Following a new survey published by the Office for Health Improvement and Disparities (OHID), dentists have urged the government to take a “consistent, targeted approach” to children’s oral healthcare.

While the data revealed a slight drop in tooth decay among five-year-olds in England, overall oral health improvement progress has stalled. The data has shown the North West and London have the highest levels of dental decay with 28.7 per cent and 27.4 per cent respectively.

However, the 2023 to 2024 figures revealed that 22.4 per cent of five-year-olds experienced tooth decay, a decrease from 23.7 per cent recorded in 2021 to 2022.

East of England and South East had the lowest figures for decay with 17.5 per cent and 19.4 per cent respectively.

The West Midlands, East of England and South East have high levels of five-year-olds experiencing decay but have seen improvements since the last figures.

Inequalities in care

However, tooth decay remains a leading cause of hospital admissions for children aged five to nine years. In 2022 to 2023, 47,581 children required tooth extractions in NHS hospitals, with 66 per cent (31,165 cases) directly attributed to decay – equivalent to 120 hospital operations every working day.

A closer examination of regional data highlights some variations. North West (28.7 per cent), Yorkshire and The Humber (27.5 per cent) and London (27.4 per cent) remain highly affected areas. While some areas have seen improvements, such as a 1.9 per cent decrease in the North West and West Midlands, other regions continue to struggle.

The report noted, “inequalities in prevalence of experience of dentinal decay in five-year-old schoolchildren significantly reduced from 2008 to 2015 but there has been little change in inequalities since then."

A call for action

The Faculty of Dental Surgery has warned the high number of hospital admissions due to tooth decay places unnecessary strain on NHS resources and exposes young children to the risks associated with general anaesthesia.

Charlotte Eckhardt, dean of the Faculty of Dental Surgery at the Royal College of Surgeons, said, “We’ve seen a slight improvement overall in the number of five-year-olds with tooth decay, but it is still too high. The fact that more than one in five children still suffer from an entirely preventable condition is concerning. Supervised toothbrushing programmes (STPs), which the government has said it will implement, offer a glimmer of hope, but their roll-out is uneven across the country.

“STPs have proven to reduce dental decay within a single year after children have been enrolled. Paying for themselves within just three years.

"Areas like London demonstrate how fragile improvement can be without sustained intervention. We need a consistent, targeted approach in hard-hit areas, with the government taking swift action to improve NHS dental access for all children.”

While the fieldwork for the survey effectively predates the 2024 election, the BDA has warned the oral health gap risks widening without decisive action from the government.

Hospital admissions caused by tooth decay among young children has previously been described as ‘Dickensian’ by ministers. However, the BDA has said there has been no progress on the rollout of Labour manifesto pledges to fix the failed contract fuelling the crisis in NHS dentistry or to deliver tried and tested preventive programmes in schools.

Eddie Crouch, BDA chair, said, “This oral health gap was made in Westminster, with children paying the price for official failure to take dentistry seriously.

“A new government calls this 'Dickensian', but it will take deeds, not words, to turn this around.”

References available on request.

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