Dental Health: Children

Baroness Grey-Thompson Excerpts

Thursday 18th January 2018 Grand Committee

[Baroness Grey-Thompson (CB)]

My Lords, I thank the noble Baroness, Lady Gardner of Parkes, for tabling the debate. I have a number of interests to declare: I am a vice-president of the Local Government Association; I am the chair of ukactive; and last year I published a report on duty of care in sport, which I was asked to complete by the right honourable Tracey Crouch MP, the Minister for Sport in another place, where oral health was reported to me from several different groups of people. I also spoke at a periodontology conference last year, as declared on my entry in the register of interests, where I met Professor Ian Needleman from UCL. That sparked an interesting conversation about the oral health of athletes, which led me to consider the wider impact it could have on the future of elite sport. In my personal experience—without going into too much detail—I found it hard to eat or tolerate any food in my stomach on race days, so I travelled everywhere with a toothbrush. It was not always possible to clean my teeth after I had been sick; my teeth show signs of decay because of that.

Every major Games I have attended has a polyclinic, which includes doctors, opticians and dentists. At the London Games, the polyclinic was designed and built to treat 200 athletes a day; from seven in the morning to 11 at night, it was full. In 2012, it had 3,220 “encounters” with athletes. The biggest proportion—52%—of those were for musculoskeletal issues, but second on the list was dental issues, which affected 30% of athletes. That number is very similar to previous Games, as well as Rio 2016. In their research study, Needleman et al found that 300 athletes showed high levels of disease, and 20% reported that this had had a serious negative impact on training or performance. It is often assumed that athletes will be at the peak of physical fitness, so those numbers are quite shocking. In this context, future consideration needs to be given to the consumption of sports or energy drinks, gels and other products which are invaluable for athletes in training, but come with unforeseen consequences. As an older athlete on a programme, you may get advice on what to use, but as a young person you may not. There are some sports programmes that have quite young athletes and I wonder whether lessons on oral health should be specifically included in the induction process for young athletes. While lots of athletes are checked for various health issues before they go to the Games, my teeth were never looked at. What consideration has been given, beyond the soft drinks levy, to whether children should be allowed to purchase energy drinks, and what encouragement could be given to help them to understand the products they contain?

The figures on the number of children going into hospital for extractions are, quite frankly, shocking—not just because of the numbers, but the cost that has on the NHS and the long-term impact on children’s health. It is not just about cleaning your teeth or going to the dentist; it is also about what you consume. I am very supportive of the Government’s childhood obesity strategy and the soft drinks levy. It could be incredibly useful, but many companies are changing their products to just go under the limit of what they would be taxed on.

In a chance discussion, a friend who is a governor of a primary school said that they have a large number of children on free school meals. More than 15% of children in state schools are eligible for free school meals. When they introduced a breakfast club to increase attendance, they found virtually all those children had very poor oral health. Now they fundraise to buy toothbrushes to keep in school, so children clean their teeth after the free breakfast, and they also encourage them to clean them at lunch time.

We also need to think about children’s activity. If you are eating a poor diet and drinking too many fizzy drinks, you are not going have the energy to be active. This has a huge impact on our children’s health. I would like to draw your Lordships’ attention to the research on what happens during school holidays. For children on free school meals, many do not eat in the summer holidays. It is also very easy to eat a poor diet of pre-prepared meals, which can be high in sugar or salt, or to eat fast food. A charity called StreetGames has set up a programme called Fit and Fed, which ensures that children have access not only to activity but to free, nutritious meals. I chair ukactive, which has produced research showing that, in the summer break, there is a much greater divide between the fitness levels of children from poorer socio-economic backgrounds and those who are more affluent. The poorest 25% of primary school children experience a drop in their fitness levels 18 times greater than the richest 25%. So it is not just oral health—it is what we eat and what we drink—and ukactive is working with partners to open up dozens of school sites across the country this summer to address issues of inactivity among children. We are also going to be looking at how we can educate children on oral health

The inactivity crisis that we are facing, coupled with things like poor oral health, is significantly limiting our children’s opportunities. I realise that the things I have talked about this afternoon cut across a number of government departments, and many issues are for other Ministers, but this is an important area where cross-government work is vital.