Dr Sejal Bhansali is Chairman of Conservative Dentists. She is a qualified general dentist from Kings College London.
Our eyes might be the window into the soul, but our teeth provide an accurate view of our day-to-day life. Teeth can be rotten, wise or broken; they reveal our diet, health, wealth and life chances.
Oral health, sadly, does not grab the headlines in the same way as obesity. However, it has a significant impact on our general health. The link between heart disease, diabetes and pregnancy-related complications and oral health is well understood after close study.
Decayed teeth have the potential to cause pain, infection, and swelling. Tooth decay is 90 per cent preventable by reducing sugar intake, regular brushing, frequent exposure to fluoride and routine visits to the dentist. Dental treatment is a significant cost to the NHS, with spending in England amounting to £3.4 billion, whilst an additional £2.3 billion is spent on private dental care. The NHS spends £50 million on tooth extractions for children, the majority of which are due to tooth decay.
Dental decay is still the main reason why children under the age of five are admitted to hospital for procedures under General Anaesthetic. Public Health England have reported that 25 per cent of all five-year-olds in England experience tooth decay in at least three or four of their teeth. In some parts of the country it can affect as many as 50 per cent of all five-year-olds. Yet 42 per cent of children did not visit an NHS dentist in the year ending 31 March 2017, even though such check-ups are free.
Tooth decay can have a broader impact on health and wellbeing, affecting both physical and mental health as well as impacting a child’s development and confidence. Poor oral health can cause problems with eating and sleeping, resulting in time away from school. Tooth decay can impact a child’s self-confidence. In October 2017, a Children’s Oral Health debate in Westminster Hall heard that in a recent survey more than a third of 12-year-olds said that they are embarrassed to smile or laugh because of the condition of their teeth, which can often make it harder for them to socialise.
The Sugar Tax was introduced to mixed reactions, with some bemoaning the further extension of the ‘nanny state’. The results, however, speak for themselves. Since the introduction of the current levy, Treasury estimates, based on market data, suggest that 50 per cent of manufacturers have reduced the sugar content of their drinks. Evidence from Mexico, who have operated a similar tax since 2014, showed that after the first full year of introduction Mexicans were consuming 12 per cent fewer sugary beverages than in the year leading up to the tax’s introduction.
The true impact of the tax will not be seen for several years, however. It is also clear that this cannot be the only weapon in our armoury. Improved education is critical, but who do you educate and how? A recent Australian study has suggested that putting photos of rotten teeth on sugary drinks, like the visual health warnings placed on cigarette packs, could have an impact. Which came first, the chicken or the egg?
I passionately believe that we should educate children and their parents or guardians from an early age, and that Government, both local and national, is missing an opportunity. Analysis by Public Health England has suggested that if oral or public health professionals are involved in supporting oral health improvement programmes, that can lead to significant improvements and long-term savings.
A visit to the dentist can be a scary for anyone, especially children who can be influenced by their already dental-phobic parents. Relying on parents to take their children to visit a dentist is not enough. At present, there is a gap in the Early Years curriculum in stressing the importance of oral health to general health and happiness. In addition, there is little to no readily available information in digital or video form for parents and children on oral health, how to brush your teeth and the best diet.
The challenge of education is made worse by the limited interaction between oral and public health professionals and educators. Dentists and associated professionals may send their children to nurseries and schools but are they encouraged or incentivised to offer their services to educate?
The Government has a golden opportunity to improve oral health and so leave a legacy of children with strong and healthy teeth as well as seeking an alternative approach to fight against obesity. This opportunity can be met by embracing the digital age and encouraging joint working across Government, education and health care.