Kimberley Lloyd-Rees considers what dental professionals can do to help.
Earlier in 2022, we heard about a new study which will look at the role dentists can play in reducing obesity in the UK. The study’s lead said, “(dentists) are ideally positioned to screen and intervene to reduce obesity. If we are serious about reducing obesity… it will require an all-hands-on-deck approach, including active advocacy from dental health professionals.” With statistics showing how over half of adults (male and female) in the UK are overweight, and 26 per cent and 29 per cent (respectively) obese, this does support the need for a multi-agency approach, working together for healthier communities.
Obesity is also a global problem. On World Obesity Day in March, the WHO urged countries to do more to tackle the crisis, which affects more than a billion people worldwide, with that number still increasing. Obesity impacts general systemic health, including oral health, as well as mental health and wellbeing. Early intervention can make a huge difference, with evidence to show the significant associations between a child’s obesity status and that of their parents or carers.
The causes of obesity are multi-factorial. In the UK, we have seen how the government has tried to encourage better nutrition via public health campaigns and measures, for example, banning adverts for high-fat, sugar, and salt products, both on TV and online, before 9pm – although these plans have recently been delayed. But what and how families eat at home has long been a complex issue. We are already seeing the impact of high inflation and soaring food prices, for example. In an extensive and recent study of over 13,000 adults conducted by the Office for National Statistics, 31 per cent said they were spending less on food to help the family budget stretch further. The data from the study was published just two days before energy bills were set to rise, affecting millions of households. Our patients’ choices, decision-making processes and motivations are not likely to be unaffected by these challenging economic conditions.
Oral health practitioners want to empower people to reduce their risk of oral disease, and tackling poor nutrition and obesity is one way we can. There are barriers and limitations to acknowledge, such as access, time and other resources. But we are ideally placed to work with families and establish good relationships with different generations. Reducing sugar intake, particularly via sugar-sweetened beverages, is routinely covered in consultations, for example. These drinks are a key contributor to poor oral health status in children, as well as being a factor for being overweight or obese.
Via previous studies, we can also find some support for broader weight management and nutrition advice in the dental setting. Research published in 2019, which evaluated the perceptions of adults attending private practices on healthy weight promotion by DCPs, found that whilst those who were overweight or obese were “significantly more sensitive” to receiving information in this area, the majority of patients did welcome it. Also noted by the authors of this study was that, among the cohort, “awareness of risk of periodontitis, carcinoma and overall adverse health outcomes associated with overweight or obesity was low”. Other, earlier, pieces of research have focused on younger patients and preventive/management interventions for childhood obesity; unlike GPs, DCPs are able to have “regular and routine contact with a high proportion of young people”.
A patient-led approach when delivering messages related to oral health supports good outcomes. Improved nutrition, eating a well-balanced diet and avoiding sugar-sweetened beverages will prevent weight gain in all ages and is essential for avoiding dental problems and disease. If a patient is already struggling with being overweight, tips about reducing hidden sugars may be well received. Dental care professionals are always guided by good principles of care, including showing empathy and being respectful about privacy and this is, for some, a very sensitive subject. They can use their knowledge, along with their ability to communicate with all sorts of people to tailor their support, especially for those who are anxious, feeling demotivated, or don’t know where to start. They can help them take control of their health and wellbeing, taking small steps to a better lifestyle. Elevated oral hygiene can also boost mood, confidence and self-esteem, invaluable when trying to lose weight; you could recommend Tandex products which are designed for everyday cleaning, including comfortable interdental brushing with tools such as the new Woodi, with an FSC-certified birchwood handle.
Dental care professionals can collaborate with other health care professionals to reduce obesity, which is a risk factor for serious systemic disease, including oral disease. Although more work and investment is needed to coordinate an approach and establish a joined-up, nationwide strategy, which may include increasing interventions beyond advice, DCPs often have a relationship with patients that others don’t. Our enhanced participation in tackling obesity could therefore provide a valuable opportunity to improve the statistics.
References available on request.