Children hospitalised unnecessarily from tooth decay, experts warn

• Despite being 90% preventable, 1/3 of children in England suffer from tooth decayⁱ
• It is the most common reason why 5-9 year olds are admitted to hospital
• NHS spends £30 million on hospital based tooth extractions for children under 18 years old
• 30% of children in England did not visit a dentist between 2012 and 2014 – double that of Scotland
• In some cases children are admitted for multiple tooth extractions under general anaesthetic.

Action is needed to improve children’s oral health after 2013-2014 saw almost 26,000 children admitted to hospital for tooth extractionsⁱⁱ warned the Faculty of Dental Surgery at the Royal College of Surgeons. Tooth decay is the most common cause of hospital admissions amongst five-nine year old children. It is not only distressing for patients and parents but also has a significant financial impact on the NHS. In a paper published today, The state of children's oral health in England the faculty highlights that tooth decay is almost entirely preventable and for the first time urges the government, political parties and stakeholders to take greater measures to tackle the disease.

Inequality in access to children’s NHS dental services in England has resulted in significant variation in rates of tooth decay, with limited improvement in access to dental services being seen over the last few years. Today almost 64% more five-year-olds suffer from tooth decay in the North West of England compared to the South East.ⁱⁱⁱ In addition, London in 2012^iv had the third highest prevalence of tooth decay in the country, while data showed that a significantly lower percentage of children visited the dentist in London compared to the North of England.

England currently lags behind Scotland and Wales in investing in improving children’s oral health. Between 2012 and 2014 the number of children who did not see an NHS dentist in England was double that of Scotland, where government led initiatives have been introduced to increase parental awareness of tooth-brushing and oral health in general. The Scottish and Welsh government’s investment in national Childsmile and Designed to Smile programmes have provided a 6% reduction in tooth decay between 2007 and 2012 in Wales and savings of £6 million in dental treatments between 2001-2002 and 2009-2010 in Scotland.^iv

Professor Nigel Hunt, Dean, Faculty of Dental Surgery at the Royal College of Surgeons said:

“It is unacceptable that so many children are being hospitalised from tooth decay when the disease is preventable. Many of our members are paediatric dentists who see first-hand the distress this causes children and parents.

“We need to work together to encourage improvements in diets, regular dental check-ups and brushing with fluoride toothpastes.

“As a faculty we urge the government and political parties to recognise the imminent need for a comprehensive educational programme and roll out of water fluoridation schemes to prevent children from being hospitalised unnecessarily.”

Water fluoridation schemes have also been shown to reduce the rate of tooth decay with as many as 45% fewer children aged 1 to 4 in fluoridated areas admitted to hospital for tooth decay than those in non-fluoridated areas. In England, only 10% of the population benefit from a water supply where the fluoride contentis at the optimum level for dental health.^v

Improving the state of children’s oral health not only reduces unnecessary distress for parents and children but by keeping children out of hospital, NHS finances can be used more efficiently. Currently the NHS spends £30 million on hospital based tooth extractions for children under 18 years old so investing in preventative measures early on could mean long term savings for NHS Trusts.^vi

The Faculty of Dental Surgery has made a number of recommendations for improving children’s oral health and the standard of care being received by patients. The paper outlines the following:

• A government led education programme around the importance of oral health should be introduced
• Awareness of the impact of sugar on tooth decay should be increased
• The current shortage in paediatric dentists needs to be addressed so children receive timely care
• Children’s access to NHS dental services should be addressed. Dental statistics should begin measuring the number of children visiting the dentist every 12 months, rather than 24 months
• A comprehensive water fluoridation scheme should be rolled out across the country.^vii

Notes to editors

1. The Faculty of Dental Surgery at the Royal College of Surgeons of England is committed to enabling dentists and specialists to provide patients with the highest possible standards of practice and care. Registered charity number: 212808

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[i] Public Health England. National Dental Epidemiology Programme for England: oral health survey of five-year-old children 2012. A report on the prevalence and severity of dental decay. London: PHE; 2013.

[ii]Hospital Episode Statistics (provisional), Health and Social Care Information Centre, 2013. Data provided after FOI request.

[iii] Public Health England. National Dental Epidemiology Programme for England: oral health survey of five-year-old children 2012. A report on the prevalence and severity of dental decay. London: PHE; 2013.

[iv]Health and Social Care Information Centre. NHS Dental Statistics for England – 2013–14. London: HSCIC; 2014

[v]Public Health England. Delivering better oral health: an evidence-based toolkit for prevention (third edition). London: PHE; 2014

[vi]Department of Health. Reference costs 2012 to 2013. London: DH; 2013.

[vii] The state of children’s oral health in England. Faculty of Dental Surgery. Royal College of Surgeons of England. January 2015.