Government pledges to ‘do much better’ on oral health

Government pledges to ‘do much better’ on oral health

The Green Paper says that the Government needs to do much better on oral health, with tooth decay being the most common reason for hospital admission for children aged 5 to 9 years old – ‘yet it is largely preventable’. They will consult on rolling out a school toothbrushing scheme in more pre-school settings and primary schools in England and explore ways of removing the funding barriers to fluoridating water.

The Green Paper aims to ‘give our children a good start in life’, improving the oral health of children is a Public Health England priority, it says. They will consult on rolling out a school toothbrushing scheme in more pre-school settings and primary schools in England and ‘on proposals that will allow us to reach the most deprived 3 to 5-year-olds in all areas of the country’. The aim would be to reach 30% by 2022.

The Government also says it will explore ways of removing the funding barriers to fluoridating water to encourage more local areas that are interested to come forward with proposals. “NHS England will actively seek partnerships between local authorities and the NHS, with councils rewarded for their fluoridation efforts by receiving a share of the savings from fewer child tooth fillings and extractions,” it says and adds: “This also includes examining the role that water companies can play in supporting fluoridation efforts.”

Case study: Leicester’s Healthy Teeth, Happy Smiles

In 2012, Leicester City Council had the highest prevalence of tooth decay in 5-year olds across local authorities in England: 53%. It responded by prioritising help for preschool children as part of Leicester’s Healthy Teeth, Happy Smiles! programme. This evidence-based programme ensures that good tooth brushing behaviour with a fluoride toothpaste is established early in a child’s life and becomes part of their normal daily routine.

Almost 900 members of staff have been trained to deliver supervised tooth brushing with almost 9,000 children benefiting from daily supervised brushing. By 2017, the prevalence of tooth decay to 39%.

Reaction from the profession

The British Society of Paediatric Dentistry welcomed the Green Paper. Spokesperson Claire Stevens, said: “This Green Paper represents a massive and welcome change in emphasis. It looks at the wider determinants of health and making it easier for people to make healthier choices for themselves and their families. Investing in oral health prevention instead of spending millions of pounds on the management of dental decay is the smart way forward and an approach which we hope the incoming Prime Minister will fully support.

“Tooth brushing schemes are an important intervention which work. Combined with getting children in to see a dentist early – a dental check by one – we are optimistic that the number of general anaesthetics for dental extractions will start to come down.”

In contrast the BDA PEC Chair Mick Armstrong said: “A Green Paper setting out big ideas to finally put prevention into practice now looks more like a fire sale. The tragedy is this document contains numerous tried-and-tested policies, which could save children from pain and our NHS millions in treatment costs. In the rush to avoid the charge of ‘Nanny Statism’ the first casualty cannot be evidence-based policymaking. Health professionals will look to the next government to show leadership, and will not let this process be swept under the carpet.”

Support also came from The National Community Water Fluoridation Network, which welcomed the commitment in the Green Paper that the NHS should work more closely with local authorities to implement water fluoridation schemes. Simon Hearnshaw who is spearheading the network, praised the initiative, saying that if half the money saved on dental treatment was to be shared with local authorities, this would more than cover the recurring costs of water fluoridation.

He added: “Although the cost of water fluoridation is not great it nevertheless represents a financial barrier to local authorities which have so many responsibilities and limited budgets. We will be doing what we can to support councils in the most deprived areas by sharing the wealth of evidence that we have amassed on the safety and efficacy of water fluoridation.”

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