Britain’s rotten teeth boroughs! The towns and cities with the WORST dental decay in children
- More than 33,000 children had their decayed teeth surgically removed last year as a result of a lack of brushing, poor diet and sugary drinks
- Children as young as five-years-old are being referred to hospital to have up to 18 of their milk teeth pulled out, experts say
- Youngsters in Yorkshire and Humberside have the worst teeth in England, with around 7,600 children having their teeth removed at hospital
Britain’s outraged dentists are today calling on the Government to tackle a ‘national scandal’ that means more than 33,000 children a year have such rotten teeth that medics have no option but to surgically remove them.
Children as young as five-years-old are being referred to hospital to have up to 18 of their 20 milk teeth pulled out, experts say.
Horrified dentists, who have described the emotional turmoil of sending toddlers as young as two to have their teeth taken out, are demanding the government introduce a national strategy for the prevention of tooth decay in children.
Statistics show around 33,815 children in England had their decayed teeth taken out in hospital last year as a result of a lack of brushing, poor diet and sugary drinks. Experts estimate these surgical procedures cost the NHS nearly £31.5 million.
Statistics show 33,815 children had their decayed teeth taken out in hospital last year as a result of a lack of brushing, poor diet and sugary drinks
Children in Yorkshire and Humberside have the worst teeth in England, with around 7,600 youngsters having their teeth surgically removed at hospital due to teeth decay last year.
The North West closely follows, with an estimated 6,770 children being admitted to have their teeth taken out whilst 6,715 children in the capital underwent the same surgery.
For children aged ten and under, the figures are damning. For many of these children, it will be their first visit to the hospital.
In Yorkshire and Humberside, children of this age group – who are still at primary school – accounted for 6,225 extractions as a result of tooth decay.
Around 1,300 of these surgeries were to remove teeth from children aged four or under.
Yorkshire is closely followed by London, with an estimated 5,300 children aged ten or under facing having their teeth removed at hospital. In the North West, around 5,230 children underwent the same surgery – 4,260 of whom were aged between five and nine years old.
Children as young as five-years-old are being referred to hospital to have up to 18 of their 20 milk teeth pulled out, experts say
Tips on how to keep your child’s teeth healthy
- Teeth brushing should be supervised because it’s very difficult for a child to brush their teeth on their own.
- Snacking throughout the day can cause increased problems for dental care. This should be avoided.
- It’s about the frequency rather than the amount that the child is eating.
- Brush teeth twice daily for about two minutes with fluoride toothpaste.
- Brush last thing at night before bed and on one other occasion.
Each procedure costs the NHS around £930, according to NHS England figures from last year.
The most common reason for a child to attend a hospital between the ages of six and nine is to have their teeth out, according to the Local Government Authority.
Most children admitted to hospital under the age of ten years old will have their rotten teeth removed under general anaesthetic, according to the British Dental Association.
Horrified dentist Paul Woodhouse said it frustrates him to see the statistics.
‘It makes me mad as hell because dental disease is 99 per cent preventable,’ he tells MailOnline. ‘There is absolutely no need for a child to go into hospital to have their teeth taken out if we follow some really basic things. It’s tragic.
Dr Woodhouse, from the Grange Dental Practice in Norton, Stockton-on-Tees, County Durham, said: ‘Dental decay should not be an acceptable disease in a first world country in the year 2020. That’s just a national embarrassment. It’s a disgrace that we think it’s OK for kids to have decaying disease in their mouths.
‘Dental disease is something we fail our children on.’
Horrified dentists, who have described the emotional turmoil of sending toddlers as young as two to have their teeth taken out, are demanding the government introduce a national strategy for the prevention of tooth decay in children
Children in Yorkshire and Humberside have the worst teeth in England, with around 7,600 youngsters having their teeth surgically removed at hospital due to teeth decay last year
Mr Matthew Garrett, the Dean of the Faculty of Dental Surgery at the Royal College of Surgeons of England, agrees.
‘The sad news about these statistics is that these admissions are avoidable. And more needs to be done to stop the rot in advance.
‘It’s not an uncommon scenario for a child to come into hospital and have all of their 20 milk teeth out,’ says Mr Garrett, a consultant in restorative dentistry at the Royal National ENT and Eastman Dental Hospitals in London.
Dr Paul Woodhouse (pictured) says the youngest patient he’s sent to hospital to have their teeth surgically removed is two years old
‘We are not talking about general anaesthetic for one or two teeth. We are talking about general anaesthesia for a significant number of teeth.’
Dr Woodhouse says the youngest patient he’s sent to hospital to have their teeth surgically removed is two years old.
By two and a half years old, all of the milk teeth should be through. By the age of six, their adult teeth should be starting to emerge.
