The Time Bomb of Children’s Oral Health – Upcoming Webinar to Discuss Post-Covid Issues

Eminent dentists, hygienists, academics and a politician are being brought together to discuss current issues around children’s oral health and the challenges arising from Covid-19 as it effects the UK and the rest of the world. In the UK alone, around a quarter of 5 year olds in the UK having had tooth decay and the latest Public Health England figures showing there were 14,545 tooth extractions within this age group. And, the cost of tooth extractions for young children is now approaching £8 million.

A webinar for dentists, hygienists and all those interested in children’s oral health, is being held on Wednesday 24 June at 13.00 UK time. The event is free and you can register via: 

All participants will be eligible for one hour CDP.

Speakers on the webinar will include Sir Paul Beresford, Dentist and MP; Professor Ferranti Wong, Professor of Paediatric Dentistry QMUL and Emma Pacey, Regional Lead for Dental Therapy at Health Education England LaKSS

The webinar is being hosted by Victoria Wilson, Dental Hygienist and Founder of the Smile Revolution and also includes Dr Nigel Carter, Chief Executive of the Oral Health Foundation and Professor Robert Hill Chair of Physical Sciences in the Dental Institute at QMUL.

Richard Whatley, Chief Executive of Biomin Technologies, who is organising the webinar said,” These expert professionals are well placed to discuss the serious issues around oral health for children both currently and in the post Covid world. They will look at the situation from a global perspective covering policy to clinical matters and assess how children’s oral health can be improved.”

The speakers will also consider the Government’s current strategy and how Britain compares to the rest of the world in terms of oral health for children.

“It is estimated there have been 800,000 missed dental appointments, across all ages, in the UK alone due to Covid-19,” said Biomin’s Richard Whatley. “Looking ahead, it is important to not only ensure safe dental treatment but also to come up with strategies to motivate and inspire engagement in oral health among young children.”

The webinar will also look problems areas including hypoplysia and possible solutions including re-mineralising products, such as the new Biomin F for Kids, which could help address children’s oral health. This new toothpaste for children aged three to six, is based on the same clinically proven technology as BioMin F and actively restores and protects children’s teeth, preventing damage.

New study finds water fluoridation reduces the number of children admitted to hospital for dental treatment under GA

Children living in greatest deprivation have most to gain from having a fluoridated drinking water supply, according to new research. Fluoride is added to water in order to prevent tooth decay and the new study demonstrates that community water fluoridation is particularly beneficial for the youngest children in the poorest communities.  

The research was carried out in New Zealand and published in the International Journal of Epidemiology. It adds to the body of research demonstrating that community water fluoridation (CWF) reduces dental health inequalities.  The key findings of the research are:

  • Children from the most deprived areas are more likely to be admitted to hospital for the treatment of pain or sepsis (abscesses) caused by dental decay
  • Fluoridation of the water supply reduces the number of children being admitted to hospital for dental extractions under a general anaesthetic
  • The youngest children in the 0-4 age category in the most deprived areas benefit most from water fluoridation

In New Zealand, around 60% of the population benefits from fluoridated water, mostly city-dwellers. The team from the University of Canterbury in Christchurch compared the number of hospital visits of children in 0-4 and 5-12 age categories from both fluoridated and non-fluoridated areas.

Professor Mike Lennon, a member of the British Fluoridation Society’s executive, said: “This paper shows the evidence supporting the benefits of fluoride in drinking water is getting stronger. It demonstrates that you can reduce the risk of negative dental experiences for children from poor homes. Without fluoride in the water, they are more likely to end up in hospital with toothache.”

The role of water fluoridation in reducing health inequalities was identified in the UK in the University of York Systematic Review of 2000.  Since then, the evidence base has continued to grow with more research undertaken in the UK as well as Israel, Korea and Australia.

Professor Lennon said the data collected by the team from the University of Canterbury had been rigorously analysed. Their focus was ambulatory sensitive hospitalisation (ASH) which are hospital outpatient admissions for preventable conditions, in this instance for tooth decay and infection.

Comparisons were carried out between different census areas and then adjusted for factors which could negatively influence the result, such as living miles away from a dental practice. The overall conclusion of the study is: “As deprived areas have the highest incidence of dental ASH, caries and poor oral health, those who live in the most deprived areas have the most to gain from CWF. In summary, our study supports evidence linking CWF to better health in children. Variation in CWF contributes to structural inequities in oral-health outcomes for children.”

Simon Hearnshaw, the Chair of the Local Dental Network for North Yorkshire and Humber and coordinator of the National Community Water Fluoridation Network, welcomed the research, saying: “This paper provides more support for the argument that fluoridation is effective and reduces the social-health gradient. The challenge now is to implement schemes to bring these important benefits to deprived communities.”

The latest research is entitled: Area-level deprivation, childhood dental ambulatory sensitive hospitalizations and community water fluoridation: evidence from New Zealand

Dr Ranj is ‘Strictly’ Saving Teeth with new online videos for children

NHS doctor, TV presenter, author and celebrity contestant on Strictly Come Dancing, Dr Ranj, is the star of three new mini-videos unveiled today. Actor Gemma Oaten who rose to fame in TV soap Emmerdale supports Dr Ranj as the voice of sidekick Supertooth. 

