I am concerned about the welfare of my grandchildren.
OK, I know you've never met the little darlings but bear with me for a moment and I'll tell you why you should be interested.
Despite living in one of the most affluent societies in the world, state provision of oral healthcare for children in England leaves much to be desired.
Here are some of the most disturbing facts:
Is it justifiable to treat a condition that is largely preventable?
Tooth decay accounts for more child hospital admissions than any other reason.
A staggering average of 160 children per day undergo general anaesthesia for the removal of teeth. We might consider a tooth extraction to be a minor procedure; but when did you last meet a 'minor' general anaesthetic?
Apart from the physical risks the whole episode is disrupting, stressful for the family, and distressing for the child. As well as this hospital treatment is costly for society and drains NHS resources; hardly justifiable to treat a condition which is largely preventable.
What about the outcome? At best we'll be left with a child deprived of their full complement of teeth, often for many years. This has far-reaching consequences; the child may not be able to eat properly, compromising a normal diet and affecting normal development.
Studies have shown premature tooth loss can adversely affect school-readiness. Certainly, psychological issues can arise; a child may feel embarrassed or different from his or her peers which may impact on the ability to socialise normally.
Who is not getting dental care, and why not?
Four in ten children in England haven't seen a dentist for over a year.
Dental care for people under the age of 18 is free and NICE guidelines recommend attendance at least annually. So, what's going wrong? Of course, some parents are not seeking dental care for their children but a great many who try find significant difficulty in locating a dentist in their area prepared to see children on the NHS.
According to BBC research only about 60% of High Street dental practices are accepting new child patients, largely due to restrictions and quotas imposed by the NHS contract.
The scourge of sugar: public education and a lack of funding
The average five-year-old eats its own body-weight of sugar each year.
Picked up a five-year-old recently? That's some weight of sugar! Perhaps that might have something to do with the amount of tooth decay among the young? By and large, very young children don't buy the sweets themselves so there's still a huge amount of public education necessary.
With that in mind it's easy to assume poor child dental health is the fault of parents. Sometimes we hear comments that the parents are being negligent in allowing their children's teeth to deteriorate.
But how can anyone be negligent, if they really don't understand the risk factors themselves? There still are a lot of people out there who would benefit from advice and instruction and it must be down to the profession and public health agencies to deliver these messages.
On such initiative is the preventive oral health programme 'Starting Well' but guess what? It's underfunded and only being introduced by thirteen local authorities with no plans for a national roll-out despite potentially having a real impact on reducing the misery of dental disease as well as saving the Government valuable resources funding dental treatment.
Oral health inequalities
So, another problem. Not only is the provision of child dental health a problem; it's a postcode-lottery problem as well!
There are huge regional differences.
In my own area over a quarter of 5-year-olds have decayed teeth (26%) making them three times more affected than the national average of 8%. Some areas fare even worse: a child in Blackburn is seven times more likely to experience decay than one born in Surrey. That just isn't fair.
So what's to be done?
This issue is too big for individuals in the profession to address on their own. It's a national issue. Scotland and Wales have had dedicated, funded child oral health programmes for over a decade which have delivered significant improvements in both countries.
It's time for England to act.
What can you do?
The BDA has been working hard with MP's across the political spectrum to secure a debate in Parliament which could lead to positive changes in oral health care for children in England.
The debate is taking place in Westminster Hall on 31 October. To ensure as many MP's as possible attend, it's up to us as dentists to encourage them, and leave them in no doubt about the facts surrounding this issue and the potential consequence for future generations of ignoring it.
This isn't just about England either, policy and oral health promotion need to be coordinated across the UK, so dentists from all four nations should get their MPs to speak up.
I've written to my MP. Please write to yours asap.
Many MP's will be unaware of the importance of the debate or even its background. Point out to them how vital it is to take part, and perhaps point out how popular they may become if they're seen as champions for children's health!
The BDA has helpfully given a draft letter that you can use and adapt, if you want, or you can just add in your MPs name and your name and address and send to your MP.
Local statistics are also available if you'd like to personalise your letter still further. Contact email@example.com for further details.
My daughter is expecting her third baby later this month. Like many young mums she has a number of friends who are also pregnant.
It would be wonderful to think the dental health of these and all other children could be assured. With your help this just might happen so please write to your MP today and be part of helping to change the future of children's dental health.
Philip Lewis, Dentist