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Counting the cost of tooth extractions

Blog Author Mick Armstrong

Blog Date 04/12/2018


The number of children having tooth extractions in hospital is one story that just won’t go away.

The latest figures have reached the front pages, and should spark some soul searching at the Department of Health and Social Care. 

Official figures tell us 322 children under the age of 10 underwent full mouth clearances to remove all their teeth under general anaesthetic - in English hospitals in the last five years.

Yet these figures – and we know coding problems are vastly understating the real size of the problem – are just the most extreme evidence of the epidemic of tooth decay were are seeing among children and young people.

Because no sooner had we interrogated this data, when word reached us the number of multiple extractions performed in English hospitals had risen again. 

Over 45,000 hospital operations performed last year – equating to 180 a day – an increase of 18 per cent in the past six years. 

The result, beyond needless suffering for the patients, is a whopping £205 million bill for our NHS. 

I know it's tragic whenever a dentist has to perform a full clearance on a child, but in many hospitals it is now simply business as usual.

That tragedy is compounded by the fact there are tried and tested policies on hand that can address this epidemic head on. In Wales and Scotland we are seeing historic reduction in childhood decay – and it’s the result of long term thinking, and real investment. 

Designed to Smile and Childsmile are working because devolved governments have offered a strategy, and put real resources behind it. 

In England we are in a different place. The Starting Well programme, delivery of a manifesto pledge to improve oral health outcomes for 'high risk' children, has no new funding attached, and is so far operating in a handful of wards in 13 local authorities.

Matt Hancock has told us prevention not cure is the mantra for the NHS. However dentistry still appears to be optional extra, and not put a penny of new investment has been put into early years prevention. 

Our message on the logic of prevention could just as easily come from any accountant. 

We are facing wholly avoidable upstream pressures on secondary and acute care from oral disease. Yet the Government’s spend per head on dentistry has actually fallen £41 to £36 per person in just five years – and primary care and public health budgets overseen by councils have seen no benefit from the NHS70 investment pledge. 

In short treating dentistry as the Cinderella Service is neither sustainable nor cost effective. 

In Scotland and Wales sustained efforts are helping turn the tables on decay in nurseries and primary schools. 

Kids in England need the authorities to do more than wave a white flag.

In the NHS’s 70th year Ministers need to offer more than unfunded gimmicks. We require a dedicated, and properly resourced national effort to end the scandal of childhood decay.

Mick Armstrong, Chair
BDA Board

Improving oral health for all

Prevention should be at the heart of any effective healthcare strategy. Tooth decay, an almost entirely preventable condition, remains the leading cause of hospital admissions among children in the UK. Successive governments have failed to provide dentists with the plans or priority to deliver on it – here’s what we are calling for. 

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