Editorial - Investment in prevention...please!



The profession has welcomed the news that the government is to introduce a sugar levy on the soft drinks industry. From 2018 the tax will be based on the volume of sugar, with two bands: those with 5g per 100ml and those with more than 8g per 100ml - pure fruit juices and small businesses will be excluded.

Although we are all too aware of the statistics, communicating to the nation, and the policy makers,the shocking facts that one-third of five year olds and almost half of eight year olds has decay in their milk teeth, with similar figures for the permanent teeth of 12 and 15 year olds, has been difficult.

For too many of these young children the end point in this disease process is a general anaesthetic, with the associated risks involved and the likelihood of further costly dental treatment in the future.Frustratingly, the Chancellor discussed this new sugar tax in relation to impacting on type 11diabetes and obesity and the current cost of dealing with these on the overstretched budgets of the NHS, with no mention of dental disease. One can only ponder as to why they refuse to take this entirely preventable dental epidemic seriously.

Overall we know there is a socio-economic factor at play in the incidence of caries and those children most in need are least likely to be able to access dental treatment. However, caries does not really discriminate and there are always exceptions, as illustrated by a mother, who also happens to be a GMP, on BBC Breakfast last week, discussing her shock at finding decay in the teeth of her seven year old son.

There are some fantastic oral health initiatives proving just what can be done to improve the oral health of children. In Scotland, the Childsmile programme offers every child attending nursery free daily supervised brushing, extending to primary schools in the most deprived areas. The children are also provided with free brushes and toothpaste and two fluoride applications a year. Parents and carers are given dietary advice for those children in their care. All of this has resulted in fewer restorations and extractions. For the policy makers this must be good news - in language they understand, it has reduced the cost of dental treatment by £5 million a year.

Based on the Scottish model, we have the Designed to Smile initiative in Wales. Although the data has not yet been published early results are similarly encouraging suggesting marked reductions in caries experience of young children.Can Westminster learn something from these devolved governments when it comes to the nation’s oral health? Why is there not a similar programme in England? What is happeningin Northern Ireland? Investing in these type of programmes not only works but saves a huge amount of money that could be used where it is needed most.

A year ago BSDHT launched First Smiles, a nationwide health education programme targeting all young children in key stages one and two. To date, the feedback from the teachers and children, and those members who were involved, has all been positive. Next month we will do it all again and, with help from our industry partners, aim to reach more schools and more children this year.

Like BSDHT members, the wider dental profession has thousands of similarly committed and passionate individuals and teams that strive to make a real difference to their local communities. The current health education and health promotion initiatives are evidence that we care.

Why then will the government not work with us to ensure that primary preventive care is adequately resourced and delivered? Why is prevention of dental disease not at the heart of the new contract? If you can answer that one, please let us know.

Heather Lewis

Editor, Dental Health


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