having a look?”, that’s where I would recognise a professional. That team approach, I’ve always found that very, very valuable.’

Struggle to access dental appointments

Pharmacist Bina Patel told The Pharmacist that she continues to encounter patients who are struggling to access dental appointments.

She said: ‘They're either coming in here with abscesses and asking me to prescribe antibiotics, because they're having to wait a long time for the dentist to see them, or they've got general problems which we're having to advise on.’

Ms Patel said that she often asks friends and family who are dentists for advice, ‘and then I give the patient the advice of what to do to hold fire until the dentist is able to see them.’

‘There's a lot of problems going on, in terms of accessibility not only for GPs, but dentists as well. And it seems the easiest port of call is either the optician for eyes or the pharmacist for everything under the sun,’ she added.

‘We’re seeing a lot of people for different conditions that you would never have seen before. And we're seeing people with conditions that have progressed to the point where really they need attention but they are just not getting it.’

Oral health ‘routine’ for pharmacists

Community pharmacist Nick Daines said that during the pandemic, while dentists were closed, his pharmacy saw an increase in patients wanting to access emergency dental products such as dental repair kits, but that these enquiries had now returned to pre-pandemic levels.

However, he said that oral health products and advice continued to be a routine part of services that pharmacies provide. In 2019, pharmacies took part in NHS England's month-long pharmacy oral health campaign by giving advice to parents and signposting to dental services.

A spokesperson for Health Education England (HEE) agreed pharmacists and their teams are ‘ideally placed in the heart of communities to help support patients with this key area of public health’.

They added: ‘All healthcare professionals understand how important oral health is as a contributor to good overall health and wellbeing. Poor oral hygiene can lead to obvious issues such as dental cavities and gum disease, but can also be a precursor to a whole host of conditions such as heart disease, cancer, and diabetes.’

HEE pharmacy and dental teams in London and the south east of England have recently released updated factsheets for pharmacists on dental care, to ‘support existing expertise’ and ‘allow the whole pharmacy team to assist patients with common dental presentations, helping them to manage urgent dental and oral symptoms’.

The factsheets have been developed with input from a variety of healthcare professionals, including a dental leadership fellow and a mouthcare specialist nurse, and include advice on recognising urgent needs as well as providing over-the counter relief where appropriate.

‘For a patient in pain, being directed to the best option at that moment is the most beneficial outcome for them, and in turn increases their confidence in their pharmacist and pharmacy team,’ said a HEE spokesperson.

HEE added that dental issues are amongst the most common reasons for calls to NHS 111, particularly at weekends. ‘Many patients visiting A&E could be managed by other services, in particular community pharmacies,’ said the spokesperson.

‘The importance of this was clearly seen during the pandemic, when pharmacies provided a vital clinical environment for patients to access.’

The Oral Health Foundation has a range of information about dental healthcare in pharmacy on its website.