Ministers remain asleep at wheel as child oral health gap widens
23 March 2023
The British Dental Association has warned Ministers need to step up on oral health inequality, as the first oral health survey of 5-year-olds published since lockdown shows once again no improvements in decay levels and a widening gap between rich and poor.
23.7% of 5-year-old children in England had experience of obvious dentinal decay. This was a marginal increase on the previous survey of 5-year-olds in 2019, where figures stood at 23.4%.
The report concludes that while absolute inequalities in tooth decay prevalence in 5-year-olds reduced from 2008 to 2015, there have been no further reductions in inequalities since then. In 2022 the slope index of inequality for the prevalence of experience of dentinal decay in 5-year-olds was 27.7%. An increase in the previous survey in 2019, when the slope index was 26.8%.
In the 2019 survey the prevalence of dental decay was higher in children from more deprived areas (34.3%) than in children from less deprived areas (13.7%) – an oral health gap of 20.6 percentage points. In 2022 data that gap has widened. In 2022 the prevalence of dental decay in more deprived areas was 35.1% compared to 13.5% in the more affluent – an oral health gap of over 21.6 percentage points.
Recent data on hospital tooth extractions among 0 to 19 year olds confirmed that tooth decay remains the most common reason for hospital admissions in children aged between 6 and 10 years – and that rates for children and young people living in the most deprived communities are nearly 3.5 times that of those living in the most affluent.
The BDA has been deeply concerned that ongoing and severe access problems, together with disruption to public health programmes and lockdown diets will widen these deep oral health inequalities further.
Dentist leaders have accused the government of doing little to nothing to arrest these trends, which requires action on the high sugar foods fuelling decay. Food Tsar Henry Dimbleby recently resigned from his role to speak openly about the Conservative Party’s failure to meaningfully reform the food system. While supervised brushing programmes in nurseries and primary schools are key parts of funded national programmes in Wales and Scotland, the UK government has failed to even bring forward pledges to consult on expanding efforts in England. While measures to simplify the rollout of water fluoridation were contained in the Health and Care Act that gained royal assent in April 2022, not a single new programme has been announced.
The BDA has slammed government for failing to show any real ambition on restoring access to dental care or arresting the exodus of dentists from the NHS. BBC research in August 2022 found 8 in 10 practices were unable to take on new child NHS patients. The professional body accused the Ministers of “rearranging the deck chairs on the Titanic, while the service slowly slips into the sea” at the Health and Social Care Committee hearing into NHS dentistry this week.BDA chair Eddie Crouch said:
“England’s oral health gap is widening, but ministers remain asleep at the wheel.
“Time and again we hear the right noises but see literally no action to break the link between decay and deprivation.
“Whether it’s providing access to basic care, rolling out tried and tested programmes in schools or fluoridating water, our youngest patients require deeds not words.”