Dental Health: Children

Baroness Thornton Excerpts

Thursday 18th January 2018 Grand Committee

[Baroness Thornton (Lab)]

My Lords, like the noble Lord, Lord Storey, I recall school dentists, and indeed our family dentist, who went by the wonderful name of Mr Slaughter.

At this point in this excellent short debate, the awful facts about the state of our children’s teeth in England have been laid before all of us, including the Minister, who I think, like me, must be hanging her head with shame that we are failing our children on such a scale. The fact that so many youngsters suffer from tooth decay and that so many require extractions at such a young age is a badge of dishonour for our health service and for our Ministers. We have failed to confront a wholly preventable disease.

This is not only a childhood problem. We are condemning a generation of children to reach adulthood feeling self-conscious and inhibited by the state of their teeth. That will certainly affect their social relations and indeed could affect their job prospects. The evidence suggests that for far too long the Government have tended to view oral health as an optional extra. For the children lining up for tooth extractions in our hospitals, tooth decay has long-term consequences. Whether they grow up to become solicitors, receptionists, hairdressers, footballers or whatever, the state of their mouths can affect their life chances. In June 2016, a YouGov poll for the British Dental Association revealed that 77% of respondents felt that decayed teeth or bad breath would hinder a candidate’s chances of securing employment in public or client-facing roles, while 62% felt that applicants with visibly decayed teeth, missing teeth or bad breath would be disadvantaged in securing any role and it would hinder their promotion prospects.

The inequalities in tooth decay are stark. For five year-olds in the most deprived areas such as Blackburn and Darwen, 56% have tooth decay. They are almost seven times more likely to have decay in their teeth than their peers in, for example, Jeremy Hunt’s constituency in Waverley, where the rate is 8%. Children from lower income families are much more likely to have dental disease than other children of the same age. At five years old, 21% of children who receive free school meals will have dental decay, while the rate is 11% among all other children; yet according to the Royal College of Surgeons, tooth decay is 90% preventable.

I know that the Minister will tell us about the Government’s new preventive oral health initiative known as Starting Well, but I have to say that when I look at the details of the programme, I cannot see how it will have the same impact that the campaigns being run in Wales and Scotland are having. They are leading the way on improving child oral health with their early intervention prevention initiatives known as Designed to Smile and Childsmile. They have led to unprecedented improvements in outcomes over recent years. If one were being really unkind, one might even suggest that the Government scheme looks a bit like window dressing.

I have some questions for the Minister and I want to echo some of the remarks made by the noble Lord, Lord Colwyn. Why is this scheme being limited to 13 local authorities? Why is it being funded from within existing dental spend when we know that dentistry is chronically underfunded, down 15% since 2010-11? Why has no new money been found when we can all see that that expenditure would fall squarely within the invest-to-save category? Can the Minister confirm that what the Government are doing is asking dental surgeries in these local authorities to volunteer to take part in this scheme? Is that an effective way to proceed? Is there a plan or a budget for a wider rollout of the scheme? If there is, when will that happen, and if there is not, why not? Lastly, what else is there?

Fluoridation needs to be made easier. It has been mentioned by several speakers in the debate, who have been quite right to say that it is a cost-effective public health initiative. I feel that I have to say that, not only because other noble Lords have mentioned it but because my noble friend Lord Hunt is so passionate about this matter—he would not forgive me if I did not mention fluoridation.

Reducing children’s sugar consumption is of course crucial. The average five year-old consumes their own weight in sugar every year. While the soft drinks industry levy is a welcome first step, we need the Government to take much more decisive action in this area, particularly around advertising, marketing and price promotions involving high-sugar products. New restrictions should be introduced on advertising high-sugar products before the 9 pm watershed on television and online, something which we on this side have pledged to do. Would the Minister like to take this opportunity to pledge to do the same?

I congratulate the noble Baroness, Lady Gardner, on tabling this important debate and I commend her for her persistence over many years in these matters. I thank all other speakers and I look forward to hearing the Minister’s remarks in response to the debate.