This week the Huffington Post asked the British Society of Paediatric Dentistry (BSPD) and the Oral Health Foundation for tips for parents on how to teach kids about the importance of looking after their teeth, and how to make trips to the dentist less of a chore.

Nearly 43,000 children and teenagers in England and Wales had hospital operations to remove teeth last year, NHS figures show.

According to the Huffington Post, Councillor Izzi Seccombe, chairman of the Local Government Association’s (LGA) Community Wellbeing Board, said the figures show we have an oral health crisis” and called for money raised from the sugar tax to be invested in “innovative oral health education so that parents and children understand the impact of sugar on teeth and the importance of a good oral hygiene regime”.

“Untreated dental care remains one of the most prevalent diseases affecting children and young people’s ability to speak, eat, play and socialise,” she added.

“These figures also highlight how regular check-ups at a dentist can help prevent tooth decay and the need for hospital treatment.”

Here are the tips:

1. Take them on a few visits before it’s their turn

A clinical director of Revive Dental Care and trustee of the Oral Health Foundation, Dr Ben Atkins said: “Getting younger kids to join you or an older sibling on a trip to the dentist is a good way of getting them used to the sights and sounds of a dentist’s room and understand there is nothing to worry about.

“Start them early, take them to the dentist before their first teeth even start to appear,” he explained.

“As soon as they are born, at my practice, we welcome babies, because then by the time they need to jump on the chair they have visited two or three times and the hardest decision is which sticker to take home.”

2. Start them early

Claire Stevens, BSPD president, told the Huffington Post about the Dental Check by One campaign, introduced to raise parental awareness of the importance of taking young children to the dentist when their first teeth come through.

“If you can start your child going to the dentist early, then as they grow up, they are not anxious – it’s a positive experience,” she explained.

3. Act as a role model

“Much of children’s anxiety comes from their parents or carers,” explained Dr Atkins. “Try to ensure you do not pass this on to the kids by avoiding speaking about bad experiences.”

One way to do this is for parents to also book an appointment themselves directly ahead of their child’s, so they can see that there is nothing to be afraid of. However, if parents are very nervous then they should be advised to have their appointment on a different day, so nerves can be treated separately.

4. Explain exactly what happens

A child may not remember his/her last appointment.

Fear of the unknown can make the whole experience seem even more daunting.

“Speak through with them exactly what will happen during their dental visit so they know what to expect,” Dr Atkins said.

5. Ensure they are comforted and rewarded

“Let them take something to comfort them, a favourite toy or book or even music can help calm them,” said Dr Atkins.

“Also after the appointment, rewards do work too, but make sure it is not sweets, – a special trip after or a new book can motivate them.”

6. Give them the option of where to sit

“The big dentist’s chair (especially when a child is so little) can seem incredibly scary, so don’t worry if the first few times they don’t make it on there alone,” parents are advised.

“Letting them sit on your lap is a great way to comfort them,” said Dr Atkins. “I find giving the patient the option: ‘Where would you like to sit, on daddy’s knee or on the chair on your own?’

“This gives the child control, and visiting the dentist is all about control, if the child feels that they are in control then a visit to the dentist can feel like a breeze.”

7. Make the experience fun

Claire Stevens commented that as a child grows older, they can climb onto the chair themselves and try to enjoy the experience of the “big chair”.

“A lot of children enjoy the fun of the moving chair going up and down,” she said. “That’s how I get my patients to feel at home in my surgery.”

The BDA is advising dentists in England, Scotland and Wales, that new regulations came into force on 1 January 2018, which means dentists using x-ray generators must register with the Health and Safety Executive.

IRR17 will replace IRR99 and the BDA advises that most of the regulations remain unchanged.

However, IRR17 introduces a three-point risk-based system of regulatory control – “notification” (for low-level risk activities), “registration” (for the operation of radiation generators) and “consent” (for the highest risks).

General dental practitioners use x-ray generators, so they will be required to apply in the “register” category (Level 2).

The regulations in Northern Ireland are currently under consultation and we will update members on this when any changes are announced.

What you need to do
We have been advised that the legal person (who is responsible for enforcing the H&S at Work Act in the practice) will need to register with the Health and Safety Executive (HSE) during January 2018 and apply before 5 February 2018.

We understand there will be an administration charge of £25 to register.
You will need to apply even if you have previously notified HSE that you work with ionising radiation.
We have been assured that the online registration system will be a series of yes/no questions, and we understand this will be similar to the existing process.
We have been told to expect more detailed guidance notes for medicine and dentistry in May 2018.

