Report calling for 'radical' changes to tackle tooth decay in children

It highlights specific challenges in the North of England

Author: Harry BoothPublished 13th Sep 2024

A new report is calling on Ministers to ignore 'nanny state' critics and make radical changes to tackle the tooth decay crisis affecting children.

Child of the North and the Centre for Young Lives is calling for a new evidence-based strategy - as millions of children across the country suffer from tooth decay.

It makes a series of recommendations to reduce sugar consumption among children and increase access to dental care.

Those recommendations include:

  • Expanding sugar tax
  • Applying restrictions on food marketing, advertising and promotions
  • Banning the sale of energy drinks to under-16s
  • Rolling out a tooth-brushing programme in schools and nurseries

It's as the report reveals that:

  • Fewer than four out of ten children in England have good oral health.
  • One in ten three-year-olds in England already have tooth decay, rising to three in ten by the age of five.
  • Research involving Year 7 and Year 8 children from deprived areas in the North of England, Scotland and Wales has found that over one-third had tooth decay in their permanent teeth. Four in ten reported that their oral health had an impact on their daily lives.
  • Families living in deprived areas are more than twice as likely to have tooth decay, and there are much higher levels of tooth decay in children in the North compared with elsewhere in England.
  • Tooth decay is also the most common reason for hospital admission in five-to-nine-year-olds.
  • In 2023, only half of children had visited an NHS dentist within the recommended maximum period of 12 months. For under-fives, it was less than a third.
  • Last year, 27,000 children in England were on NHS waiting lists for dental care by specialists, with 12,226 children on waiting lists for dental procedures under general anaesthetic with average waiting times of up to 80 weeks.

Stuart Garton, owner of The Dental House in Old Swan, said:

"The report is quite right to ask for radical changes, I think whatever we're doing at the moment is not working as well as we'd like it to and so I think we have to look at perhaps being a little bit stricter, a little bit more aggressive towards managing these issues - particularly with children's teeth.

"Some of the suggestions are really valid - things like sugar taxes, looking at banning things like energy drinks for certain age groups is a really good idea.

"I think if we can really work to improve the oral health of young children, hopefully they can then take that into adulthood and develop less issues as they grow up as well.

"A bit of a crisis within NHS dentistry"

"I just feel like there's a bit of a crisis within NHS dentistry at the moment. There's much less availability of NHS dentists and patients are struggling to get access to NHS dentistry.

"Children aren't being exposed to examinations and getting expert advice from a really young age, so we need to look at a different approach and different ideas to try and target that age group and try and see if we can drive improvements in a different way."

The report also calls for a focus on preventing children from getting dental diseases by:

  • Working with the dental profession, dental system reform, and innovative commissioning to give opportunities to prioritise improving dental services for children, particularly for those with additional needs.
  • Better mechanisms for allocation and distribution of funding based on need, and consideration of providing dental services with and through schools and nurseries.
  • A renewed emphasis on clinical prevention, including better use of fluoride treatments, dental sealants and behaviour change interventions to support families’ and children’s oral health behaviour.

Mr Garton added:

"It's (prevention) absolutely the holy grail within dentistry. It's much nicer for us to see patients and give them advice and help, rather than having to intervene and deliver potentially invasive treatment - particularly to younger children.

"It's really sad to see children attend a dentist and they've got toothache, they've got pain, they might need to have injections, have teeth removed and sadly in some situations they need to have general anaesthetic.

"Prevention is paramount"

"Prevention is paramount and I think focusing our attention around prevention is really critical to helping to reduce the problems that we're seeing."

The report highlights Liverpool's Smile Squad Initiative, a collaboration between the University of Liverpool Paediatric Dentistry team and LFC Foundation to help tackle the issues raised.

Anne Longfield, Executive Chair of the Centre for Young Lives, said:

"It is staggering that so many children, particularly in the North of England and those living in low income families, are now growing up with tooth decay and suffering from toothache and discomfort. This can affect their quality of life, sleep patterns, eating habits, and impact on school readiness and attendance, speech and language development, and overall confidence. In some areas it has sadly become the norm.

"Many children are not only missing out on NHS dental healthcare but are more likely to suffer tooth decay from a younger age.

"Be radical, go much further"

"The Government’s proposals for a programme of supervised teeth-brushing in schools is a positive step forward, as is its overall focus on boosting children’s wellbeing.

"We urge Ministers to be radical, go much further, and ignore any accusations of a ‘nanny state’. We need to take evidence-based action and to develop a national plan to tackle a rotten teeth crisis affecting millions of our children."

Paula Waterhouse, President of the British Society of Paediatric Dentistry, said:

"This report reveals how higher levels of deprivation and associated unmet dental need are more seriously impacting children and young people living in the North of England compared with their southern counterparts.

"It is time to establish an oral health strategy for children and young people across England. The evidence base garnered by existing oral health research should be used to inform Government strategy and implementation of both national and local policies.

"We need to act now"

"We need to act now. Our children’s health depends on it and it’s everybody’s business – parents, dental and medical teams, health visitors, industry, education colleagues, and policy makers. We all have a part to play."

Mark Mon-Williams, Child of The North report series editor, said:

"Toothache is caused primarily by decay and the rotten teeth of the next generation provide a stark reminder of the perilous state of the nation’s health.

"The pain of toothache is excruciating and the most brilliant teacher in the world will struggle to educate a child experiencing dental disease.

"The time has come for the UK to start taking its future seriously - and helping ensure that all children throughout the UK have a smile on their face seems a pretty good place to start."

Camilla Kingdon, Immediate Past President of the Royal College of Paediatrics and Child Health, said:

"I am really thrilled with this report because the state of our children’s teeth should be a source of national embarrassment.

"This shows that there is so much that can be done to tackle the problem. The many spin offs of a robust national strategy to improve children’s oral health would be potentially significant - benefits for tackling obesity as well as mental health issues, and potentially improving school attendance, amongst other things.

"The impact of poor oral health stretches way beyond childhood and so every one of us should see this as a key health promotion and disease prevention strategy that benefits the whole nation."

In a visit to Alder Hey earlier this year before becoming Prime Minister, Sir Keir Starmer vowed to introduce a national supervised toothbrushing programme for three to five-year-olds after saying tooth decay was the top reason that six to ten-year-olds go to hospital.

The government revealed yesterday (11 September) that a 9pm watershed on TV junk food advertising will come into force in October 2025.

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