Simplyhealth s Annual Dental Survey 2011
Contents How to find an NHS dentist 3 What treatment are you entitled to on the NHS? 3 How to manage your dental costs 3 Making the most of your dental appointments 4 Introduction 5 The revival of accessible NHS dentistry 6 NHS versus private dentistry 7 Is cost still putting people off visiting the dentist? 8 What are the reasons people put off visiting the dentist? 9 How important is dental health? 11 An education gap 12 Is inflation affecting the tooth fairy? 14 About our research 15 About Simplyhealth 15 2
How to find an NHS dentist If you have internet access you can visit www.simplyhealth.co.uk and use our Dentist Locator to find an NHS or private dentist in your area. All you have to do is enter your postcode and how far you re able to travel, and we ll provide you with details of up to five dentists. We can t recommend dentists, but can give you the details of those who have chosen to register with our locator service. You can also visit www.nhs.uk/livewell/dentalhealth and enter your postcode to search for NHS dental practices in your area. Alternatively, when you re in the area where you want to find a dentist you can text dentist to 64746 for free. You ll then receive a text message with the contact details for NHS dental practices in the area. You can also call NHS Direct on 0845 4647. What treatment are you entitled to on the NHS? You will be able to have all treatment provided under the NHS that your dentist feels is clinically necessary to maintain your dental health. There are three bands of charges for NHS dental treatment. Some treatments, such as white fillings in your back teeth, are not available on the NHS and can only be done privately. How to manage your dental costs It s important to budget for your dental appointments so you do not have to put them off. Check the cost before you have any treatment, so you don t have any unexpected charges. The dentist can give you a treatment plan which will show how much your treatment will cost. You can call 0845 850 1166 or visit www.nhsbsa.nhs.uk to get advice on how to get help with health costs. With a health cash plan or dental plan you can claim back money towards the cost of check-ups, treatment and emergencies, up to an annual limit. You simply pay a monthly premium and once you ve attended your appointment you can claim the money back, by completing a claim form and sending off the receipt. The total dental plan market in the UK (covering capitation, dental insurance, and dental cover from cash plans) was estimated to be worth 665 million in 2009 Laing & Buisson s Dentistry UK Market Report 2011 3
Making the most of your dental appointments Practicing dentist and Simplyhealth s dental advisor Michael Thomas, explains how to get the most from your dental appointments. 1 Try to make sure that you arrive in plenty of time so that you can sit down, relax, read a magazine or have a drink. You ll feel much better if you re relaxed when your appointment is due to start 2 Don t forget your toothbrush! This means that you can clean your teeth prior to sitting in the dental chair. Your dentist will be pleased to see a clean row of teeth with fresh breath 3 If you have any questions regarding your visit, write these down the day before. It s natural to be nervous, but don t let your nerves cause you to forget that burning question you ve been meaning to ask since your last visit 4 Don t be embarrassed about asking about your teeth, gums, breath or anything else that s concerning you about your oral health. Your dentist can advise you on how best to achieve your goals for your dental care 5 Why not ask your dentist what toothbrush and toothpaste are best for your teeth? There s a huge range of dental cleaning products available, so instead of guessing next time you re out shopping, choose the best product for you! 6 Don t forget to arrange your next appointment before you leave, so it s in your diary and doesn t get pushed down your list of priorities 4
Introduction It is now five years since the previous Labour Government changed the dental system so that NHS dentists were commissioned to provide a set number of courses of treatment to patients. This meant that NHS dentists had to turn patients away once they d met their set quota. Now the Coalition Government has outlined plans to reform the system, to incentivise dentists to concentrate on preventative dentistry rather than just general maintenance. It has stated its ambition for NHS dentistry in the NHS White Paper, Equity and excellence: Liberating the NHS (July 2010). It says it wants to: introduce a new dentistry contract, with a focus on improving quality, achieving good dental health and increasing access to NHS dentistry, and an additional focus on the oral health of schoolchildren. Pilots to test the new contract are being carried out this year. The ring fencing of the funds for dentistry in England will stop by the end of the year, and commissioning will be moved to a new NHS Commissioning Board by 2012/13. Changes are ahead, so it seems a good time to take stock of where dentistry in Britain is now, and whether our attitudes towards oral health have changed. We surveyed 10,000 working adults and the results show that many people are continuing to put off visiting the dentist, with cost remaining the biggest preventative factor. Accessibility to dentistry has increased, but people have noticed a decline in the quality of care they receive. There s also a lack of understanding about the information that dentists can provide, and although we worry about our teeth, many of us are not giving them the care they need. This is our sixth dental survey, and where appropriate we have referenced year on year trends. 5