The current legal requirement
The current legal requirement under IRR99 is for dental practices to appoint an RPA and this requirement remains the same under the IRR17, and that is the appointed person to go to for advice on how a practice updates their radiation protection file.

FAQs

We understand that:
For general dental practices, it is registration (rather than notify or consent), unless it refers to new premises and the HSE has not notified previously.
The fee is a one-off £25 payment.
The person responsible for the provision of dentistry as the practice has to register – it does not involve associates having to register, as they are deemed to be “employed” for these purposes
If the practice is part of a wider organisation, the overall owning body will be the one responsible for registering.
If the entity registering has more than one practice, it will still be £25 only – it is not a “per practice” fee.
Entities with more than one site will need to state how many sites are involved and the number of employees (including include self-employed dentists and all other staff).

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Student dentist CHARLOTTE GENTRY reflects on her course…

Ibegan my paediatric speciality teaching in September. I was incredibly apprehensive about starting. The idea of drilling such tiny teeth in such tiny mouths and giving anaesthetic to (stereotypically) very anxious children gave me nightmares! However, my experience so far has been a pleasant one and it’s my favourite part of the course.
Paediatrics is taught as a speciality – we get a set period of time on the dedicated clinic and we see one or two children every two weeks. I can’t help but think, is this really enough? I’ve never understood why we get such a relatively small amount of time treating children, when a large proportion of our patients will be children once we go out into general practice. Paediatrics is a speciality in its own right – of that I have no doubt. When I began the teaching, I realised how different our approach to almost everything is wihen it comes to treating children – from their medical histories to looking out for safe-guarding issues. I feel more time should be given to dental students in paediatric teaching in order for us to be able to do our utmost best when we get into the big wide world.
Many of the patients we see have been referred to us by their GDP for us to assess and treat them. This allows students like me a great chance to experience hands-on rarer and more complex cases. I can’t help but think, though, that if we are able, as undergraduates, to treat these patients surely qualified GDPs should be doing more paediatric work, too? Or are they not treating paediatric patients because of a lack of confidence due to the limited training they received at dental school?
From my experience in practice before starting at dental school, there was one paediatric treatment possibility I had never seen or even heard of – a Hall crown. We’ve been taught a great deal about these and their efficacy, and from what I’ve learnt they are an excellent treatment option that are clearly not utilised enough. No anaesthetic is required, the crown itself needs minimal adjustment and it just snaps into place. It prevents progression of and arrests the caries underneath whilst preventing a new lesion from being able to form on that tooth. They are technically easier and quicker to do than a direct restoration on a child’s tooth, which require anaesthetic and far more compliance from the child. I just have no idea why they aren’t used more frequently. Perhaps a lack of training or the cost is the answer, but, in the long term, surely utilising hall crowns would reduce costs further down the line?
I appreciate that resources – and lack of them – is a huge hurdle in practice that we do not have to such an extent at dental school. However, if Hall crowns were used more frequently, if diet sheets were used and education in oral health was more frequently imposed, in the long term it would save money and time for many dentists. Children wouldn’t need to be referred for general anaesthetic – a huge cost and time consuming treatment in itself.
There is an awful lot to fit into a five-year course at dental school and time is already a constraint. Nevertheless, I feel that paediatric teaching should be a core part of our learning, up there with our clinical practice teaching. After all, we will see kids on a daily basis and by improving the dental health of children, we can improve the future dental health of the country.

Dentists have accused the government of having a “short-sighted” approach to tooth decay in England after hospital operations to remove children’s teeth increased to nearly 43,000.

According to the BBC, there were 42,911 operations in 2016-17 – up from 40,800 the previous year and 36,833 in 2012-13, NHS figures show.

The British Dental Association (BDA) said England had a “second-class” dental service compared to Wales and Scotland.

The government said it was “determined” to reduce the number of extractions.

Doctors said many of the tooth extractions would be caused by the food and drink children consume and were therefore “completely preventable”.

Dental surgeon Claire Stevens, who works in a hospital in north-west England, said most of her patients were aged five to nine, but it was not uncommon to remove all 20 baby teeth from a two-year-old because of decay.

