The British Dental Association (BDA) has encouraged ministers to step up on oral health inequality. The first oral health survey of five-year-olds published since lockdown shows no improvements in decay levels and a widening gap between rich and poor.

The survey showed that 23.7 per cent of five-year-old children in England had experienced obvious dentinal decay. This was a marginal increase on the previous survey of five-year-olds in 2019, where figures stood at 23.4 per cent.

The report concludes that while absolute inequalities in tooth decay prevalence in five-year-olds reduced from 2008 to 2015, there have been no further reductions. In 2022 the slope index of inequality for the prevalence of experience of dentinal decay in five-year-olds was 27.7 per cent. An increase in the previous survey in 2019, when the slope index was 26.8 per cent.

In the 2019 survey, dental decay was higher in children from more deprived areas (34.3 per cent) than in children from less deprived areas (13.7 per cent). In 2022, the prevalence of dental decay in more deprived areas was 35.1 per cent compared to 13.5 per cent in the more affluent – an oral health gap of over 21.6 percentage points.

Recent data on hospital tooth extractions among 0 to 19-year-olds confirmed that tooth decay remains the most common reason for hospital admissions in children aged between six and 10 years – and that rates for children and young people living in the most deprived communities are nearly 3.5 times that of those living in the most affluent.

The BDA has been deeply concerned about the ongoing access problems. The association warns that the disruption to public health programmes and lockdown diets will further widen these deep oral health inequalities.

Dentist leaders have accused the government of doing little to nothing to arrest these trends.

The BDA has slammed the government for failing to show any real ambition in restoring access to dental care or arresting the exodus of dentists from the NHS. BBC research in August 2022 found that eight in 10 practices were unable to take on new child NHS patients. The professional body accused the ministers of “rearranging the deck chairs on the Titanic, while the service slowly slips into the sea” at the Health and Social Care Committee hearing into NHS dentistry earlier in March 2023.

BDA chair Eddie Crouch said, “England’s oral health gap is widening, but ministers remain asleep at the wheel.

“Time and again, we hear the right noises but see literally no action to break the link between decay and deprivation.

“Whether it’s providing access to basic care, rolling out tried and tested programmes in schools or fluoridating water, our youngest patients require deeds not words.”

A Department of Health and Social Care spokesperson said, “Good oral health is incredibly important and the number of children seen by NHS dentists increased by 43.6 per cent in the last year.

“We know tooth decay is often linked to deprivation, and we are taking action to provide cost of living support. All children under 18 - or under 19 and in full-time education - are exempt from dental charges.

“The number of dentists increased by over 500 last year and the government is investing more than £3 billion in NHS dentistry including so people can access services when they need them.”

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