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Children's oral health – the cost of complacency

Blog Author Mick Armstrong

Blog Date 17/01/2018

​Readers may have noted that 170 children are now facing multiple extractions in English hospitals every single day. It's obscene and preventable, and it's a debate the BDA's been leading in the press and Parliament.


In England, Scotland, Wales and Northern Ireland tooth decay – a preventable disease – remains the number one reason for hospital admissions among children aged 5-9. However the response from governments is where the four nations part ways. 


Wales and Scotland have shown they're ready to turn things around, and dedicated national programmes are delivering results. Ministers have put their money where their mouth is, and it's improving health outcomes and bringing down treatment costs.


Extractions on the rise in English hospitals 


England has traditionally enjoyed better oral health than its neighbours. And maybe that's fed official complacency, because today England is falling behind. The rate of improvement is half that of our neighbours. Deep and persistent inequalities do not appear to be narrowing – as captured in recent studies from the Nuffield Trust on the North South divide in oral health.


The Designed to Smile and Childsmile programmes in Wales and Scotland have combined dedicated funding, with elements of universal and targeted coverage, outreach in schools, nurseries and in practices.

Their England cousin, Starting Well, just recycles underspends in existing budgets and is active in parts of just 13 local authorities, with no real effort on outreach or education.  

It's the reason why Scottish government have been able to report Childsmile has cut £5 million off treatment costs, and contributed to the number of Primary One children with 'no obvious decay experience' rising from 54% in 2006 to 68% in 2014. It is why Cardiff University has seen a record-breaking 12 point fall in decay since 2007. And ultimately it's why the problem in England is growing year on year, and cost our NHS £165m since 2012 for extractions under general anaesthetic. 

These extraction stats are a badge of dishonour for any government that tries to talk the talk on prevention.


Children's oral health is a shared responsibility, and these inequalities must be confronted. As practitioners we stand ready to play our part. Parents of course are key, but it is government that has the unique power to invest, to signpost, to educate, to inform, and to engage.

In Wales and Scotland that means maintaining and building on their pioneering work. They have made investments, and they can reap the dividends from a lower treatment bill.


In Northern Ireland – which has the worst oral health metrics for in the UK – it means that once government has been restored ministers must finally grasp the nettle. 


And in England it means addressing the current poverty of ambition so millions of kids – not just the current thousands – can benefit from policies that are worthy in principle but have not a penny of new money behind them.


Let's be clear – in many parts of the UK government has abdicated its responsibility. These numbers show that ministerial indifference is not an option.


Mick Armstrong

Chair, British Dental Association


Dentistry: putting prevention first

Prevention should be at the heart of any effective healthcare strategy. Yet successive governments have failed to provide dentists with the plans or priority to deliver on it. We want to unlock that unrealised potential, read our 2017 manifesto Putting Prevention First.