THE DENTAL PASSPORT CONCEPT

The NHS depends upon the private sector providing sub-contracted dental services. Unlike general medical practice, the failure of the NHS to guarantee access to free dental services remains an unacceptable barrier to obtaining NHS benefits.  If the NHS is to succeed in providing oral healthcare services, a radical change in policy is required from within the NHS primary healthcare care sector.

For far too long NHS dental services have been considered only suitable for sub-contracting from private enterprise, despite the fact the teeth are an important part of the human anatomy occupying a vital role within the oral cavity. A comprehensive NHS worthy of the name, should include properly integrated holistic healthcare facilities that include dentistry from birth. The Red Book should provide the necessary mechanism for obtaining guaranteed access to NHS general dental practice services in the UK and include a Dental Health Voucher that can be activated within the last three months of pregnancy. The original concept of providing NHS General Dental Services (GDS) has been allowed to wither on the vine and is no more.This service should be restored for children, beginning with the provision of NHS Children’s Dental Services provided by Dental Passports.

The traditional method of item of service payments being funded from a central NHS budget has always been contentious and detailed value audits  are scarce. However, what is not in doubt is the fact that dental decay arises from negligence that cannot be successfully addressed in the absence of effective oral hygiene measures being in place. No restorative dental care should be funded by the NHS until successful preventive dental routines are already in place and validated by an NHS Dental Passport.

A first charge on any NHS dental funding should be the introduction of capitation funded NHS Dental Passports for children available as a supplement to the NHS Red Book already in widespread circulation in the UK.The availability of an NHS oral healthcare service should be via accredited NHS Dental Centres staffed by properly qualified personnel specialising in the practice and promotion of oral healthcare. Dental fitness can never be guaranteed in the absence of an oral hygiene routine that is monitored by professionals at regular intervals. A baby is born without any teeth with perfect oral health and any NHS Dental Contract should remunerate the dental team for maintaining this oral health and dental fitness (OHDF) as the teeth erupt later on. The traditional methods of estimating the dental fitness of a Nation with irregular Surveys of children’s teeth recording decayed, missing and filled teeth (DMF Index) is thoroughly unsatisfactory and a waste of precious resources in the absence of routine follow up dental examinations and patient tracking.

A Passport Contract

A Red Book NHS Dental Voucher should be introduced that can be taken to an NHS Accredited Dental Service Provider for validation. This Dental Voucher will entitle the pregnant owner to obtain a fifteen month NHS General Dental Service (GDS) Contract that will include oral hygiene and a twelve month contract for maintaining the oral health and dental fitness (OHDF) of the newborn child. An NHS Dental Passport Contract will be issued in respect of every dentally fit one year old child and remain valid until 16 years of age. Regular dental appointments will be recorded at 4 monthly inspections and the OHDF status maintained with capitation payments made every three years at 4,7,10,13 and finally at 16 years of age. A Passport Warranty (OHDF) can be invalidated in the event of the 4 monthly attendance programme being breached. Passports will be extended for OHDF patients until 21 years of age and/or the completion of further education. Restorative dentistry should be made available under NHS Passport Contracts on a grant-in-aid basis.The introduction of attractive NHS Dental Passport Contracts will encourage the dental profession to create Oral Hygiene Clinics within NHS Medical Centre facilities with a reduction in the overhead costs of providing restorative dental facilities. A “Drill and Fill ” routine will be replaced by a “Predict and Prevent” regime.