Current research indicates an overall improvement in the oral health of children in the UK. A study published by Public Health England (PHE) in 2013,
National Dental Epidemiology Programme for England, oral health survey of 5 year old children 2012, showed that, since 2008, tooth decay in five year olds has reduced from 30.9 per cent to 27.9 per cent, the proportion of children with untreated decay has reduced from 27.5 per cent to 24.5 per cent and 72.1 per cent of five year olds are free from tooth decay, up from 69.1 per cent.
While the statistics are generally promising, the study indicates there is much work yet to do. For example, regional variations need to be addressed - 21.2 per cent of five year olds in the South East are affected by decay, compared to 34.8 per cent in the North West. Decay levels are also higher in more deprived local authorities. Also concerning is that that one in every four children starting school does so with some degree of tooth decay having, on average, between three and four teeth affected. Meanwhile, a third of children aged 12 have visible dental decay.
So what are the solutions to improve the landscape – albeit a promising one? As all practitioners know, fluoridation is the subject of ongoing debate. Although patients may be receiving mixed messages about the benefits of fluoridating water and whether it causes any damage to their long-term health, another PHE report, Water fluoridation: health monitoring report for England 2014 confirmed the significant benefits to children from fluoridating the water supply, as well as throwing significant doubt on the notion that it can cause any harm.
It showed that children in areas that have fluoridated water have less tooth decay than those in areas that have not - as many as 45 per cent fewer children aged one to four in fluoridated areas are admitted to hospital for tooth decay, mostly for extractions, than in nonfluoridated ones. Undergoing such an invasive and possibly traumatic operation at such a young age will also increase the likelihood of dental phobia, which they will carry forward as they grow up and therefore be unwilling to seek further care in the future. When deprivation and ethnicity are taken into account too, 28 per cent fewer
five year olds have tooth decay in fluoridated areas than nonfluoridated ones – so the reduction in tooth decay in children of both ages in fluoridated areas appears to be greatest among those living in the most deprived local authorities. Fluoridation, according to this study, could reduce the dental health gap.
Though fluoridation will be a topic for debate for a long time to come, what all healthcare providers do agree on is that the consumption of snacks and drinks that are packed with sugar are increasingly problematic to the public health. Experts in all fields have welcomed a formation of a new group, Action on Sugar. Established to tackle and reverse the growing obesity epidemic, limiting ‘hidden’ sugars added to food and drinks will obviously have a beneficial effect on children’s oral health too, with the increase
in consumption of sugary drinks being a key reason for the increase in tooth decay. In early 2014, two schools banned sugary drinks altogether, a move which many practitioners believe should be adopted by the Government as
a template and rolled out across the entire country. The chief executive of the British Dental Health Foundation, Nigel Carter, said: “Proposals such as the introduction of a duty on sugary drinks and brands reducing the amount of sugar in their soft drinks have both been mooted in the last 12 months. If we were to build on these foundations, there will be an inevitable reduction in
consumption and benefits for both general and dental health.”
If limiting sugary drinks is a key message that you give to your young patients and their parents, they also need to know that simply just brushing their teeth twice a day is not enough. Using the correct oral care products, and the correct techniques, is advice that you can give at every appointment in order that good habits and teeth-cleaning routines are learned at an early
age. Recommending gold standard oral care products, such as those available from Curaprox, can be hugely beneficial.
In conclusion, a collaborative approach between the health bodies, the government, and practitioners is needed to improve the statistics of child oral health even further. While the topic of fluoridating the water may be under scrutiny and debate, good dental habits, including limiting sugary snacks and drinks and using an effective range of oral care products are all key to delivering the message.