‘The reason why they had such bad teeth at two years old is poor cleaning and way too much sugar from fruit juices and sweets,’ explains Dr Woodhouse.
He recalls having to refer a five-year-old boy to hospital to have 18 out of his 20 milk teeth. It was the child’s first visit to the dentist.
‘Every tooth apart from two had dental decay because of a lack of cleaning. It’s tragic,’ he says. ‘It’s really horrendous that a kid looses a tooth but to lose 18 of his 20 in one sitting? That’s shocking.
‘The little boy hasn’t been back to the practice since we sent him off to hospital. He’s probably not going to attend until he has another problem.’
The most common reason for a child to attend a hospital between the ages of six and nine is to have their teeth out, according to the Local Government Authority
Signs of a decaying tooth
Most people with decaying teeth will notice a black or brown mark on the tooth.
Once those brown lesions have developed it means there is a cavity and a hole in the tooth.
Quite often in a milk tooth, if there are brown marks, it is too late to save the tooth because the damage has spread too far.
‘The idea of routine regular dental checks allows us to pick up on any lesions that are there much, much earlier and prevent them from spreading,’ says Dr Paul Woodhouse.
The youngest patient Dr Woodhouse has personally removed teeth from is four years old. ‘There was just non-stop crying from the patient and the mother was crying.
‘I was not in the best emotional state doing it because I have to use local anaesthetic. So that means putting a little needle into the gum next to the tooth and pulling it out. And doing that on a toddler is horrendous.’
Just last week, a six-year-old came into the surgery after having two teeth removed in June. He is now going to lose another two milk teeth.
‘He’s basically got no back teeth to bite on at six and a half years old. At this level we are talking about extracting deciduous teeth.’
Children are referred to hospital for general anaesthetic for a number of reasons, such as the difficulties trying to operate on a young child with local anaesthetic at a dental practice. Or they may need to much work done that a visit to the hospital is the only feasible solution.
Many of these children are having their milk teeth meaning that they have a second chance once their adult teeth come through. But it’s not so simple.
‘The trouble is that the children who come in and lose all their baby teeth have already got the bad habits and the bad dietary patterns set in place,’ says Dr Woodhouse. ‘Those things will just continue into adulthood.’
The youngest patient Dr Woodhouse has personally removed teeth from is four years old
Losing milk teeth also means that the teeth underneath them come through quicker and often erupt in the wrong place. ‘It sets up a chain of reaction of a whole set of reactions,’ Dr Woodhouse says.
Mr Garrett worries about the impact these experiences of having their teeth removed will have on children’s desire to visit the dentist in the future.
Matthew Garrett worries about the impact these experiences of having their teeth removed will have on children’s desire to visit the dentist in the future
‘Up and down the country, children are having their baby teeth taken out. If the first experience of a dentist that a child has is being put to sleep to have all your teeth removed, it doesn’t stand them in very good stead for future treatments. I do worry about that.’
With patients so young coming into their practices every day, dentists have spoken of the emotional toll of either removing the teeth with local anaesthetic or referring children to hospitals to undergo general anaesthetic.
‘I won’t lie; emotionally, it’s draining,’ says Dr Woodhouse. ‘Every time I see a child with tooth decay come in, it sticks with me. It really upsets me. I hate treating kids. I’ve got two girls who are seven and three years old.’
‘I don’t have a problem with kids coming in with their teeth knocked out because they’ve fallen off their skateboard because they’re doing something fun and adventurous,’ he continues.
‘But I feel like shouting every time I see a kid with decay. My daughter’s classmates at school have had their teeth taken out and I hear conversations in the playground where parents are talking about their kids having black teeth and going to have them removed,’ continues Dr Woodhouse.
‘It’s just accepted that it’s OK because it’s baby teeth. It’s bloody not. It’s a tragedy.’
Mr Garrett adds: ‘It’s very saddening to see the to see these children coming in with huge holes or swelling because of the infection and putting them to sleep when it can be avoided.
‘It’s like an anaesthetic conveyor belt, I suppose, because it’s such a short operation but there are so many of them.’
Losing milk teeth also means that the teeth underneath them come through quicker and often erupt in the wrong place
Lockdown restrictions have also meant the number of children being admitted to hospital or seeing dentists has drastically reduced.
Across England, the number of hospital admissions for tooth extraction was just 908 between April and June this year. In contrast, there were 9,062 hospital surgeries in the same period in 2019.
The admissions have increased slightly between July and September this year with 3,542 hospital visits for tooth extractions – but this is still well below the 8,812 admissions for the same period in 2019.
Many dental practices are only able to see emergency patients meaning the children and adults who need routine check-ups aren’t able to have them.
