The health and wellbeing of millions of children is being impaired by poor oral health. Steve McCabe MP sets out how to address this growing public health issue in three simple steps
Childhood tooth decay represents a major public health issue which is in real danger of being overlooked at a time when the National Health Service is underfunded and overstretched. It is no exaggeration to say that this problem affects the lives of millions of children, including some of the most vulnerable.
Statistics provided by Public Health England show that 25 per cent of all five-year-olds have tooth decay and in some parts of the country the figure is 50 per cent. Perhaps not surprisingly, there is a clear link between deprivation and childhood tooth decay with the poorest areas suffering the worst levels of oral health. Hospital admissions for children in Birmingham almost doubled in the four years up to 2015, but this hides the very different lives lived in the same city. In Sutton Trinity ward in Birmingham’s affluent Sutton Coldfield, less than 10 per cent of five-year-olds have tooth decay, but in Selly Oak, that figure rises to 40 per cent, almost twice the national average.
Over 45,000 children and young people were admitted to hospital in England over the past year because of tooth decay. 26,000 of them were aged five to nine, making it the leading cause of hospital admissions and emergency operations. This is not only detrimental to health and wellbeing, but it is also costly to the NHS. In the financial year 2015-16, over £50m was spent on tooth extractions for children. Shocking though these figures are, tooth decay is almost entirely preventable.
Many health experts now agree that childhood tooth decay can have a broader and long-term impact, affecting physical health, mental health and a child’s development and confidence. Children with poor oral health can have problems with eating and sleeping which often results in time away from school. Public Health England reports that the average number of missed school days in North West England was three, but some children missed as many as 15 days because of dental problems.
There are three crucial steps to addressing this problem: getting children to brush their teeth twice a day; ensuring they see a dentist regularly from a young age; and, reducing the amount of sugar consumed.
ChildSmile is an educational programme delivered across Scotland since 2001 and has been credited with making a dramatic improvement. It supports supervised tooth brushing sessions in primary schools and nurseries, as well as providing twice yearly fluoride varnishes. A similar initiative called Designed to Smile was introduced in Wales in 2009. We need something similar in England. After much delay, a pilot programme is about to commence in 13 areas, but there is limited information about the project, the funding and how the areas were selected.
According to recent figures on dental attendance 42 per cent of children aged 0-17 did not visit an NHS dentist in the 12 months to 31st March 2017. In Birmingham, that figure is 47 per cent. The Royal College of Surgeons has reported that in the same 12 months, 80 per cent of children aged between one and two did not see a dentist although official advice recommends they should begin dental check-ups as soon as their first teeth come through.
I am sure that the government will be keen to remind me about money, but perhaps I can remind them of the clawback of £95m through undelivered units of dental activity in 2013-14 rising by 36 per cent to £129m in 2016-17. At present three visits for fluoride treatment equals one UDA, roughly worth £60 to a dentist. Perhaps we need incentives similar to those paid to GPs when they take part in government prevention programmes.
There are question marks over how likely it is that the soft drinks industry will meet government targets and earlier this year the Food and Drink Federation said they would not meet the voluntary reduction of 20 per cent in sugar content by 2020. It is time that the obesity strategy was revisited with a serious determination to reduce the amount of sugar in food and soft drinks products. We also need action on ‘teaspoon’ labelling and a ban on price promotions involving high sugar products.
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Steve McCabe is member of parliament for Birmingham, Selly Oak. He tweets at @steve_mccabe
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