She said she has also extracted a 14-year-old’s permanent teeth due to fizzy drinks. They then needed false teeth.
‘Startling’ figures

An analysis of NHS figures by the Local Government Association, which represents councils in England and Wales, found the equivalent of 170 hospital tooth extractions a day were being carried out on under-18s.

These are done in a hospital under general anaesthetic, rather than at a dental practice.

The operations would have cost the NHS about £36m last year and £165m since 2012, the LGA found.

Mick Armstrong, chairman of the BDA, said: “These statistics are a badge of dishonour for health ministers, who have failed to confront a wholly preventable disease.

“Tooth decay is the number one reason for child hospital admissions, but communities across England have been left hamstrung without resources or leadership.”

The BDA said England was receiving a “second-class service” because, unlike Wales and Scotland, it has no dedicated national child oral health programme.

It said the government’s centrepiece policy Starting Well – aimed at improving oral health outcomes for “high-risk” children – had received no new funding and was operating in parts of just 13 local authorities in England.

Dr Sandra White, director of dental public health at Public Health England, said parents could reduce tooth decay through cutting back on their children’s sugary food and drink and encouraging them to brush their teeth with fluoride toothpaste twice a day, as well as regular trips to the dentist.

A debate on children’s dental examinations and treatment is due to take place in the House of Lords on 18 January.

The British Dental Association has announced Phil Grigor as its new Scotland Director.

Phil joins the BDA from the University of the West of Scotland, where he served as Head of Strategic Planning. He will take up his role on 12 February 2018.

A former academic, Phil has worked extensively in policy for the Scottish Health Department, NHS in Scotland and at Audit Scotland, where he served for 10 years managing a range of projects on national and local level including transport, health inequalities and education.

Derek Harper, a practice owner in Kirkcaldy, Fife, and member of the BDA’s Principal Executive Committee said:

“Dentistry in Scotland is under huge pressure. Phil has worked across the public sector, including at the heart of Scottish government, and comes equipped with the insight and experience to help us win the argument for a sustainable service. We were hugely impressed with his strategic approach and are delighted to have him join the team.”

Phil Grigor added:

“I am proud to be joining the BDA as its new Scotland Director. We face funding shortfalls, low morale and oral health inequalities. However, with the Scottish Government’s oral health improvement plan due to be published, this is also a time where we can really look to shape future oral health policy. I am determined to give our members the strongest possible voice at Holyrood, and to help to ensure all Scots can enjoy effective oral health.”

Volunteer-run charity, Dentaid begins performing free procedures on the British public who are unable to see a dentist.

They have set up temporary surgeries in Britain in order to relieve people of their dental pain, seeking to help those that are vulnerable, homeless or unable to book an appointment with a dentist.

Chief executive Andrew Evans said: “We recognised there was a need within the UK with people struggling to access NHS care.

“I have heard dentists saying it is worse than at one our projects in Malawi. The state of oral health in the UK has been a big surprise.”

Recent figures reveal that 160 youths are having teeth taken out under general anaesthetic in England every day. Dentaid began treatment after learning that those visiting food banks were unable to eat due to their dental health. The worst affected area is said to be West Yorkshire, with NHS Choices stating that 96 per cent of practices are unable to accept new patients.

The British Dental Association has stated that Government funding is only enough to pay for half the population.

Gum disease and tooth loss are just a few oral health issues that have been linked to frailty in older men, according to a new study.

With weight loss, exhaustion and low physical activity being a few of the significant symptoms observed over a three-year period, Dr Nigel Carter, Chief Executive of the Oral Health Foundation says that these problems can effect the wellbeing of older men to such an extent that it can “impact a person’s quality of life”.

The study further revealed that twenty per cent of over 1,000 participants had no teeth, with 11 per cent having experienced gum disease.

Dr Carter adds: “we often see first-hand the difficulties that poor oral health in elderly can have, including making it harder to eat, swallow, speak, get adequate nutrition and even smile”.

Participants – aged between 71 and 92 – took part in examinations of their height, weight, walking speed and strength of grip, as well as their oral health. These consequential health problems are proven to be widespread, with the men studied living in 24 towns across the UK.

While sensory impairments like eyesight, physical function, disease and hearing are regarded as highly important issues, Dr Carter believes the detection of poor oral health could be used to identify fragility but says it is “often ignored when assessing the care of older people”.

Dr Carter concludes: “A simple daily routine of brushing our teeth last thing at night and at one other time during the day with a fluoride toothpaste could vastly improve the health our mouth moving into later years.”