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​New study: prevention not treatment must be way forward for kids' teeth

 27 November 2019


The BDA has welcomed a focus on prevention and reduced intervention in a new study on the effectiveness of fillings in children.


However, the Association has stressed that all treatment options must remain available so that dentists can use their expertise and clinical judgement to recommend the most appropriate option for each patient and each tooth.


The three-year UK-wide FICTION study from academics based in Dundee, Newcastle, Sheffield, Cardiff, Queen Mary University of London, and Leeds tracked children who experienced tooth decay and pain and allocated them to groups receiving conventional treatment (filling plus prevention), sealing in of the decay plus prevention or prevention alone. The results showed little difference in outcomes between the groups.


The paper, published in the Journal of Dental Research, recommends that preventive measures can be used to stop decay from worsening in children. But the BDA says the conversation should really be about how to prevent children having tooth decay in the first place, not about how best to treat it when it happens.


The BDA has called on all parties to resource a national programme to prevent child tooth decay, based on existing efforts in both Wales and Scotland. It has long advocated the Scottish programme Childsmile as a potential model for England, a national effort in nurseries and schools with both universal and targeted components that has already reduced the bill for dental treatment costs by £5 million a year.


England lacks a properly funded equivalent, with local authorities paring back efforts in the face of £85 million of cuts to public health grants. Studies by the King's Fund have found the single biggest areas for cuts have been miscellaneous services, including dental public health.


Tried and tested polices like supervised brushing in early years settings can generate up to a £3.66 return on investment for every £1 spent in the most deprived communities, according to Public Health England modelling. 


BDA Chair Mick Armstrong said:


"This research provides helpful evidence that less invasive options are available for treating decay in children, where a dentist judges them to be appropriate.


"The real issue is why so many children still require any kind of treatment for a wholly preventable disease.


"Sadly, prevention requires an investment of time and resource that the authorities in England have been unprepared to make.


"In Scotland and Wales properly funded efforts are securing record breaking improvements in oral health. In England an absence of leadership has left cash-strapped councils paring down a patchwork of provision.


"Schemes like supervised brushing pay for themselves. We've heard aspirations, but we look to the next government to make a tangible commitment to a national programme to tackle childhood decay."