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Data from the Adult Dental Survey conducted in 2009/10 have recorded some major changes in the pattern of oral conditions in British adults. The change in the number of sound and untreated teeth in recent decades has been particularly marked in younger adults. Across all ages there were 17.9 sound and untreated teeth per dentate adult, but among the youngest (16-24-year-olds) it was 26.9 teeth indicating rapidly improving prospects for young adults compared with their predecessors. Between 1998 and 2009 the overall prevalence of caries of all types in England has fallen dramatically from 54% to 31% overall, but the number of teeth affected by caries among those people affected by decay is almost unchanged at around 2.7 affected teeth per person. Caries, and the reduction in caries, affected people of all ages. The rate of new restorations is correspondingly low and young adults in particular had fewer restorations than their predecessors. Much activity is now likely to be around repairing or extending existing restorations. By contrast 37% of dentate adults had crowns, up from 34% in 1998, averaging around three crowns per person among those who have crowns. A minority of British adults had a very healthy periodontal status (17%) and moderate periodontal disease (pockets of 4 mm to less than 6 mm) has also reduced markedly in the last decade, in line with measurably less plaque and more frequent brushing. However, more severe disease has increased slightly (from 6% to 9% of adults). The frequency of impact of poor oral health on people's lives has also reduced in the last decade. However, while clinical conditions are improving, there is a proportion of dentate adults that experience negative effects on their daily life frequently (16%) and/or severely (17%) due to their oral health; who are more likely to be those in a lower socioeconomic position and those with worse clinical status in terms of caries and periodontal disease. [ABSTRACT FROM AUTHOR]

Introduction: Dental caries, gum disease, and tooth loss are all preventable conditions. However, many dental care systems remain treatment oriented rather than prevention oriented. This promotes the treatment of oral diseases over preventive treatments and advice. Exploring barriers to prevention and understanding the requirements of a paradigm shift are the first steps toward delivering quality prevention-focused health care., Objectives: To qualitatively explore perceived barriers and facilitators to oral disease prevention from a multistakeholder perspective across 6 European countries., Methods: A total of 58 interviews and 13 focus groups were undertaken involving 149 participants from the United Kingdom, Denmark, Germany, the Netherlands, Ireland, and Hungary. Interviews and focus groups were conducted in each country in its native language between March 2016 and September 2017. Participants were patients ( n = 50), dental team members ( n = 39), dental policy makers( n = 33), and dental insurers ( n = 27). The audio was transcribed, translated, and analyzed via deductive thematic analysis., Results: Five broad themes emerged that were both barriers and facilitators: dental regulation, who provides prevention, knowledge and motivation, trust, and person-level factors. Each theme was touched on in all countries; however, cross-country differences were evident surrounding the magnitude of each theme., Conclusion: Despite the different strengths and weaknesses among the systems, those who deliver, organize, and utilize each system experience similar barriers to prevention. The findings suggest that across all 6 countries, prevention in oral health care is hindered by a complex interplay of factors, with no particular dental health system offering overall greater user satisfaction. Underlying the themes were sentiments of blame, whereby each group appeared to shift responsibility for prevention to other groups. To bring about change, greater teamwork is needed in the commissioning of prevention to engender its increased value by all stakeholders within the dental system., Knowledge Transfer Statement: The results from this study provide an initial first step for those interested in exploring and working toward the paradigm shift to preventive focused dentistry. We also hope that these findings will encourage more research exploring the complex relationship among dental stakeholders, with a view to overcoming the barriers. In particular, these findings may be of use to dental public health researchers, dentists, and policy makers concerned with the prevention of oral diseases.