The revival of accessible NHS dentistry It is estimated that 58% of primary care dentistry spending was on NHS treatment in 2009/10 ( 3.3 billion), with 42% on private dentistry ( 2.4 billion) Laing & Buisson s Dentistry UK Market Report 2011 The latest figures from Laing & Buisson estimate that spending on NHS dentistry outgrew that of the private sector in 2009/10. Our results show that this could be because people are finding it easier to find an NHS dentist. The number of people who say they have struggled to find an NHS dentist has dropped by 10% to 29%. Encouragingly only 7% say they have struggled to find an NHS dentist for their children, a drop of 17% on last year. 2008 2009 2010 2011 Have you struggled to find an NHS dentist for you? 23% 35% 39% 29% Have you struggled to find an NHS dentist for your children? 9% 24% 24% 7% The number of people struggling to find an NHS dentist in the South East jumps to 35%, with 9% saying they have struggled to find an NHS dentist for their children. However, this is still well below the national levels that we saw in last year s survey. 6
NHS versus private dentistry We ve already seen that people are finding it easier to find an NHS dentist and that spending on NHS dentistry is greater than private dentistry. When asked whether they believed private dentistry offered better quality than the NHS, 37% said yes. There were four main reasons that were cited for this: 1. Improved treatment 2. More attention to their concerns and questions 3. They don t feel rushed 4. Greater flexibility of appointments However, despite 37% saying private dentistry offered better quality, a greater number of people (42%) said they would prefer to see an NHS dentist. This indicates that cost, rather than quality could be a key driver in people s decision to use the NHS. This is backed up the NHS Information Centre Annual Dental Survey 2009, which found that 63% cited affordability as the main reason for using an NHS dentist. The Department of Health s publication NHS Dental Services in England (April 2010) says that all treatment that is clinically necessary will be provided under the NHS. Encouragingly 68% said they had never had to wait for dental treatment. However, there is a difference between NHS and private dentists. 18% said they had to wait for treatment at their NHS dentist, compared to 5% who had to wait for treatment at their private dentist. According to NICE guidelines (2004), the longest interval between dental appointments for adults should be 24 months The fact that access to NHS dentistry has improved could be masking the real story, as our results show that quality hasn t improved at the same pace. People may see NHS dentistry as the more affordable option, but more than half (54%) say they ve experienced a decline in the quality of treatment they receive. The days of visiting the dentist every six months are fading away: 20% say they are not asked to visit the dentist as much 18% say the NHS does not cover as much as it used to 17% feel that they do not receive the same level of treatment (such as a scale and polish) as they used to Improving quality is something the present Government says it wants to address. 7
Is cost still putting people off visiting the dentist? Although people are finding it easier to find an NHS dentist, which generally remain cheaper than private dentists, cost is still the major factor that s preventing many from attending their appointments. 40% say they ve put off going to the dentist because they can t afford it. This is down slightly on last year s 43%, but shows that cost is still an issue. 14% say they ve actually changed their dentist in the past three years because bills were too expensive, showing that people will vote with their feet if cost gets out of control. The regional results show that in the South East, South West, North East and Northern Ireland more people have had to put off visiting the dentist due to cost. Unsurprisingly, people in Scotland and Wales do not worry about the cost as much, as dental charges are much lower. Charges in Wales have been frozen at 2006 levels and are Band 1 12, Band 2 39 and Band 3 177. NHS dental patients in Scotland pay 80% of the NHS dental treatment fee. 8
