27 March 2017

Following the release on Tuesday of what are incredibly disturbing and entirely avoidable statistics from the Faculty of Dental Surgery (FDS) showing that tooth extractions in children aged four and under have increased by 24% in the last decade¹, the UK's leading oral health charity, the Oral Health Foundation, have looked at what needs to be done to ensure that this horrific trend is put to a stop.

These new statistics from the Royal College of Surgeons, highlight the current appalling state of our children's oral health in the UK. In the last year there were 9,206 extractions carried out on children aged four and younger. This has risen by almost 25% in the last decade alone.

The charity is keen to highlight the crucial fact that every single one of these cases is entirely avoidable. Through the implementation of effective education and a relatively simple oral health routine as soon as their first tooth appears, no child should have to suffer from tooth decay or go through the trauma of having to have teeth surgically removed, something which often scars them for life.

As a result, the Oral Health Foundation have outlined five policies which need to be implemented in the United Kingdom to change the state of children's oral health for good.

Local Authority Funding

Over recent years' local authorities have seen their purse strings increasingly tightened from above with Public Health budgets being particularly badly affected and ultimately, there is a chronic lack of funding for to seriously assess and address the oral health of their local populations.

Local authorities are therefore unable to properly implement the recently issued series of NICE guidelines for oral health. As a result, the public increasingly suffer from a lack of oral health services to educate, inform and treat them effectively. Funding cuts have also resulted in many oral health promotion teams being disbanded. This obviously reduces the amount of resource invested in grassroots level activities within local communities across the UK.

It is easy to see that poor oral health is becoming an increasingly important issue countrywide and the government needs to stop ignoring the issue. The local authority's role needs to be less on managing the care pathway of suffering children and more on preventing the need for treatment in the first place. Ultimately, they must to be given the resources to do this. The vast majority of child admissions to hospital for tooth extractions are entirely preventable and the local authorities' role needs to major on ensuring that these preventive messages are received.

Educational Reform

Did you know that oral health education is not required to be taught in UK schools? We believe this is a huge oversight which is leaving generations of children without the required education on the importance of their own oral health in many aspects of their future life. A major issue with this is that many parents and carers believe that it is taught and therefore might not dedicate as much time as they maybe should in educating on oral health at home. This leaves the child without the required level of knowledge on oral health to look after themselves effectively.

By introducing oral health into the curriculum in Early Year's Education, Key Stages 1, 2 and 3, we can dramatically change the outlook of oral health in the UK. It is crucial that any future educational policies include everything from basics of brushing routines, right through to the diet, the role of sugar and its effect on our oral health. We have to ensure that every child gets the correct information, delivered by a qualified professional and is something which is continually reinforced throughout a child's educational development.

UK Wide Child Smile

It is incredibly short-sighted of the government to continually ignore the sustained success of the Child Smiles Programme in Scotland, a dedicated national programme designed to improve the oral health of children in Scotland and reduce inequalities both in dental health and access to dental services.

The programme has shown that substantial cost savings are possible on oral health within the lifetime of a Parliament if a plan is implemented effectively. Not to roll out and adequately fund a similar targeted programme right across the UK is a huge mistake, the public really do deserve better than this.

It is a great pity that even with her undoubted political skills the Chief Dental Officer, Sara Hurley, has not been successful in getting proper funding for a national unified Smile for Life programme, but instead we have a mish mash of different funding models and examples of good practice from around the country as a sort of Pick ‘n' Mix.

Sugar Reforms

When the sugar levy on fizzy drinks was announced last year, we reached a major milestone in addressing one of the major problems contributing to the poor state of the UK's oral health, or so we thought.

But for oral health it has been the same old story, yet again it has been overlooked in aid of ‘sexier' headlines on obesity, itself an undoubted problem in the UK. Oral health issues related to sugar were not mentioned once by the then Chancellor or the Exchequer, nor by his successor in his recent statement, and no funds from the levy have been reserved to invest in oral health education and preventative projects, or to aid in cost of treatments.

We would like the government to take the sugar levy seriously and, at least, acknowledge sugars role in the state of the UK's children's oral health crisis and spend some of the funds raised on treating this.

Ideally, we want to see the sugar levy toughened up if it is to have any real impact. Milk based drinks and juices with high levels of sugars need to be subject to the levy as they are not. There also needs to be real action to stop advertising of unhealthy foods and drinks to children and multipacks need to be regulated. Only when the government take this seriously will the sugar levy be effective by showing tangible and worthy results.

Reduce the ‘Tax on Dentistry'

Last year we saw a 5% rise in NHS patient charges for dental treatment across all three levels and on the 1st of April we will see another 5% rise. In the past year, overall NHS dental charges will have risen well above the inflation, and what this effectively amounts to is a ‘tax on dentistry' for the public.

A huge problem in getting people into the dental practice to get the treatment they often desperately need. In survey after survey over many decades' patients have repeatedly cited dental charges as one of the major barriers to attendance.

This is against a background where the rest of the health service is entirely free at the point of delivery, and means that even those who attend have always resented dental charges. This has forced a lot of people to turn to their GP or A&E when they need dental treatment, areas which do not have the expertise, knowledge or equipment to carry out the necessary treatment, it also has put a huge strain on NHS resources.

The government is not supporting dentistry by continually raising charges, it is forcing more and more people away from the practice. There has to be a limit, NHS dentistry price rises must stop and the government must invest more into oral health to ensure the future generations oral health.

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Resources

1. Royal Society of Surgeons (2017) "Shocking 24% increase in tooth extractions performed on children aged 0-4 in last decade" Publication Date 21 March 2017, Available online at https://www.rcseng.ac.uk/news-and-events/media-centre/press-releases/child-tooth-extractions-24-per-cent/