Every 10 minutes a child in England has a rotten tooth removed in hospital

Tooth decay is preventable but remains the most common reason for hospital admissions for children aged 5-9 years.

As the government’s Soft Drinks Industry Levy comes into effect, PHE’s Change4Life campaign is encouraging parents to swap sugary drinks for healthier alternatives to protect their children’s teeth.

A child in England has a tooth removed in hospital every 10 minutes due to preventable tooth decay, according to data published by Public Health England (PHE) today.

With the government’s Soft Drinks Industry Levy coming into effect today, PHE’s Change4Life campaign is reminding parents that sugary drinks – including juice drinks, energy drinks, cola and other fizzy drinks – are one of the main sources of sugar in children’s diets.

Consuming too much sugar is one of the leading causes of tooth decay and childhood obesity. Tooth decay can be prevented by cutting down on sugar as well as brushing twice a day with fluoride toothpaste.

Tooth extraction remains the most common reason for hospital admissions in 5 to 9 year olds. Figures show around 141 children a day – some just a year old – are having teeth removed. This means around 60,000 days are missed from school during the year, as well as causing problems with eating, sleeping and even smiling.

PHE’s Change4Life campaign is encouraging parents to:

1.Swap sugary drinks for lower or no sugar alternatives, including water and lower fat milks. The Change4Life website has plenty of easy drink swaps and helpful tips for families.

2.Limit fruit juice and smoothies to a total of 150ml per day and only consume with meals – they count as a maximum of one portion of our 5 A Day.

3.Ensure children brush twice a day with fluoride toothpaste (once before bedtime and once during the day) and remind them to ‘spit not rinse’, as rinsing washes away the protective fluoride. Brushing should start as soon as the first tooth appears and children should be supervised up to the age of seven.

Taking these steps can lead to fewer days off school and fewer trips to the dentist, although children should go as often as their dentist recommends.

Dr Sandra White, Dental Lead for Public Health England, said:

“It’s upsetting to see so many children admitted to hospital with tooth decay, but swapping out sugary drinks could be an easy win for busy families.

“Parents can also help prevent decay by making sure their children’s teeth are brushed twice a day with fluoride toothpaste and reducing how much sugar they’re eating and drinking.”

Parents can visit the Change4Life website for helpful swaps and tips, and download the new Change4Life Food Scanner app to see the sugar, fat, salt and calories in popular foods and drinks.

Sugar reveals:

A can of energy drink contains on average 13 cubes of sugar (based on a 500ml can).

A can of cola contains on average 9 cubes of sugar (based on a 330ml can).

A juice drink with added sugar contains on average 5 cubes of sugar (based on 200ml juice drink pouch).

Soft drinks and fruit juice combined provide a third of free sugars intake in the 11-18 year age group. Soft drinks alone provide over a fifth of intake in this age group, the highest single contributor. In younger children (1.5-3 years and 4-10 years), soft drinks and fruit juice combined provide over a fifth of free sugars intake, with a higher proportion from fruit juice. Soft drinks and fruit juice are among the top contributors to free sugar intake in these age groups. Taken from NDNS years 7 & 8 combined: https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined

Children aged 4-6 should have no more than 5 cubes of sugar (19 grams of sugar) per day, children aged 7-10 should have no more than 6 cubes of sugar (24 grams) per day and 11+ should have no more than 7 cubes of sugar (30 grams) per day.

Notes to editors

Claire Stevens, President of the British Society for Paediatric Dentistry and a Consultant in Paediatric Dentistry, said: "Tooth decay causes pain and discomfort for young children. In some cases, the decay is so serious that children need most or all of their teeth removed in one go - it's heart-breaking when this can be prevented through small changes such as cutting down on sugary drinks and introducing brushing twice daily with a fluoride toothpaste."

  1. PHE exists to protect and improve the nation's health and wellbeing, and reduce health inequalities. It does this through advocacy, partnerships, world-class science, knowledge and intelligence, and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. For more information on PHE visit www.gov.uk/phe or follow us on Twitter @PHE_uk
  2. Change4Life has created a useful infographic showing some simple drink swaps parents can make to help prevent tooth decay – this is part of our new ‘Lower sugar drinks for kids’ page on the Change4Life website. You can find helpful tips and drinks swaps here: https://www.nhs.uk/change4life/food-facts/healthier-snacks-for-kids/lower-sugar-drinks-for-kids-stop-tooth-decay
  3. Data on tooth extractions is taken from PHE’s Hospital Extraction Episodes and is published here: http://www.nwph.net/dentalhealth/
  4. For maximum protection from decay all children should use a family toothpaste with 1350 to 1500ppm fluoride. Children aged 0-3 should use a smear of toothpaste and children aged 3-6 should use a pea sized amount. The amount of fluoride in the toothpaste can be found on the side of the tube or on the packaging.
  5. PHE’s return on investment tool can help local authorities (LAs) make the case to invest in programmes which will reduce local levels of child tooth decay. The tool predicts the local impact of introducing effective schemes like supervised brushing, fluoride varnish and fluoridation. With tooth decay costing the NHS £3.4 billion each year, it also calculates the financial savings and estimates how many days off school - and days off work for parents - could be saved locally.
  6. While providing expert advice to LAs (who have the lead responsibility for oral health improvement) and dental teams across England, PHE also leads the Child Oral Health Improvement Programme Board (COHIPB). Poor oral health often affects children in the most deprived areas and COHIPB involves over 20 organisational partners from health and social care, education, the voluntary sector and government departments to help close the inequalities gap.
  7. COHIPB works jointly to achieve the ambition that every child grows up free from tooth decay and to ensure that every family in England receives consistent evidence based oral health advice and support
  8. In January 2018, C4L launched a toolkit for dental teams in England, with top tips for teeth for families and young children. Dental teams can order toolkit here: http://po.st/TTFT
  9. Tackling tooth decay and obesity requires wider action and is not just limited to parent’s individual action. PHE is working with the food industry to cut 20% of sugar from the products children consume most by 2020 – this includes milk based drinks and fruit based drinks which are outside the scope of the Soft Drinks Industry Levy



Editors Notes




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The British Society of Dental Hygiene and Therapy (BSDHT) is a nationally recognised body that represents over 4,000 Dental Hygienists and Dental Therapists across the UK and beyond.

BSDHT maintain an on-going dialogue with the General Dental Council (GDC), the Departments of Health and all of the main groups representing dental care professionals, and attends meetings of the All Party Parliamentary Group (APPG) for Dentistry, bringing dental hygiene and therapy to the attention of government ministers and MP’s.

Visit www.bsdht.org.uk for more information.

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