What are the reasons people put off visiting the dentist? 50 40 30 20 10 0 East Anglia London Scotland Yorkshire and the Humber South West South East West Midlands North West Wales Northern Ireland East Midlands North East 43% of 18-24 year olds say they have put off visiting the dentist because of cost, compared to just over a third (34%) of over 55s. Cost is also more of a problem for women, 43% say cost has caused them to put off visiting the dentist, compared to 35% of men. The NHS remains considerably cheaper than private dentistry, however not all treatments (such as white fillings in the back of teeth) are available on the NHS. Dental charges in England increased by 3% on 1 April. This has only added to the financial pressures that people face. NHS dental prices Dental Treatment Course up to 31 March 2011 from 1 April 2011 Band 1 Example: check-up Band 2 Example: fillings Band 3 Example: dentures and bridge work 16.50 17.00 45.60 47.00 198.00 204.00 9
Estimated private dental prices Dental Work Private Prices Dental Work Private Prices Dental Crown (Gold) 417 Sedated tooth removal 142 Dental Examination 43 Small tooth filling (Non white) 77 Large Tooth Filling (Non white) 101 Tooth Scale and Polish 45 Root canal 376 X-ray 28 Source: whatprice.co.uk Fortunately the majority of people (64%) have not had a dental bill of more than 150 in the last year. However, 16% say that they have had a bill of more than 150 and had to pay for it on a credit card. This shows that many people are not financially prepared for the costs associated with looking after their oral health. There are many ways that people can budget for their dentist appointments, either through a dental insurance plan or a health cash plan. It is worrying to see that so many people have had to put off dentist appointments because of cost, and this could be having a major impact on the nation s dental health. 10
How important is dental health? Dental appointments are vital, not just for the general health of our teeth, but also because they uncover other health issues such as gum disease and even mouth cancer. People do feel dental health is important, particularly when it comes to their choice of partner, as 66% say they wouldn t date someone with bad teeth or bad dental health. It seems, however that visiting the dentist may never be a popular thing to do. In fact, 41% say they d rather have dinner with their in laws or clean the toilet than go to the dentist. This could be why 2% say they ve never visited the dentist, a figure that rises to 4% for 18-24 year olds. However, 59% say they ve visited their dentist within the last year and 13% say they ve visited them within the last 18 months. 16% have visited their dentist between 18 months and five years and 10% say they have not seen their dentist for over five years. No matter how frequently individuals visit their dentist it s good to see nearly three quarters (73%) do understand that dental appointments are considered as an everyday health need. Yet, this still leaves more than a quarter (27%) who believe it s a luxury. There s also a stark difference between people s attitudes as they get older. Younger people place far less importance on their dental health, with almost a third (32%) of 18-24 year olds saying visiting the dentist is a luxury, not an everyday need. This may be why only half have seen a dentist in the last year. In contrast 23% of over 55s see the dentist as a luxury, but 71% have seen the dentist in the last year. Viewing dentistry as a luxury can be linked to the fact that so many people are struggling to afford their appointments. Although the majority realise the health need, it remains a luxury that they just cannot afford. There s also a difference between men and women s attitudes to the dentist. 34% of men say visiting the dentist is a luxury compared to 23% of women. People do worry about the impact their dental health can have on other aspects of their life. 58% feel that their chances of career progression are affected by having good teeth. This becomes more of a concern as people get older, 70% of over 55s feel their career could be hampered, compared to 63% of 18-24 year olds. 11
An education gap Of course good dental health relies on people taking personal responsibility for their teeth. However, for people to realise their responsibility they need to be fully informed. We found that many people were unaware of how they should care for theirs and their children s teeth. The NHS says that parents can take their children to the dentist as soon as they are born, to get advice on how to look after their dental health. However, they should definitely take them when their teeth start to appear. 42% of parents do not know this, 26% think that they should only take their children once they start to eat solid foods, and 16% think it should be when they have all their permanent teeth. Children should have all their permanent teeth (except wisdom teeth) by the age of 13 British Dental Health Foundation (www.dentalhealth.org 14/04/2011) Fortunately 53% of children had never had a filling. However, a worrying 11% of parents say that their child was under five years old when they had their first filling. A further 18% were under ten years old and 15% were over ten. Toothache and dental emergencies are also forcing parents to make unplanned visits to the dentist. 15% said they ve had to make one unplanned visit with their child in the past five years. 