The videos, which can be found here,  combine live action with computer animation. The aim is to give parents, carers and children the tips they need to keep teeth healthy. During the Covid-19 lockdown, dentists are only providing emergency treatment, which makes preventive advice on avoiding dental decay more important than ever. 

Dr Ranj and Supertooth guide children in different age categories and demonstrate, in just a few minutes, how to brush teeth. The key tips to promote prevention of dental decay are:

  • Brush for two minutes at least twice a day, including last thing before bed
  • Use a fluoride toothpaste
  • Spit, don’t rinse after brushing your teeth

Statistics released by NHS Digital show that nearly 60,000 children go into hospital annually to have teeth extracted under general anaesthetic. The cost for the treatment of this preventable disease is roughly £50 million annually.

The videos were instigated for the British Society of Paediatric Dentistry (BSPD) by real-life Toothfairy Claire Stevens, a Consultant in Paediatric Dentistry and a spokesperson for BSPD. She explained: “Every year, when statistics for dental extractions in children are published, I am interviewed by the media who are horrified that so many children are ending up in hospital having teeth taken out and they want to know why. As a children’s dentist, I know that the main culprit is frequent consumption of sugary foods and drinks, especially between meals. We also know that it can be a challenge to teach children to brush their teeth when they are young and then encourage them to keep brushing as they get older. We had to find a way to reach parents with helpful advice in a fun and non-judgemental way.”

Coincidentally, she was contacted by Ben Underwood, a dentist and the creator of the free Brush DJ app, who was looking for videos that would give parents and carers accurate information in the most accessible format – short, fun and online.

Claire went on a mission to speak to Dr Ranj who had co-created and presented the CBeebies show Get Well Soon. Her daughter loved the programme and would quote Dr Ranj after watching the show.

“As soon as I spoke to him, I knew he was the right person to help make some watchable videos for children. He was immediately on board with the messages and he insisted on giving of his time freely.”

Now in collaboration, Ben and Claire carried out research among high-risk patients supported by BSPD Exec member, Hannah Walsh. They learned that the parents of the target group favoured videos which are short, fun, have star quality and include animation. All aspects of the videos, the length, format, design and distribution, have been tailored in response to the feedback they received. The results are now being written up by Dr Walsh as an academic paper.

The final crucial pieces in the jigsaw, said Claire, were production and sponsorship. They were fortunate to have Joff Powell and his team at Pedwar Productions make the videos and he invited actor Gemma Oaten to be the voice of the animated character Supertooth.

She said: “Health care solutions provider Henry Schein and dental suppliers Dentisan generously came on board as sponsors and I have been supported by BSPD Executive throughout. Now we all hope to see positive results – fewer children in our clinics with decay.”

Dr Ranj commented: “Every child deserves to grow up happy and healthy, and that absolutely includes having healthy teeth. I’ve seen so many instances where dental health is forgotten, or people just don’t realise its importance, until it’s too late. The statistics around how many children have to have teeth removed because of decay are shocking. All it takes to prevent this situation is some simple advice and practice, which is why I’m so keen to be part of this campaign.” 

Patrick Allen, Managing Director of Henry Schein UK and Ireland, commented: “We at Henry Schein are very happy to partner with the BSPD and Brush DJ to help promote the importance of children’s oral health to their overall wellbeing. The videos with Dr Ranj are an excellent and innovative way to help engage with families so they understand the importance of their children brushing their teeth, which can support reducing the risk of getting tooth decay.”

Bob Newsome, Managing Director at infection control manufacturing specialists Dentisan said, “We are delighted to have been able to help spread the word about the importance of daily tooth brushing for children. These videos are a perfect blend of a serious message given in a fun and age-appropriate way.”

View the videos on YouTube here.

Dentists: Heatwave resulting in spike in sugar consumption among kids

The British Dental Association has urged restraint as new figures show kids are eating five times their recommended daily sugar intake during the summer, with the heat pushing them to ice creams, lollies and soft drinks.

A poll of 1,000 parents with children aged two to 17-years-old conducted by mydentist found sugar intake will be hugely boosted during the break from school. 24.5 per cent of parents estimated they gave their children twice as much sugar over summer compared to other times of year. 15.6 per cent said three times as much, with 11.5 per cent suggesting more than five times.

The BDA has been a leading advocate of action on sugar, including the soft drinks industry levy. It has called on parents to take responsibility over sugar consumption, and on Ministers to deliver an ambitious follow up to its landmark Obesity Strategy, with measures to restrict the marketing, sale and formulation of sugary products.

Every 10 minutes a child in England has a tooth removed in hospital due to preventable decay according to figures from Public Health England. Tooth extraction also remains the most common reason for hospital admissions in five to nine-year-olds.

Russ Ladwa, Chair of the BDA’s Health and Science Committee, said: “It is tempting to beat the heat with soft drinks and ice cream, but parents must recognise the damage these sugar-laced confections can do.

