It is the end of an afternoon in theatre and I have extracted more than 100 teeth from my operating list of eight patients, the youngest a two-year-old who needed all 20 baby teeth removing because they were so decayed. I watch in silence as a child younger than my own is transferred from the operating table and I wonder how we reached this point as a society where I don’t believe we truly value oral health, nor realise the implications of failing to do so.
Nearly 20 years after observing my first general anaesthetic as a student it doesn’t get any easier. I regularly see parents overcome by guilt and emotion as they watch their child being put to sleep, or recovering dazed and confused in the recovery suite. Sometimes after a busy afternoon I sit in the theatre and wonder if there is more I can do, sometimes I have nothing left to give.
Responsibility for oral health promotion has been devolved to cash-strapped local authorities
As an NHS consultant in paediatric dentistry, it sadly comes as no surprise to me that removal of decayed teeth remains the most common reason for a child aged five to nine years to be admitted to a hospital in England. In these straitened times, it seems so wrong that every year we spend around £35m on operations to treat a disease that is almost always preventable.
The frustration is that the solutions are already out there. Ten years ago, the Scottish government agreed to invest in a programme of oral health prevention called Childsmile. Now every child in Scotland has access to free daily supervised tooth brushing in nursery and free dental packs to support tooth brushing at home. Dental registration is encouraged and those communities and individuals who are higher risk have more support. The result? Scotland is reducing the millions of pounds it spends on general anaesthetics and turning around the oral health of its children, for the princely sum of £17 per child per year.
Wales has a similar Designed to Smile programme but in England, responsibility for oral health promotion has been devolved to cash-strapped local authorities. This means that it is a postcode lottery with some excellent programmes, such as Teeth Team in Hull, while in other areas existing services are being decommissioned.
England needs urgent investment in oral health prevention. It is actually more cost effective to prevent, rather than treat, dental disease but more importantly we could be preventing tens of thousands of young children, and their families, from potentially experiencing pain, swelling and sleepless nights and time away from school or work.
Every child has a right to good oral health yet still we see one in eight three-year-old children with obvious signs of decay. We need a more radical approach to reduce the persistent inequalities in oral health, which are immoral in this day and age. We need more compassion, an accelerated programme of product reformation so that the sugar content is reduced, and a war on marketing of high sugar products aimed at children.
If you have any concerns about your child's oral health our Liverpool Dentist will be happy to discuss these with you and to take care of your child's teeth. You can contact us here to make an appointment or complete a registration form to be registered with our NHS Dentist in Liverpool.