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Leading dental surgeons call for sugar free schools to tackle scourge of child tooth decay in England

15 Aug 2019

Dental surgeons say all schools in England should be encouraged to become sugar free to tackle worrying levels of child tooth decay. The call comes as analysis by the Faculty of Dental Surgery (FDS) at the Royal College of Surgeons of England (RCS) shows more than 100,000 hospital admissions for children under the age of ten in England due to tooth decay over a three year period1. This is despite the condition being almost entirely preventable. 

The FDS has published a new position statement today (15 August) on children’s oral health which is an update to their January 2015 report ‘The state of children’s oral health in England.’ The statement also calls on the new Government to stand by previous commitments in the Childhood Obesity Plan and Prevention Green Paper.  The FDS says supervised tooth brushing schemes in England should be put in place before 2022 so that more children at risk of decay can benefit.

Key statistics on children’s oral health in England:

There were 102,663 hospital admissions due to tooth decay among children under the age of 10 between April 2015 and March 2018.1
23.3% of five year old children have visible decay.3
33.7% of five year old children living in the most deprived areas of England have tooth decay, compared with just 13.6% of those in the least deprived areas.4
41.4% of under-18s did not visit an NHS dentist during 2018, rising to 77.0% of young children aged between one and two.5

As well as being distressing in itself, dental decay can have wider consequences for children, such as making it difficult for them to sleep, eat, socialise and putting them at risk of acute sepsis. Dental pain caused by decay can be detrimental to performance in school, affecting children’s concentration in lessons and potentially requiring them to take time off for dental appointments. At worst, children with untreated tooth decay may need to have multiple teeth out under general anaesthesia2

While important progress has been made since the FDS launched its children’s oral health campaign in 2015, for example the introduction of the soft drinks industry levy, it is vital that policy-makers and the oral health profession remain focused as there is still work to be done. The FDS would like to see a national public health campaign introduced highlighting that all children should see a dentist at least once a year as recommended by the National Institute of Health and Care Excellence, and that NHS dental care is free for under-18s. 

Professor Michael Escudier, Dean of the Faculty of Dental Surgery at the Royal College of Surgeons of England, said: “It is incredibly worrying that levels of tooth decay among children in England remain so high – especially when you consider that it is almost entirely preventable through simple steps such as brushing twice a day with appropriate strength fluoride toothpaste, visiting the dentist regularly and reducing sugar consumption.

“The FDS believes that limiting the availability of surgery foods and drinks in schools is essential to reducing the amount of sugar our children consume. While the Government has committed to reviewing school food standards, we would like to see them go beyond this to encourage all schools in England to become sugar free. We would also support the publication of nutritional guidelines for packed lunches.

“The scourge of child dental decay cannot be allowed to continue. Everyone needs to play their part in ensuring our children have healthy, happy teeth.”

The dental surgeons add that it is vital to children’s oral health that the new Government stands by previous commitments on sugar reduction, in particular, proposals to restrict price and location promotions for products high in fat, sugar and salt (HFSS) and tightening regulations on TV and in online advertising. 

Other key recommendations made in the FDS position statement include:

The new Government should maintain the soft drinks industry levy, and follow through on a commitment in the Prevention Green Paper to extend the levy to include sugary dairy drinks. Consideration should also be given to including other products that do not meet government reformulation targets. Some of the revenue raised from the levy should be used to fund oral health improvement programmes.

Government should remove funding barriers that local authorities face to fluoridating their water supplies, as proposed in the Prevention Green Paper.

Action should be taken to reduce the sugar content of commercial baby foods.

There should be no further cuts to local authority public health budgets.

The new NHS dental contract should be introduced at the earliest possible opportunity.

The Government should commission an urgent review into the factors affecting access to primary, secondary and emergency dental care.

Oral health should be included in pre-registration training for all public health professionals.

The Child Oral Health Improvement Programme Board should continue to co-ordinate action to improve children’s oral health, and relevant epidemiological research programmes must be maintained.

Professor Escudier adds: “Since we launched our campaign in 2015, we have seen the state of children’s teeth improve in parts of England but worryingly, inequalities persist in different areas of the country. We know that children living in the most deprived parts of England are much more likely to experience tooth decay than those in the most affluent. There’s a real opportunity to build on the progress that has already been made and stamp out these inequalities, so that all children in England can benefit from good oral health.”


Notes to editors

1. Figures taken from NHS Digital Hospital Admitted Patient Care Activity Diagnosis datasets for 2015-16, 2016-17 and 2017-18.

2. Public Health England (2017) Health matters: child dental health

3. Public Health England (2018) National Dental Epidemiology Programme for England: oral health survey of five year old children in 2017, p. 8-9

4. Public Health England (2018) National Dental Epidemiology Programme for England: oral health survey of five year old children in 2017, p. 29 (Figure 25)

5. Figures taken from NHS Digital, NHS Dental Statistics for England 2018-19, Second Quarterly Report

6. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

7. For more information, please contact the Press Office: Telephone: 020 7869 6047/6052; Email:; Out of hours media enquiries: 07966 486832.


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