Dental Health: Children

Baroness Redfern Excerpts

Thursday 18th January 2018 Grand Committee

[Baroness Redfern (Con)]

My Lords, I thank my noble friend Lady Gardner for bringing this debate to the Grand Committee today. I am pleased to have the opportunity to speak on the important issue of children’s oral health. I refer to my interests as listed in the register of interests.

Looking back over a number of years, I see that attention has continued to be drawn to the impact of sugar on children’s oral health, together with the interlinked growing problem of obesity facing our young children. I wish to take up the issue of advertising, particularly where young people are a captive audience at popular programme times. Good advertising would certainly help to promote the importance of good oral hygiene and support lots of winning smiles.

I welcome the improvement in children’s oral health over the past 20 years, but, unfortunately, 12% of three year-olds still experience tooth decay. We know all too well that dental decay is the top cause of childhood hospital admission for five to nine year-olds, with hospital trusts now spending £35 million on extractions of multiple teeth for the under-18s. It is a massive cost to the NHS. To put it in context, twice as many under-10s have to have extractions as young people who break their arms—that speaks volumes. Significant oral health inequalities continue to exist for children who live in deprived communities when compared with those who live in affluent areas, and this must be addressed. I highlight also those children with disabilities, who have even poorer outcomes.

Unfortunately, young children who have to undergo tooth extraction, and those with high levels of disease, have an increased risk of disease in their permanent teeth. Local authorities are now responsible for commissioning public health services for children and young people, and have the power to consult on proposals, such as water fluoridation schemes and intervention. That does not require behaviour change by individuals, and as such, choice should be offered.

What can be done to improve children’s dental attendance? An important strand must be to work with and support external partners collectively in continual preventive care, especially for looked-after children and children from families living in poverty. It is vital to raise awareness of the fact that children should visit the dentist at least once a year and to make sure that everybody realises that it is free and that children should have check-ups in the first 12 months of life. In particular, I refer to the new “Dental Check by One” campaign, which should have more widespread and prominent advertising.

Close ties with primary and secondary schools are vital. They should promote good oral health and highlight any issues around reducing sugar consumption in food, snacks, drinks, energy drinks and fruit juices. It is estimated that children consume around three times more sugar than the recommended maximum amount. Importantly, teenagers have the highest intake of all age groups, consuming some 50% more sugar on average. For awareness, surely clear teaspoon labelling is needed from our manufacturers, who we hope will come forward in support and give a real step change to their packaging.

The Government have set out a pilot scheme in 75 practices, looking at incentivising care, but many families wish to see a much bigger and quicker rollout, together with a hard-hitting media and advertising campaign that does not only focus on oral health, but targets the obesity challenge. Both of those represent major public issues facing the UK, which could be incorporated into a coherent national strategy.

I want to take the opportunity to thank the Minister, the noble Lord, Lord O’Shaughnessy—who is not here today—for answering my Written Question on what plans there are to introduce new initiatives to improve dental health in areas of deprivation. I thank him for his reply, referring to the “Starting Well” programme. I wonder whether the noble Baroness, the Minister, has any information to hand with the latest number of dental practices now wishing to join that programme.

Finally, even now, it is sad that 41.5% of children aged nought to 17 did not visit an NHS dentist in the 12 months up to 30 September 2017 and 78.7% of children aged between one and two did not visit a dentist. As I referred to earlier, in 2015-16, the cost to the NHS of tooth extractions in young children aged nought to 19 was £50.5 million; that amount must be reduced as quickly as possible. I hope therefore that the Government will consider investing more—not only in prevention, but in earlier intervention.