9% had to make two and 7% made over three. Taking children to the dentist as early as possible will help them get used to the surroundings, and ensure they become aware of the importance of looking after their teeth. It can also uncover any problems early on and prevent long term issues. The Coalition Government has said the oral health of schoolchildren will be a particular focus for its new dental contract. It s important that parents understand how they can help their children look after their teeth, so they stay strong and healthy throughout their lives. The fact that many people are not seeing their dentist as regularly means they do not regard them as a person to go to for health information. There s a general lack of understanding about the information dentists can provide: Only 29% would think about consulting the dentist about the dental education of their children 34% would speak to them about identifying oral cancer 55% would consult them about removing wisdom teeth 20% say they wouldn t ask their dentist about any of the above 12
Dentists can provide a wealth of information about dental health and other health issues that can be connected to it. For instance gum disease can increase the risk of long term health problems such as heart disease, stroke and diabetes. Patients can talk to their dentists about any one of these issues, and just like a GP they can provide valuable, professional advice. Mouth Cancer is diagnosed in 5,000 people each year in the UK British Dental Health Foundation (www.mouthcancer.org 14/04/2011) It seems many do not fully understand how they should care for our teeth either. The British Dental Health Foundation says that we should brush our teeth twice a day and for two minutes each time. However, 80% of people are not following the recommended guidelines. The majority of people we surveyed (33%) said they only brush their teeth for between 31 seconds and one minute. Worst still, 9% said they only managed between 10 and 30 seconds each time. Only 9% brush their teeth for the full two minutes. On average how long do you brush your teeth for? 10-30 seconds 31-60 seconds 60-90 seconds 91-120 seconds 121+ seconds 13
Is inflation affecting the tooth fairy? Of course many children associate losing their first teeth with the arrival of the tooth fairy. We asked how much the tooth fairy was leaving behind in these days of austerity. In 11% of households the tooth fairy doesn t visit at all, but where she does 62% say the going rate for each tooth is between 1 and 3. 19% say the tooth fairy leaves anything under 50 pence, and in a fortunate 3% of households she leaves over 5 for each tooth. 14
About our research The research was conducted by OnePoll using an online fieldwork methodology. OnePoll surveyed 10,000 working adults between 8 March and 14 March 2011. It abides by the Market Research Society (MRS) code of conduct. Based around principles of data protection legislation and research ethics, the MRS code has the confidence of the business community, Government and regulators. About Simplyhealth We ve been helping people access affordable healthcare for nearly 140 years. Our range of health cash plans, dental plans, private medical insurance and self funded health plans help 2 million people look after their health. 10,000 businesses also choose us as their healthcare provider. Our Simply Dental Plan covers check-ups, treatment, accidents and emergencies. It s designed to help customers manage the cost of routine visits to their dentist and get insurance for the unexpected. The Simply Cash Plan also includes a dental benefit that provides cash back for check-ups, treatment and hygienist fees. Our health cash plans help people take personal responsibility for their everyday health. Simplyhealth launched in 2009 after bringing together HSA, BCWA, LHF, HealthSure and Totally Active. We believe that our personal customer service sets us apart and we go the extra mile to help. We take the time to do things the right way and are bothered about our clients, customers and communities. We follow mutual values and only invest our profits back into the business or give them away to health related charities. Last year we donated 1.6m. Simplyhealth, we can be bothered. 15
Contact us For more information about Simplyhealth, please visit www.simplyhealth.co.uk or contact us using the details below: If you are interested in healthcare for your workforce: call 0845 075 0063 If you are interested in healthcare for you and your family: call 0800 072 6715 If you are an intermediary looking for healthcare options for your clients: call 0800 294 7303 If you are interested in mobility products and daily living aids: call 0800 048 2793 If you are a journalist looking for further information, case studies or an interview: call 0844 579 2266 email pr@simplyhealth.co.uk visit www.simplyhealth.co.uk/media-centre Follow us on Twitter @SimplyhealthUK or visit our Facebook page We can be bothered Simplyhealth Hambleden House Waterloo Court Andover Hampshire SP10 1LQ 1104006 Simplyhealth is a trading name of Simplyhealth Access, registered and incorporated in England and Wales, No.183035. Registered office: Hambleden House, Waterloo Court, Andover, Hampshire, SP10 1LQ. Authorised and regulated by the Financial Services Authority. Your calls may be recorded and monitored for training and quality assurance purposes.