About this guideline

What does this guideline cover?

The Department of Health (DH) asked the National Institute for Health and Care Excellence (NICE) to produce this guideline on oral health needs assessments and community oral health promotion programmes, in particular, for vulnerable groups at risk of poor oral health (see the scope).

This guideline does not provide detail on oral health promotion and dental treatment in residential or care settings or preventive information, or cover treatments and advice provided by dentists.

(See Related NICE guidance for other recommendations that may be relevant to oral health).

The absence of any recommendations on interventions that fall within the scope of this guideline is a result of lack of evidence. It should not be taken as a judgement on whether they are cost effective.

How was this guideline developed?

The recommendations are based on the best available evidence. They were developed by the Public Health Advisory Committee (PHAC).

Members of the PHAC are listed in Membership of the Public Health Advisory Committee and the NICE project team.

For information on how NICE public health guidelines are developed, see the NICE public health guideline process and methods guides.

What evidence is the guideline based on?

The evidence that the PHAC considered included:

  • Evidence reviews:

    • Review 1 'Review of evidence of the effectiveness of community-based oral health improvement programmes and interventions' was carried out by Bazian Limited.

    • Review 2 'Qualitative evidence review of barriers and facilitators to implementing community-based oral health improvement programmes and interventions' was carried out by Bazian Limited.

  • A review of economic evaluations 'Literature review of economic evaluations on oral health improvement programmes and interventions', produced by Newcastle Upon Tyne Hospitals and York Health Economics Consortium External Assessment Centre. The principal authors were: Donna Coffin, Joyce Craig, Mick Arber and Julie Glanville.

  • Economic modelling 'RX058: Economic analysis of oral health improvement programmes and interventions' was carried out by Newcastle Upon Tyne Hospitals and York Health Economics Consortium External Assessment Centre External Assessment Centre. The principal authors were: Lindsay Claxton, Matthew Taylor, Michelle Jenks and Alexandra Filby.

  • Commissioned reports:

    • Report 1 'An overview of oral health needs assessments' was carried out by the Dental Public Health Unit, Cardiff University. The principal authors were: Ivor Chestnutt, Maria Morgan, Nigel Monaghan, Shelagh Thompson and Lucy Collins.

    • Report 2 'Commentary on selected systematic reviews' was carried out by the Dental Public Health Unit, Cardiff University. The principal author was Professor Ivor Chestnutt.

  • Expert papers

    • Expert paper 1 'Working with vulnerable adults and older people at greater risk of poor oral health'. The principal author was Carole Hill, Tameside & Glossop Health Improvement Service.

    • Expert paper 2 'Overview of the Childsmile programme'. The principal author was Graham Ball, Childsmile Programme NHS Director and Dental Public Health Office Scotland.

Note: the views expressed in the expert papers above are the views of the authors and not those of NICE.

  • Fieldwork report: 'Field testing NICE guideline on "Oral health: local authority oral health improvement strategies"' was carried out by Word of Mouth.

In some cases the evidence was insufficient and the PHAC has made recommendations for future research. For the research recommendations and gaps in research, see Recommendations for research and Gaps in the evidence.

Status of this guideline

The draft guideline, including the recommendations, was released for consultation in May and June 2014. At its meeting in June 2014, the PHAC amended the guideline in light of comments from stakeholders and experts and the fieldwork. The guideline was signed off by the NICE Guidance Executive in September 2014.

The guideline complements NICE guidelines (in development) on Oral health promotion approaches for dental teams and Oral health in residential and nursing care.

All healthcare professionals should ensure people have a high quality experience of the NHS by following NICE's recommendations in patient experience in adult NHS services.

All health and social care providers working with people using adult NHS mental health services should follow NICE's recommendations in service user experience in adult mental health.

The recommendations should be read in conjunction with existing NICE guidance unless explicitly stated otherwise. They should be implemented in light of duties set out in the Equality Act 2010.

The guideline is available on NICE's website. The recommendations are also available in a pathway for professionals whose remit includes public health and for interested members of the public.

NICE produces guidance, standards and information on commissioning and providing high-quality healthcare, social care, and public health services. We have agreements to provide certain NICE services to Wales, Scotland and Northern Ireland. Decisions on how NICE guidance and other products apply in those countries are made by ministers in the Welsh government, Scottish government, and Northern Ireland Executive. NICE guidance or other products may include references to organisations or people responsible for commissioning or providing care that may be relevant only to England.


NICE guidelines can help:

NICE has developed tools to help organisations put this guideline into practice.

Updating the recommendations

This guideline will be reviewed 3 years after publication to determine whether all or part of it should be updated. Information on the progress of any update will be posted on the NICE website.

Your responsibility

This guideline represents the views of the Institute and was arrived at after careful consideration of the evidence available. Those working in the NHS, local authorities, the wider public, voluntary and community sectors and the private sector should take it into account when carrying out their professional, managerial or voluntary duties.

Implementation of this guideline is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guideline, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guideline should be interpreted in a way which would be inconsistent with compliance with those duties.


© National Institute for Health and Care Excellence 2014. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE.

ISBN 978-1-4731-0804-2

  • National Institute for Health and Care Excellence (NICE)