More than 19 million appointments are being missed due to dental practices being shut and not being able to work at full capacity.
For those children with small areas of decay, which are being left untreated, it means the decay will progress.
‘I think that the oral health inequalities will widen further because of access problems to dental care during the pandemic and there has been a suspension of public health programmes.
‘Lockdown has disrupted normal day to day routines at home which could in turn undermine tooth brushing habits.’
Dentists have been left frustrated that so much money, around £31.5 million last year, is being spent on the surgical extraction of teeth for youngsters – something that is preventable.
‘The cost of the NHS and the public finance being spend on these treatments is expensive,’ says Mr Garrett.
Dr Woodhouse adds: ‘This is an extremely large amount of money and nobody wants to talk about this.
‘We belittle the value of dentistry because ‘it’s just teeth’. It’s not. It’s more of a window into the general health of the patient,’ he argues.
Dental problems can lead to systematic health problems and gum disease, a chronic inflammatory disorder. It has been linked to systemic disorders ranging from heart problems to arthritis.
‘I get mad as hell with parents. I get mad as hell with the government because they don’t provide any kind of education or national direction for policy, especially in England,’ says Dr Woodhouse.
Dental problems can lead to systematic health problems and gum disease, a chronic inflammatory disorder
Efforts in Scotland and Wales to tackle poor dental hygiene among children
Scotland and Wales have been leading the way on improving child oral health.
Their early intervention preventive initiatives ChildSmile and Designed2Smile have led to unprecedented improvements in outcomes in these countries in recent years.
Childsmile, which supports supervised tooth-brushing in primary schools and nurseries, and provides twice yearly fluoride varnishes to children, is said to be saving £5m a year in treatment costs.
In England, the Government recently launched an oral health prevention scheme called Starting Well.
But the scheme is currently limited to just 13 local authorities, and is being funded from within existing dental spend.
‘No parent wants to be told that they are doing a bad job for their kid. It’s a really hard conversation to tell them they are letting their child down because they aren’t brushing their teeth. Nobody wants to do that. But it’s the truth.’
Experts are now calling on the government to act, whilst acknowledging the role parents must take if this national health issue is to be tackled.
In England, they are calling for a national strategy for the prevention of tooth decay in children. It would involve education – getting across the message of how vital it is to brush children’s teeth and for them to have a healthy, balanced diet.
‘It’s a great failing by this government, the last government and the previous government before them that none of them have grasped the nettle of tooth decay because it’s a really simple public health issue,’ argues Dr Woodhouse.
‘By throwing a little bit of money at it early doors, it could save them millions because every tooth that we fix and save, we have to keep fixing for the rest of that person’s life.’
He continues: ‘The government have got a responsibility to educate and provide funding prevention schemes. But also it comes from the bottom too.
‘Speaking as a parent, you have the responsibility to look after your children. If they are getting decay, you’re not doing it properly.
‘And this extends to grandparents. As lovely babysitters as they are, they should not be filling your kids up with biscuits and sweets when they go round.’
‘We need a renewed commitment to sugar tax by the government,’ says Mr Garrett.
The sugar levy has seen a 44 per cent drop in the sugar levels in soft drinks since 2015. ‘It’s encouraging. But it’s clear that more needs to be done if we are going to tackle childhood dental disease, decay and obesity,’ he adds.
Dentists have been left frustrated that so much money, around £31.5 million last year, is being spent on the surgical extraction of teeth for youngsters – something that is preventable
‘More needs to be done because no dentist wants to put a child on an operating list to have their teeth taken out.
‘It’s critical we deal with this now rather than wait because we are likely to see an increase in the number of children presenting for general anaesthetic extractions because of the lockdowns and also because of reduced access to dental care.’
A British Dental Association (BDA) spokeswoman said: ‘The BDA is acutely aware that most cases of tooth decay are preventable.
‘It’s terrible that children’s lives can be blighted like this – as they often experience severe pain, sleepless nights and miss days from school. They can also have difficulty socialising and eating.
‘The figures are shocking and reflect oral health inequalities. Scotland and Wales are leading the way as properly funded nationwide efforts are securing record breaking improvements in oral health.
Sadly, prevention requires an investment of time and resources; in England an absence of leadership has left cash-strapped councils paring down a patchwork of provision.
An NHS spokesperson said: ‘The NHS has nearly 25,000 dentists offering care – the highest number on record – and during the first wave of the pandemic over 600 urgent dental centres were set up so patients could access urgent treatment.
‘NHS dental practices remain open for business and dentists are seeing more patients for face-to-face appointments every month.
‘While practices are understandably prioritising urgent care alongside recalling patients to complete outstanding dental care, if a patient is worried about their teeth or oral health, or that of their child, then they should call their dentist.’
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