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CPD: GC
The caries comeback – why glass ionomers matter more than ever Aim:
To enhance the knowledge and clinical decision‑making of oral healthcare teams on dental caries and the evolving NHS dental landscape, along with the role of glass ionomer and glass‑hybrid restorative materials in delivering effective, prevention‑focused and minimally invasive patient care.
Learning objectives: • To describe the current trends in adult dental caries prevalence • To explore recent NHS dental contract reforms and how they influence caries management • To evaluate the clinical indications and advantages of glass ionomer and glass‑hybrid restorative materials GDC anticipated learning outcomes: B,C Dental caries remains a major public health issue in the UK.1 This means oral healthcare teams should consider sustainable improvements to enhance patient care. The good news is that an increasing number of adults are retaining more natural teeth into later life.2 However, the latest adult oral health survey (AOHS,2023), published in 2025 showed: • 41% of adults had obvious caries affecting the pulp and/or the dentine layer. This represents a 13% increase in caries prevalence Vs. the 2009 survey, almost reversing the previous decrease, bringing the 2023 estimate closer to the one of 1998 rather than 2009. This increase was also more pronounced in middle-aged and older adults with the largest proportion being primary disease on teeth not previously restored2 • 64% of adults had clinical caries in one or more teeth on the crown or roots when using enamel caries as a sensitive measure2 This increase in caries levels coincides with a shift in the dental landscape with an increasing acceptance of the benefits of the minimum intervention oral care (MIOC) framework providing a personfocused, prevention-based, susceptibility/ needs-related, team-delivered approach to help ensure effective access to primary oral and dental care.3 Restorative material choice is also shifting, not only to align with the MIOC framework, but also as a direct result of guidance around the use of dental amalgam. For many, dental amalgam has been the material of choice for high need patients due to its practical benefits in clinical dentistry. However, its use has been challenged due to the environmental and health impacts attributed to the 50% elemental mercury it contains. The demise of dental amalgam was hastened by the United Nations Minamata Convention in 2013 which led to a phase out for use in children 15 years and under, and this phase out was subsequently extended to cover pregnant/nursing women in July 2018. This, along with an imposed ban on the export by the European Union in January 2025 and a ban on
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the manufacturing and import of dental amalgam in the EU from July 2026, increasingly challenges the ongoing use and availability of dental amalgam in the UK. These changes leave oral healthcare teams from all practice settings looking for alternative restorative materials.4 Additionally, delivery of NHS dentistry is also changing. Dental contract reforms introduced in England from 2022 to 202657 provide oral dental contract changes healthcare teams new ways of managing higher need caries patients. This includes best clinical practice supporting MIOC’s efficiency in managing oral diseases and enabling oral healthcare teams to deliver long-term, high-quality and patient-centered oral healthcare. These reforms mark a significant step in improving both access to NHS dentistry and the care people receive. They also respond to concerns raised by dental professionals about aspects of
previous contractual arrangements they felt limited their ability to provide optimal care. These reforms, as they apply to the treatment of dental caries, include: • Band 2 treatments from December 2022 were subdivided into additional bands two of which include the placement of permanent fillings5,6 • Band 2a awards 3 UDAs: Includes up to 2 teeth requiring permanent fillings • Band 2b awards 5 UDAs: For a combined total of three or more teeth requiring permanent fillings or extractions • As part of 2022/2023 NHS dental reform, dental therapists and dental hygienists can now also open and close NHS courses of treatment to provide direct access to NHS care within their GDC scope of practice5-6, if they are competent and indemnified to do so. This allows dental therapists to carry
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out direct restorations on primary and secondary teeth as part of an NHS course of treatment. Guidance on ‘Building dental teams: Supporting the use of skill mix in NHS general dental practice’7, suggests that maximising the potential of the wider dental team has the potential to: • reduce patient wait times by increasing flexibility in care provision • contribute to efficient contract performance • enhance working conditions through workload distribution • improve recruitment and retention in dental teams • boost workforce wellbeing through team working • support professional development This guidance document opens with a quote from a dentist who uses skill mix in practice:
The Probe | June 26
03/06/2026 12:20:41