DENTAL HEALTH
At the root of the problem
What can be done to tackle the persistent problem of dental decay in children? Joanne Curran investigates
HE figures make for grim reading. Dental decay affects more than 40 per cent of UK children by the age of five and in some parts of the country 75 per cent of pre-school children have rotting teeth. Te statistics have barely changed in 20 years and, to top it all, there is still no conclusive evidence for the most effective approach in managing decay.
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Te reasons why poor child dental health has persisted for two decades are many. One explanation may be that some parents struggle to find an NHS dentist to treat their children as more practitioners opt for private practice. In the last Dental Health Survey in 2003, a quarter of parents of 12 to 15-year-olds and a fiſth of parents of five to eight year-olds claimed they had trouble finding a dentist for their child.
Professor Jimmy Steele, head of the school of dentistry at the University of Newcastle, told Summons that children’s oral health has “improved enormously in the last few decades, but there is still room for improvement.” He believes the reasons for poor oral health are “the same as they have always been: poor diet, a lack of awareness and perhaps an attitude that accepts that dental decay is a normal part of growing up.”
Damaging factors
Te rise in tooth decay has also been blamed on changing dietary trends, as fizzy drinks, fast food and bottled water (which lacks fluoride) become increasingly popular. And sometimes a parent or carer’s own fear or mistrust of the dentist may prevent them seeking care for their child. Janet Clarke, president of the British Dental Association, said some parents believe the health of their children’s milk teeth is not important. In an article in the Times, she said: “A lot of people think that baby teeth don't matter but they are hugely
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mistaken. Children can have severe pain in milk teeth, which then have to be removed. Because baby teeth hold a space open for adult teeth to come through, if they have decaying or removed teeth, that space gets smaller and there isn't enough room. Tis can lead to growth problems later, and mean that they have to wear a brace.”
Income level can also be a factor when seeking dental care for children. Figures published by the Audit Commission in February 2010 show that tooth decay is a greater problem in low income communities. Over 150,000 more children have decayed, missing and filled teeth in deprived areas compared with the rest of the country, a gap which has increased dramatically over the last ten years. Lack of awareness is another factor. Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, said: "Dental disease is the most common preventable childhood disease and good education at an early age can have a significant impact. Parents are very much responsible for helping their children to develop a good oral health routine and ensure regular visits to the dentist."
Future hope
Despite the gloomy figures, there have been concerted efforts in recent months to tackle the problem. Tis includes recommendations made by Professor Jimmy Steele in his 2010 review of NHS dentistry in England – some of which are now being implemented. In April 2011, it was announced that a pilot project of a new dental contract is being launched across 62 practices in England that will reward practitioners according to the quality of care they deliver for patients rather than the number of treatments carried out. It is Professor Steele’s belief that NHS dentistry should be more about quality outcomes and disease prevention than simply measuring units of dental activity (UDAs).
“Dentists can only do so much; parents and schools both have a role, as does wider society ”
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