“Tooth decay is now a wholly preventable epidemic, and the number one reason a child will be admitted to hospital. Yes, we need parents to take responsibility over what they buy, but Ministers also need to force industry to change the way they formulate and market these products.

“Added sugar is cheap, addictive and nutrient free. Ultimately if you want to keep the kids cool and hydrated reach for the water.”

Tooth decay in five-year-olds now increasing in some parts of England

Survey figures published by Public Health England (PHE) show the state of oral health of five-year-olds in the North West, Yorkshire and The Humber and the West Midlands has worsened since the last survey in 2014-2015, bucking a previous improving trend. Overall, in 2016-2017, 23.3 per cent of five-year-olds in England experienced tooth decay, improving from 24.7 per cent in 2014-2015.

More than a third (33.9 per cent) of five-year-olds in the North West have tooth decay, according to PHE’s data. The proportion of five-year-olds with tooth decay is also very high in Yorkshire and The Humber, where 30.4 per cent have rotting teeth. In the West Midlands more than a quarter (25.7 per cent) of five-year-olds are suffering decay.

The Faculty of Dental Surgery has said that although an overall drop in the percentage of 5-year-olds is welcome and reflects the work that has gone into educating families about oral health in recent years, including through NHS England’s new Starting Well programme, more needs to be done to stop deterioration in the worst affected areas of England.

Stephen Fayle, Board Member of the Faculty of Dental Surgery at The Royal College of Surgeons, said: “We are very disappointed the proportion of young children with tooth decay has increased in some areas of England, especially as this deterioration has occurred in parts of the country where decay levels are already high. This growing inequality is despite efforts to educate children, parents and carers. It is even more concerning when you consider that approximately ninety per cent of dental decay is preventable.

“More work must be done to understand why the message isn’t getting through in these areas, or if it is, why it isn’t leading to the decrease in tooth decay, seen in other parts of the country. With so many children still suffering from decay, we also need to make sure children can easily access NHS dental services, which are free for under-18s.

“We are pleased the overall number of five-year-olds in England with tooth decay continues to decrease. Many, including the Faculty of Dental Surgery, have worked hard in recent years to make people aware of the awful state of our children’s teeth.

“We can’t let children’s oral health fall off the Government’s agenda. We need to be constantly pushing for public health initiatives that remind families to brush teeth regularly with fluoride toothpaste, reduce sugar consumption and visit the dentist routinely.

“We would also like to see the promising ‘Starting Well’ initiative rolled out more widely across the country – for example, there are currently no programmes in the West Midlands even though this region has seen a rise in levels of tooth decay.”

The full results of the oral health survey of five-year-old children 2017 published by Public Health England are available here:

Dental neglect: Children falling through the cracks in “siloed health service”

The BDA has renewed its call for a joined-up strategy on children’s oral health, as new research reveals that GPs are not given the time or training to spot the tell-tale signs of dental neglect.1

The study, published in the British Dental Journal, surveyed all GPs in the Isle of Wight about their awareness and perceptions of dental health care in the identification of abuse. Among these family doctors, usually the first point of contact with the NHS, the majority had never liaised with a dentist. 96 per cent of respondents had never received any formal dental training and some did not perceive dental health to be important. Only five GPs mentioned a link between a lack of dental registration and childhood neglect and no GPs worked at clinics where child dental registration status was recorded.

Dental neglect is a marker of child neglect. It was defined in 2009 in the UK as “the persistent failure to meet a child’s basic oral health needs, likely to result in the serious impairment of a child’s oral or general health or development.” The research demonstrates that GPs lack time, training and confidence to identify dental neglect during routine examination of the oropharynx, and lack awareness of dental neglect as a potential marker of wider systemic neglect.

The study also notes that the sheer ubiquity of dental neglect within the general population may have desensitised many health practitioners to its wider social and health consequences, and blurred the lines between neglect and economic deprivation.

Official data shows that 41.8 per cent of children in England had not been to see a dentist for a check-up in the 12 months up to June 2017. Tooth decay remains the number one reason for hospital admissions among children across the UK. The BDA believes that progress can only be achieved by breaking down silos across the health service, along with co-ordinated and properly funded public health interventions.

The BDA’s Chair of General Dental Practice, Henrik Overgaard-Nielsen, said: “Tooth decay can be a tell-tale sign of abuse or neglect, and many children are falling through the cracks in a siloed health service. GPs bear an enormous burden and it cannot fall to them to ‘multitask’, when government is failing to deal with the problem.

“Tooth decay is the number one reason for child hospital admissions, but dentists are not seeing those at most risk early enough to make a difference. Poverty, neglect or ignorance can be huge barriers to good oral health, and we desperately need joined-up policymaking to tackle them.

“Oral health has such a low profile that it is not surprising that awareness of its importance is low in other parts of the NHS. When we face an epidemic of decay, dentistry can’t be left in a corner. Without meaningful engagement in education, in media and across the health service we simply cannot expect progress.”

  1. See: Colgan, S.M et al (2018). ‘Bridging the gap’ – A survey of medical GPs’ awareness of child dental neglect as a marker of potential systemic child neglect, The British Dental Journal, published 11 May 2018