A standardised framework for the local commissioning of dental services for people with diabetes has been published by NHS England and NHS Improvement.
This document, Commissioning Standard: Dental Care for People with Diabetes, has been developed in recognition of the link between gum disease and diabetes.
It covers type 1 diabetes and those with, and at high risk of, type 2 diabetes and aims to help guide commissioners to introduce new procurements for existing contracts in a planned way that considers local capacity and capability.
In emphasising local resourcing, these standards do not place mandatory requirements on existing providers, the publication said. It says the recommended changes outlined relate to new procurements only and will involve redirection of an existing resource.
According to the commissioning standard: “Planning of services should be underpinned by a needs assessment. In the context of this commissioning standard, an oral health needs assessment should be used to determine if current dental services for people with diabetes are adequate, given the context above.
“Commissioners will then need to work with their Local Dental Network and associated Managed Clinical Networks to redesign services where required, which may involve awareness raising, skill mix review and additional training and competence development.”
The International Diabetes Federation and European Federation of Periodontology have set out a clear roadmap for the co-morbid relationship between periodontitis and type 2 diabetes and their joined-up management.
This commissioning standard supports the local implementation of pathways for patients to enable the benefits of timely and effective periodontal management on oral health and importantly general health to be realised.
The document stated: “It is now clear that there is a bidirectional link between diabetes and periodontitis (gum disease). People with type 2 and type 1 diabetes are at greater risk of developing periodontitis and people with periodontitis are at greater risk of developing type 2 diabetes. In addition, effective treatment of periodontitis in people with type 2 diabetes can improve glycaemic control to an extent that can reduce the need for an additional prescribed medication as well as to reduce systemic complications associated with increased glycaemia.
“People with type 2 and type 1 diabetes… need to access effective dental care and local pathways should be developed to support this. This will require local engagement between providers and commissioners of dental services and diabetes services, and the commissioning of dental services with the appropriate skills and competences to deliver the care required.”
To access the document, click here.
In May 2017, the DT reported on the results of a national survey which highlighted a lack of education in gum disease relating to diabetes.