04 • Child health


As the cost of extracting decayed teeth in children soars, Sameera Teli takes a closer look at the causes and potential solutions for this long-standing problem


THE BATTLE AGAINS I


T WAS the end of World War 2 and the end of sugar rationing that saw consumption of one of the nation’s favourite ingredients sky-rocket. By 1958 it’s estimated as much as 50kg of the stuff was being


eaten per person per year in the UK. Great news for the sugar industry, but not so great for children’s oral health. Back then, the Children’s Dental Health Survey suggests as few as 13 per cent of five-year-olds


had teeth without any caries, and only five per cent of 12-year-olds. Fortunately improvements have been made. The introduction and


widespread use of fluoride from the 1970s and greater access to dental care has greatly helped reduce decay levels through preventative measures. By 1983, half of British five-year-olds and nearly a fifth of 12-year-olds had teeth without any caries, rising in 2003 to 57 per cent and 62 per cent respectively. Despite being almost entirely preventable, tooth decay continues to


have a major impact on young people’s lives – but why? And what can be done about it?


Social factors It is useful to understand which groups are most at risk. Dental Public Health England’s National Dental Epidemiology Programme recently reported on the prevalence and severity of tooth decay found in more than 110,000 five-year-old children through an oral health survey in 2015.


The number with decayed, missing (due to decay) or filled teeth was


the lowest in almost a decade, with a 20 per cent decrease in the level of tooth decay since the last survey in 2008. A reduction in severity of decay was noted for the whole of the UK but not significantly so in all regions. Surveys in Scotland and Wales also showed comparable


outcomes over a similar time. The UK report noted the impact of ethnic background, geographic


location and deprivation on levels of tooth decay. It found decay levels varied amongst ethnic groups, with children


from Chinese and Eastern European backgrounds having higher levels of decay experience than any other ethnic groups. This information can be useful at a local level to help better tailor dental services for different patient types. Geography also played an important part. The report highlighted


significant variation across regions: higher decay levels were recorded in northern parts of the UK, particularly in areas with greater levels of deprivation.


So although overall levels of decay are falling, the inequality gap


remains. Looking at data beyond local authority level in more detail could help show where the inequalities lie and where more focused help is needed. In response to this survey, FGDP(UK) Dean Dr Mick Horton said: “The further increase in the proportion of young children free of tooth decay is great news, but the fact remains that a quarter of five-year-olds have an almost entirely preventable disease - and a quarter of these are not even receiving treatment.”


Direct action These patterns are reflected in statistics from the Local Government Association (LGA) showing that dental decay is the primary reason children aged five to nine are admitted to hospital in England. Such admissions rose by 14 per cent between 2010-2011 and 2013-2014. A recent LGA report revealed the NHS spent a massive £35.3 million


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