Dentists are eligible for a free flu vaccine through occupational health arrangements made by their employer. Flu vaccination is recommended for all frontline healthcare workers who have direct contact with patients and service users. Employers should commission a service which makes access easy for all frontline staff, encourage staff to get vaccinated and monitor the delivery of their programmes.

All frontline health and social care staff are designated as key workers including dentists and their teams.

As set out in the green paper Advancing our health; Prevention in the 2020s, the Government intends to seek views on the merits of expanding the current provision to reach more children in pre-school and primary school settings in England. Water fluoridation is also clinically proven to improve oral health particularly for children. The green paper set out a commitment to reduce the barriers to expanding water fluoridation and this is being carefully considered.

There has been no recent national evaluation of the effectiveness of the existing local authority led individual schemes that promote toothbrushing. Public Health England regularly review available evidence on the effectiveness of measures to promote oral health including supervised toothbrushing. This includes evidence from schemes in England and those in other parts of the United Kingdom including the well-established scheme in Scotland.

As set out in the green paper Advancing our health; Prevention in the 2020s, the Government intends to seek views on the merits of expanding the current provision to reach more children in pre-school and primary school settings in England. Water fluoridation is also clinically proven to improve oral health particularly for children. The green paper set out a commitment to reduce the barriers to expanding water fluoridation and this is being carefully considered.

There has been no recent national evaluation of the effectiveness of the existing local authority led individual schemes that promote toothbrushing. Public Health England regularly review available evidence on the effectiveness of measures to promote oral health including supervised toothbrushing. This includes evidence from schemes in England and those in other parts of the United Kingdom including the well-established scheme in Scotland.

Funding has been received for 2019/20. The Adult Dental Health Survey protocol has been developed and stakeholder engagement completed. Funding for 2020/21 would enable the commencement of the survey fieldwork. The COVID-19 pandemic is likely to impact on the clinical examination.

National Health Service dentists have been receiving their full funding with minor adjustments throughout the COVID-19 period. They are now open for face to face including routine care and are restarting services in line with the increased infection control required to minimise the risk of transmission. NHS England and NHS Improvement are carefully considering any impact this may have on the overall provision of primary care dental services.

With NHS services under intense pressure as COVID-19 spread, we ensured that we had as many beds available as possible to care for patients with severe respiratory problems during the COVID-19 pandemic peak.

To enable this, every hospital in England suspended non-urgent elective operations to free up additional capacity needed to assist with the COVID-19 response. With the pandemic easing, National Health Service providers are now expected to recover the maximum elective activity possible between now and winter, making full use of available capacity both in the NHS and in contracted independent hospitals.

Elective care activity is now ramping up, and by October we expect the NHS to deliver:

- The same number of outpatient attendances, follow ups, scans and endoscopy procedures as October last year; and

- 90% of the overnight elective procedures and day cases carried out last October.

Dental extractions which require general anaesthesia and therefore are carried out in hospital are included in this recovery by the NHS.

In light of the current COVID-19 pandemic and associated economic climate a decision was made to freeze dental patient charges at 2019/20 levels. This is a temporary freeze being kept under review. No changes have been made to current dental exemption arrangements.

The Government has provided enhanced support to the retail, hospitality and leisure sectors through business rates relief given the direct and acute impacts of the COVID-19 pandemic on those sectors.

A range of further measures to support all businesses, including those not eligible for the business rates holiday, such as medical service providers, has also been made available.

The Government will consider any further financial assistance necessary to help businesses get through this period.

This information is not routinely collected centrally. However, the Department estimates that the total Government outlay is on average around £230,000 for the provision of a Bachelor of Dental Surgery, and around £110,000 for the provision of foundation training for a dental graduate.

The following table shows patient charge revenue for National Health Service dental services from 2015/16 to 2018/19.

