The pediatric tooth decay crisis continues in England, as the British Dental Association (BDA) reports 179,218 extracted teeth from children age 9 years and younger in dental practices across the nation in 2014 and 2015. The BDA also says that the £14 million (or $23.3 million) the National Health Service (NHS) spent on these procedures would have been better used to fund a nationwide prevention program.
“Why are we carrying out extractions when we should be saving pain and money by aiming to keep healthy teeth in healthy mouths?” asked Henrik Overgaard-Nielsen, chair of the BDA’s General Dental Practice Committee.
The Childsmile program in Scotland and the Designed to Smile program in Wales both focus on raising parental awareness of the importance of tooth brushing and oral health in general. According to the BDA, they have reduced the need for fillings and extractions in children, as dental disease disproportionally affects the most disadvantaged in society.
“This new figure reflecting dental extractions in primary care reinforces the vital work of dentists in treating young children suffering from dental decay,” said Claire Stevens, spokeswoman for the British Society of Pediatric Dentistry.
“We support the call for more money to be invested in prevention. With excellent programs of prevention in Scotland and Wales, we don’t have to look too far to find potential templates for an English scheme,” Stevens said.
In Scotland, every child gets a dental pack with a toothbrush and a tube of toothpaste with at least 1000-ppm fluoride on at least 6 occasions before the age of 5 years. Also, children get a free-flow feeder cup before their first birthday. Children who are 3 and 4 years old in nursery school get free, daily supervised toothbrushing as well.
In Wales, health visitors and other professionals who work with children are taking part in pilot preventive programs for children up to the age of 3 years. From 3 to 5 years, children in nursery school participate in toothbrushing and fluoride varnish programs. And, children ages 6 to 11 years get fissure sealants and preventive advice.
The percentage of children who don’t have any obvious tooth decay in Scotland has increased from 54.1% in 2005 and 2006 to 68.2% in 2013 and 2014, reports the Scottish government. Meanwhile, the Welsh government and Cardiff University reported a 6% drop in the number of 5-year-olds who had tooth decay from 2014 to 2015.
England has made some recent improvements as well. A Public Health England survey reported that fewer than 25% of 5-year-olds now suffer from tooth decay, compared to 27% in 2012 and 31% in 2008, with a 9% increase in the number of children with no obvious decay since 2008. But the number of extractions still concerns the BDA.
“We already know that tooth decay is the number one reason why children are admitted to hospitals, costing the NHS around £35 million (or $50.7 million) a year,” Overgaard-Nielsen said. “However, a less well known factor until the BDA’s disclosure today is that the vast majority of rotten teeth are removed in dental practices around the country.”
The BDA obtained the total number of extractions in response to a freedom of information request made to the NHS Business Services Authority, which professes payments for treatments carried out by general practitioners. Also, the Department of Health has announced 10 pilot prevention programs in England, though the BDA is concerned about the lack of dedicated funding for them.