What is this guideline about?

What is this guideline about?

This guideline makes recommendations on undertaking oral health needs assessments, developing a local strategy on oral health and delivering community-based interventions and activities.

Oral health is important for general health and wellbeing. Poor oral health can affect someone's ability to eat, speak, smile and socialise normally, for example, due to pain or social embarrassment (see the Department of Health's Dental quality and outcomes framework).

Oral health problems include gum (periodontal) disease, tooth decay (dental caries), tooth loss and oral cancers.

Many of the risk factors – diet, oral hygiene, smoking, alcohol, stress and trauma – are the same as for many chronic conditions, such as cancer, diabetes and heart disease. As a result, interventions that aim to tackle these risk factors (taking a 'common risk factor approach') will improve general health as well as oral health (Watt and Sheiham 2012). See section 6 for NICE guidance on maternal and child nutrition, obesity, alcohol and smoking cessation.

The recommendations in this guideline aim to:

  • promote and protect oral health by improving diet and reducing consumption of sugary food and drinks, alcohol and tobacco (and so improve general health too)

  • improve oral hygiene

  • increase the availability of fluoride[1]

  • encourage people to go to the dentist regularly

  • increase access to dental services.

This guideline focuses, in particular, on people whose economic, social, environmental circumstances or lifestyle place them at high risk of poor oral health or make it difficult for them to access dental services. It is not possible to provide a comprehensive list of all these groups, but they include people:

  • who are homeless or frequently move, such as traveller communities

  • who are socially isolated or excluded

  • who are older and frail

  • who have physical or mental disabilities

  • who are from a lower socioeconomic group

  • who live in a disadvantaged area

  • who smoke or misuse substances (including alcohol)

  • who have a poor diet

  • from some black, Asian and minority ethnic groups for example, people of South Asian origin

  • who are, or who have been, in care.

This guideline is for local authorities, health and wellbeing boards, commissioners, directors of public health, consultants in dental public health and frontline practitioners working more generally in health, social care and education. (For further details, see Who should take action?) In addition it may be of interest to members of the public.

See About this guideline for details of how the guideline was developed and its current status.



[1] Water fluoridation is outside the scope of this guideline. See Water fluoridation: health monitoring report for England 2014 (Public Health England 2014).

  • National Institute for Health and Care Excellence (NICE)