Source: NHS England

The Dental Prescribing Dashboard developed by the NHS Business Services Authority and Public Health England, includes data for National Health Service local area teams. Latest available data show general dental practitioners issued 2,912,579 prescriptions for all antimicrobials including antibiotics during April 2017 to March 2018. There were 715,545 prescriptions between January and March 2018. The Dental Prescribing Dashboard will be refreshed in summer 2019.

Analysis is based on items prescribed by NHS dentists, but some patients may attend a general medical practice with a dental infection and receive a prescription from their general practitioner (GP). These prescriptions are not included, as we cannot determine the reason why a GP prescribed antibiotics.

The English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) Report 2018 provides information on NHS dental prescribing in dental practices and consultations. The ESPAUR report for 2019 scheduled for publication later this year will publish data for the 2018 calendar year. The ESPAUR 2018 report is attached.

NHS Digital publishes quarterly information on the number of adults who have seen a National Health Service dentist in the previous 24 months and children who have seen an NHS dentist in the previous 12 months.

There are no current plans to change the age breakdown of the data that is routinely published.

In England, local authorities are responsible for assessing oral health needs and improving the oral health of their local population including those over the age of 65.

To support local authorities in this role Public Health England (PHE) published Commissioning better oral health for vulnerable older people: An evidence-informed toolkit for local authorities which gives an overview of the impact of oral diseases in vulnerable older people and presents the evidence of what works to improve their oral health. The toolkit for local authorities is attached. It is supported by an evidence review and a resource compendium to support oral health improvement of vulnerable older people in all settings.

Timing of the next Adult and Child Dental Health Survey has yet to be confirmed.

While we are currently unable to confirm exact details of the Green Paper, NHS England has a legal duty to commission National Health Service dental services to meet local need including people living in care homes.

The forthcoming Green Paper will be based on a number of principles including whole-person, integrated care with the NHS and social care systems operating as one.

The National Institute for Health and Care Excellence Oral health in care homes quality standard provides guidance to care home staff on assessing the oral health needs of patients on admission and advises on the need for residents to be helped to find a dentist if they do not already have one. A copy of the quality standard is attached.

We do not hold this information.

Information on the numbers of prescriptions for all antimicrobials, including antibiotics, issued by general dental practitioners is only available for the complete years of 2016 and 2017. In these years 3,198,411 and 2,977,302 National Health Service prescriptions were issued respectively.

From 2013 to 2017, the trend of antimicrobial prescriptions continued to decrease by 24.8%. The number of daily defined doses of antimicrobials per 1,000 inhabitants per day prescribed by dentists was 0.19 in 2013 and 0.16 in 2016; with an 8.3% decrease from 2016 to 2017. In the previous five years the proportions of daily defined doses of antibiotics issued by general dental practitioners out of all prescriptions, from hospital inpatients and outpatients, general medical practitioners and other community practitioners, were 4.8% in 2013, 4.8% in 2014, 4.5% in 2015, 4.6% in 2016, 5.2% in 2017.

The English Surveillance Programme for Antimicrobial Utilisation and Resistance Report 2018 provides information on National Health Service dental prescribing in dental practices and consultations. From 2013 to 2017, the trend of antimicrobial prescriptions which includes antibiotics, continued to decrease by 24.8%. The number of daily defined doses of antimicrobials per 1,000 inhabitants per day prescribed by dentists was 0.19 in 2013 and 0.16 in 2016; with an 8.3% decrease from 2016 to 2017. The decline was largely attributed to less amoxicillin being prescribed between 2013 and 2017. A copy of the report is attached.

Information on how many children have been prescribed antibiotics or more than one course of antibiotics for dental problems in England over the last five years is not available as this data is not collected.

No assessment has been made of the potential impact of prescribing antibiotics to children who are waiting for tooth extractions due to tooth decay on their immune system and the levels of antimicrobial resistance.

The Department does not hold information on whether patients have been prescribed antibiotics following an attendance at an accident and emergency department.