Recommendations

People using services have the right to be involved in discussions and make informed decisions about their care, as described in your care.

Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off‑label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

1.1 Oral health advice given by dentists and dental care professionals

1.1.1 Give all patients (or their parents or carers) advice during dental examinations based on the oral health messages in Public Health England's Delivering better oral health. This includes:

  • advice on oral hygiene practices and the use of fluoride

  • advice about diet, smoking, smokeless tobacco and alcohol intake.

1.1.2 Ensure the advice is tailored to meet individual needs. (See section 1.2 in this guideline and recommendation 8 in NICE's guideline on behaviour change: individual approaches.)

1.1.3 Ask and record whether the person uses tobacco. Follow recommendation 6 in NICE's guideline on smoking cessation services and, if necessary, offer brief advice and offer to refer them to the local stop smoking service.

1.1.4 Consider asking people about their alcohol use, following recommendations in NICE's guideline on alcohol use disorders: preventing-harmful drinking.

1.1.5 Consider delivering oral health improvement messages in a variety of formats and using different media to meet the needs of different groups.

1.2 How dentists and dental care professionals can adopt a patient‑centred approach

1.2.1 Encourage the dental practice team to develop a good relationship with patients so they can help them maintain good oral health. All staff, including reception and support staff, should understand the importance of creating a welcoming environment for everyone. This includes:

  • families with babies or very young children

  • children and adults with a physical or sensory impairment.

1.2.2 Recognise that contact with those who do not attend regularly (for example, when they attend for emergency care) provides an important opportunity to establish a positive relationship.

1.2.3 Provide information about how people can find a local dentist or find out if they qualify for free or subsidised NHS dental care. If they do qualify for free or subsidised care, tell them where they can find out how to make a claim (see NHS Choices information on dental costs).

1.2.4 Listen to patients' needs and offer tailored advice, without judging them if their oral health is poor or if some of their behaviours adversely affect their health (see NICE's quality standard for patient experience in adult NHS services).

1.2.5 Create an individually tailored dental care plan with the patient or their parent or carer. This should combine strategies to prevent, as well as to treat, oral health problems. To develop the preventive part of the plan, ask about the patient's:

  • personal circumstances and their oral health (in the past and now) to gauge their risk of poor oral health

  • oral hygiene practices and how often they use fluoride

  • behaviours that may affect their oral health in the short or long term, including their diet, smoking, or using smokeless tobacco or alcohol (see more information in the context section)

  • existing health conditions or any disabilities or other difficulties that might prevent them from maintaining or improving their own oral health, or the oral health of someone they care for.

1.2.6 Ensure the patient, or their parent or carer, understands the plan to maintain or improve their oral health.

1.2.7 Be aware of the personal, cultural, social, environmental and economic barriers to good oral health. This includes:

  • the links between poor oral health and socioeconomic deprivation

  • recognising that some people may not think it is important to go to the dentist regularly

  • understanding that some parents or carers may not realise that it is important to keep children's primary teeth healthy

  • being aware that people may need help to use dental services.

Terms used in this guideline

General dental practice

General dental practices are commonly known as 'high street dentists' and provide primary care dental services. Wherever we refer to dentists, dental care professionals and dental practice teams, we mean those working in general dental practices.

For other public health and social care terms see the Think Local, Act Personal Care and Support Jargon Buster.

  • National Institute for Health and Care Excellence (NICE)