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Leading dental surgeons call for better care for primary teeth

10 January 2011

Some children in England may be experiencing avoidable dental pain and distress because decayed primary teeth – or “milk teeth” – are left un-restored or not restored to a consistently high quality by some dentists working under the NHS, says a leading dental surgeon in January’s edition of the FDJ. Professor Monty Duggal says that many children are living with severe and regular toothache, dental abscesses and oral facial infection as a consequence of unsatisfactory treatment and resources; with children from low income families suffering with the highest rates of dental disease.

The opinion piece called Carious primary teeth in children: can or should they be left untreated? asserts that the level of care provided for tooth decay in young children “is a matter of national shame”; a recent NHS oral health survey found on average 30 per cent of 5 year old children have either one decayed, missing or filled tooth1 with rates varying widely across the country. Studies also suggest that children from deprived families have eight times the level of dental disease found in children from the least deprived backgrounds2. Despite these data and evidence that untreated decaying teeth in young children causes pain3, in some regions only 10-12 per cent of children are reported to have been treated with restorative care4.

Professor Duggal, Paediatric Dental Surgeon and author of FDJ opinion piece said: “Dental hospitals regularly receive referrals for untreated or inadequately treated decayed primary teeth because some NHS dentists do not have adequate funding streams, or in some cases training, to provide good restorative treatment especially for extensively decayed primary teeth. Sadly we know that many children who have their diseased primary teeth surgically removed will return a few years later with decaying permanent teeth. To break this cycle and to prevent children experiencing severe dental pain at a young age there has to be adequate resources both for the prevention and treatment of dental decay in children.”

Miss Kathryn Harley, Paediatric Dental Surgeon and Dean-elect of the Faculty of Dental Surgery at the Royal College of Surgeons said: “Many of our members regularly perform extractions for young children who have painful decayed primary teeth. Improving NHS Paediatric restorative dentistry services to treat primary teeth would benefit children twofold; reducing avoidable dental pain in the short term, and helping children to form a positive outlook on maintaining dental health in the long term.”

Read the full article Carious primary teeth in children: can or should they be left untreated? in January’s edition of the FDJ at: 

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Notes to Editor

  1. The Royal College of Surgeons of England is committed to enabling surgeons to achieve and maintain the highest standards of surgical practice and patient care. Registered charity number: 212808. For more information please visit www.rcseng.ac.uk.
  2. The Faculty of Dental Surgery at the Royal College of Surgeons of England is committed to achieving and maintaining the highest standards of clinical practice and patient care across the dental specialities. For more information please visit www.rcseng.ac.uk/fds.
  3. The FDJ of the Faculty of Dental Surgery of the Royal College of Surgeons of England is the official journal of the Faculty of Dental Surgery and is published four times a year in January, March, June, and October.
  4. The principal aim of the FDJ is to provide expert opinion to inform the whole dental community on contemporary issues across the spectrum of dentistry and dental practice. For more information please visit http://www.rcseng.ac.uk/publications/fdj.
  5. If you have any queries please contact:
  6. References:
  1. NHS Dental Epidemiology Programme for England, Oral Health Survey of 5 year old Children 2007/2008
  2. Wyborn et al, Dental Health of Five Year Old Children in Yorkshire and the Humber 2005/06 Yorkshire. Yorkshire and Humber Public Health Observatory; July 2008.
  3. Shepherd MA, Nadanovsky P, Sheiham A, The prevalence and impact of dental pain in 8 year old school children in Harrow, England. Br Dent J 1999: 187;38-41.
  4. Pitts NB, Boyles J, Nugent ZJ, Thomas N, Pine CM. (2005).  The dental caries experience of 5-year-old children in England and Wales (2003/4) and in Scotland (2002/3). Surveys co-ordinated by the British Association for the Study of Community Dentistry in 2001/2002. Comm Dent Health, 22, 46-56.