Nearly nine in 10 tooth extractions are for decay in 0-5s

Author: Louise Prime

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Most tooth extractions in children aged 0-5 years are done because of avoidable tooth decay, and tooth extraction is still the most common hospital procedure in 6-10 year olds, official data from Public Health England (PHE) revealed today. It is urging parents to swap sugary drinks and foods for healthier alternatives and ensure children’s teeth are brushed twice daily as these changes can have the greatest impact on children’s teeth. PHE also noted that although the overall level of decay is improving in children generally, it is more than twice as high in deprived areas of England as it is in less deprived areas – and the Royal College of Paediatrics and Child Health is calling for action at national, local, and individual level to “tackle the postcode lottery in children’s oral health”.

PHE reported that:

  • There were 59,314 tooth extractions in 2017-18 (of which 38,385 were because of tooth decay), compared with 61,301 in 2016-17 (39,010 for tooth decay).
  • In 0-5 year olds there were 14,545 tooth extractions in 2017-18 (12,783 because of tooth decay); in 2016-17 the data were for 0-4 year olds rather than 0-5 year olds, so a direct comparison cannot be made.
  • Although the total number of extractions decreased slightly since last year, the percentage of extractions as a proportion of the population did not (0.3% of the 0-19-year-old population).
  • Children’s oral health is improving, with 77% of 5-year-old children in England now free of obvious decay. However, children from deprived areas have more than twice the level of decay (34%) as those from the least deprived areas (14%).

Dr Max Davie, officer for health improvement at the Royal College of Paediatrics and Child Health, commented: “Despite being highly preventable, tooth decay remains a significant public health issue, particularly in deprived areas where children are three times more likely to experience severe tooth decay due to higher-sugar diets and poorer oral hygiene. We know that poor dental health can have a major impact on a child’s physical health and quality of life, and lead to problems such as infections, eating difficulties, and absences from school.

“Action is needed at a national, local, and individual level to tackle the postcode lottery in children’s oral health, and reduce the number of children having to endure uncomfortable tooth extractions, often under general anaesthetic. Reducing the amount of sugar consumed by children, particularly in fizzy drinks, is vital, as well as the provision of ongoing, regular, and easily accessible dental care.

“We recommend that all children should see a dentist as soon as their first teeth come through and at least by their first birthday, and that all families should be supported from birth to implement good oral hygiene including twice-daily brushing.”

Professor Michael Escudier, dean of the Faculty of Dental Surgery at the Royal College of Surgeons, added: “The figures published today by Public Health England are horrifying. … [We] would also like to see supervised tooth brushing sessions introduced in nurseries and primary schools across England, as similar initiatives have already been successful in improving children’s oral health in Scotland and Wales.”

PHE warned that although children’s sugar consumption has recently declined slightly, it is still well over the recommended daily limit – often reaching 11g at breakfast alone. It reported that apart from fruit juice, which counts as one of the five a day, the 10 main sources of sugar in children’s diets are: sugary soft drinks (including squashes, juice drinks, energy drinks, cola and other fizzy drinks) – 10%; buns, cakes, pastries and fruit pies – 10%; sugars, including table sugar, preserves and sweet spreads – 9%; biscuits – 9%; breakfast cereals – 8%; chocolate confectionery – 7%; sugar confectionery – 7%; yoghurt, fromage frais and other dairy desserts – 6%; ice cream – 5%; and puddings – 4%. Through its Change4Life campaign it is encouraging parents to:

  1. Swap sugary drinks and snacks such as split-pot yoghurts for lower or no sugar alternatives, including lower-sugar yoghurts or no-added sugar juice drinks. The Change4Life website has plenty of easy ‘sugar swaps’ and helpful tips for families.
  2. Limit fruit juice and smoothies to a total of 150ml per day and only consume with meals – they count as a maximum of one portion of our five a day.
  3. Ensure children brush twice a day with fluoride toothpaste (once before bedtime and once during the day) and remind them to ‘spit not rinse’, as rinsing washes away the protective fluoride. Brushing should start as soon as the first tooth appears.
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