Dental Health: Children

Baroness Benjamin Excerpts

Thursday 18th January 2018 Grand Committee

[Baroness Benjamin (LD)]

My Lords, 15 years ago, as I sat in the dentist’s chair for my annual check-up, my dentist said despondently that the patient before me had been a three year-old whose teeth he had extracted. Today this is not an out of the ordinary occurrence among children across the country. Children’s oral health has become a major public health issue, so I congratulate the noble Baroness on securing this important debate.

As we have heard, 90% of child tooth decay is preventable, but it is an issue that affects 25% of five year-olds across England, and in some parts of the country it rises to more than 50%. Last year nearly 43,000 hospital operations were carried out to remove teeth in children and teenagers, which is equivalent to 170 operations a day. The excessive consumption of sugary food and drinks combined with poor oral hygiene is a major cause behind these cases.

Good oral health can help children to be more confident and perform better at school, and it can make a significant difference to their long-term oral health. Children with high levels of disease in their primary teeth run an increased risk of developing disease in their permanent teeth, so addressing this issue early can make a real difference to children’s lives. Visiting a dentist on a regular basis is essential to maintaining good oral health. It helps to ensure that oral health problems are identified at an early stage and is an opportunity for dentists to provide advice to parents and children about maintaining a good oral care routine and managing their diet. However, the statistics around dentist attendance are concerning. Many children aged between nought and 17 never see an NHS dentist. This is despite Public Health England’s advice that children should start having dental check-ups when their first teeth appear, normally at around six months.

What can we do to improve this situation? The first thing is to get the message out as widely as possible that not only should children be visiting the dentist but, crucially, NHS dental treatment is free for all children under the age of 18. Equally, if we are encouraging parents to take their children to the dentist regularly, we must ensure that dental practices themselves are welcoming, friendly places where parents feel comfortable. The oral heath profession has to play its role too. To tackle the problem of child tooth decay, everyone needs to work together: health visitors, midwives, community nurses, early years workers, pharmacists and others all have the opportunity to engage with children and their parents. It is essential that they all provide consistent and accurate advice about maintaining good oral health.

Among others, the Faculty of Dental Surgery has called for oral health to be included in health workers’ training and professional development. This is not about training health visitors to be dentists, but about enabling them to identify signs that a child may have an oral health problem and to signpost them to further help. Perhaps the Minister can indicate what the Government are doing to ensure that the public health workforce is properly trained in the importance of oral health and how they can support children and parents in maintaining it.

We need also to address the variation in dental access across the country. Last year, the media reported on the difficulty that people in some areas have in accessing treatment—areas such as Cornwall, where more than 14,000 people are on a waiting list to register with an NHS dental practice. While NHS dental treatment is free for children, if parents themselves do not go to the dentist, for whatever reason, this can be a significant barrier to children’s attendance.

Public Health England has given direction on a range of evidence-based oral health activities that local authorities should be implementing, as demonstrated in Scotland’s Childsmile initiative. However, there appears to be limited national momentum to ensure that all LGAs are undertaking their responsibility for child oral health and prevention. What action are the Government taking to ensure that all LGAs are actively implementing Public Health England’s recommendations at local level? How many LGAs have sustained programmes for tooth brushing and toothpaste distribution, community-based fluoride varnish programmes and supervised tooth brushing in nurseries? What are the Government’s plans to improve oral health education so that parents and children understand the impact of sugar on teeth and the importance of a good oral health regime?

The good news is that child tooth decay is a problem we can all solve, if we work together and get simple things right to prevent the appalling suffering, anguish, loss of school time, depression and unnecessary pain that children are going through today.