Many kids in England need hospital care for early childhood caries

2013 09 16 13 51 46 154 Dental Bib Girl 200

Almost a third of 5-year-old children in England have caries, which is also the most common reason why 5- to 9-year-olds are hospitalized, according to a new report by the Royal College of Surgeons' Faculty of Dental Surgery.

While oral health in England has improved significantly since the 1970s, at least partly because of the widespread availability of fluoride, nearly 30% of 5-year-olds in England have caries, according to the 12-page report. The authors also noted that, for these children, at least three of their teeth are affected.

“It is lamentable that tens of thousands of children need to be admitted to hospital when poor oral health is largely preventable.”
— "The state of children's oral health in England" report by the Royal College of Surgeons' Faculty of Dental Surgery

About 46,500 children and young people younger than age 19 were admitted to hospitals because of oral health problems in 2013-2014. Almost 26,000 were children between 5 and 9, representing a 14% rise since 2010.

"It is lamentable that tens of thousands of children need to be admitted to hospital when poor oral health is largely preventable," the authors wrote, stating that it cost nearly 30 million pounds ($46 million) for hospital-based tooth extractions for English children in 2012-2013. Also, more than 30% of children in England did not see a National Health Service dentist between 2012 and 2014, the report noted.

The authors recommended that the government mount a public campaign to stress the importance of children seeing a dentist, starting when their first teeth appear.

"Education is the key to improving oral health, particularly in areas of social deprivation where rates of tooth decay are highest," the report concluded.

Benefits of fluoridation

The authors also suggested the greater adoption of fluoridation, noting reports show that children living where drinking water is fluoridated have fewer caries. A 2014 public health report that found 45% fewer children age 1 to 4 were hospitalized for caries in areas that had fluoridated water.

The British Society of Paediatric Dentistry recently issued a statement supporting water fluoridation in the U.K., noting that the World Health Organization has consistently found water fluoridation to be safe and effective. Water fluoridation is used in 25 countries, with 100% of the population covered in Hong Kong and Singapore, 80% covered in Australia, and 70% in the U.S. and Ireland, according to the report.

But in England, only 10% of the population benefit from fluoridated water, the authors noted.

"We would like to see the government encourage all local authorities to introduce water fluoridation schemes to reduce the significant inequalities in children's oral health across the country," they wrote.

The report authors also urged the government to raise awareness of the impact of sugar consumption on caries and explore ways to reduce it.

The report acknowledged that there is a severe shortage of pediatric dentists in England, especially in the southwest of the country, which has few or no pediatric specialists.

In addition to fluoridation, they urged the government to invest in a national oral health program, similar to Childsmile in Scotland. The Scottish project, which includes supervised toothbrushing for children in primary and nursery schools in deprived areas, has saved more than $9 million (6 million pounds) in dental costs between 2001 and 2010, according to the report.

The authors advised parents to have their children's teeth checked at least once a year, have them brush with fluoride toothpaste, ensure healthy diets and limit sugar consumption, stop bottle feeding after 12 months, have their children drink only water at night after one year, and use sugar-free medications.

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