Prevention first - modelling evidence-based prevention with the dental team for children in England.

Background The United Kingdom has a diverse, professionalised dental workforce. Dental caries remains a prevalent disease, with significant inequalities. New ways of using our dental care professionals need to be considered in delivering preventive care to all patients.Methods Data sources for an operational research optimisation model included child (under 18 years) population demography; National Health Service (NHS) data; epidemiological data on dental caries experience from three national surveys; and preventive guidance identified from Delivering Better Oral Health V4. Data for care delivery included timings were informed by previous research and NHS working patterns. The Linear Programming model was developed for six different dental skill mix scenarios.Results Skill mix utilisation reduces time and workforce numbers, when compared with a single member of the dental team providing the preventive treatment plan. The workforce capacity ranged from 409-7,991 for dentists, 6,002-17,500 for dental therapists and 979-4,083 for extended duties dental nurses. Modelling suggests that a combination of all three dental team members provides the most efficient skill mix for this care delivery.Conclusion The development of this operational research model suggests the potential for skill mix in delivering evidence-informed, risk-based prevention of oral and dental disease in children in England in dental settings and beyond.