Children’s oral health has been “neglected to the point of rot”, the Government says.
Dentistry minister Stephen Kinnock has addressed the oral health crisis blighting the nation’s children as new data shows almost a quarter of five-year-olds have tooth decay. A damning report has concluded that efforts to improve kids’ teeth in poorer areas have failed since 2015.
Each five-year-old with decay has on average three and a half rotting teeth. Dentinal decay rates in four regions have got worse with London going from 25.8% to 27.4%, Yorkshire and the Humber rising from 27% to 27.5%, the South West going from 19.1% to 19.7% and the North East going from 22.2% to 22.6%.
Writing in the Mirror, Mr Kinnock said: “For years, NHS dentistry has been neglected to the point of rot, with too many patients unable to get an appointment and a lack of clear prevention strategy letting down our young children. It is shocking, but sadly unsurprising, that further data published today shows almost a quarter of five-year-olds in England have suffered painful tooth decay. And poor oral health affects whole families. It impacts a child’s ability to eat, smile, play and causes pain and infection, with days missed from school. Parents meanwhile are forced to miss work to take them to the dentist – if they can even find one.
“It is truly Dickensian that the most common reason children aged five to nine are admitted to hospital is to have their decayed teeth extracted. This shames our country, and illustrates the crisis in children’s oral health. We can, and we must, do better.”
The Office for Health Improvement and Disparities releases a report on the state of children’s oral health every two years and this latest one covers the 2023/24 year up to the General Election. It stated: “The cause of dental decay is well understood and is related to eating and drinking sugary food and drinks. Hence the majority of dental decay is preventable.”
Overall there was a slight decrease in the prevalence of dentinal decay from 23.7% to 22.4% but the report suggests decades of progress has stalled. Tooth decay in five-year-olds had fallen from 30.9% in 2008 to 23.3% in 2017 but it has remained around that level since.
Last year children living in the most deprived areas of the country were more than twice as likely to have experienced dentinal decay with 32.2% having rotting teeth compared to 13.6% in the wealthiest areas. The report continued: “Inequalities in prevalence of experience of dentinal decay in five year old schoolchildren significantly reduced from 2008 to 2015 but there has been little change in inequalities since then.”
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Everyone should have access to an NHS dentist
More than 12 million people were unable to access NHS dental care last year – more than 1 in 4 adults in England. At the same time 90% of dental practices are no longer accepting new NHS adult patients. Data from the House of Commons Library showed 40% of children didn’t have their recommended annual check-up last year.
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The UK spends the smallest proportion of its heath budget on dental care of any European nation. Government spending on dental services in England was cut by a quarter in real terms between 2010 and 2020. The number of NHS dentists is down by more than 500 to 24,151 since the pandemic.
Change the contracts
A Parliamentary report by the Health Select Committee has branded the current NHS dentists’ contracts as “not fit for purpose” and described the state of the service as “unacceptable in the 21st century”. The system effectively sets quotas on the maximum number of NHS patients a dentist can see as it caps the number of procedures they can perform each year. Dentists also get paid the same for delivering three or 20 fillings, often leaving them out of pocket. The system should be changed so it enables dentists to treat on the basis of patient need.
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Mr Kinnock confirmed plans to scrap the Tories “New Payment Premium” which a parliamentary report showed had made the situation worse. The Tories announced a bonus rate for dentists of £50 per treatment for a new patient compared to £28 for existing patients. However they provided no additional funding for the plan so the payment came from dentists’ existing NHS contract value. This meant it was possible some practices could receive the same amount in state funding while seeing fewer patients overall.
Mr Kinnock said: “We will scrap the previous government’s wasteful and totally ineffective New Patient Premium and instead we will deliver an extra 700,000 urgent and emergency dental appointments, for those most in need. And we will reform the dental contract to make NHS work more appealing to dentists and get patients better access to care. We will not stand by as children and patients continue to suffer. We will get NHS dentistry back on its feet and fit for the future once again.”
Tooth extractions are the most common reason for hospital admission for five-to nine-year-olds. He added: “We will not stand by as children and patients continue to suffer; we must get this right. We will get dentistry back on its feet once again.”
The Mirror launched the Dentists for All campaign with the British Dental Association (BDA) to demand a return to universal access to an NHS dentist. The overall NHS dentistry budget for England has remained at around £3 billion for a decade but has seen a £1 billion real terms cut over this period due to inflation. It has become increasingly made up of the contribution from patient charges which have gone up by 45% in the last decade.
Dentists’ current payment contract effectively sets quotas on the maximum number of NHS patients they can see as it caps the number of procedures they can perform each year. Dentists get paid the same for delivering three or 20 fillings, often leaving them out of pocket.
Eddie Crouch, chair of the British Dental Association, said: “This oral health gap was made in Westminster, with children paying the price for official failure to take dentistry seriously. A new government calls this ‘Dickensian’, but it will take deeds not words to turn this around.”
The BDA says there has been “no progress” to date on a key Labour pledge to introduce supervised toothbrushing at schools. It also suspects there will be no additional funding for extra 700,000 urgent dental appointments amid fears they will be funded from the existing budget which has been shrunk over a decade.
Liberal Democrat Health spokesperson Helen Morgan MP said: “The Labour government’s promised 700,000 additional dental appointments have so far proven as real as the Loch Ness monster. To see your child in pain is one of the worst feelings a parent can go through. But to think that so much of this suffering could be prevented if the scourge of dental deserts was ended makes it all the more infuriating that we are still in this situation.”
Stephen Kinnock MP, Minister of State for Care
“For years, NHS dentistry has been neglected to the point of rot, with too many patients unable to get an appointment and a lack of clear prevention strategy letting down our young children. We’re bringing forward fundamental changes that can get the sector back on its feet, but the problems in front of us are increasingly evident, as shown by the data published today.
“Poorly-planned interventions have been all too common, with few more dire than the New Patient Premium (NPP) – extra cash payments offered to dentists willing to take on new patients. Data published today continues to show that, despite millions of pounds being paid out to practices who signed up to the NPP scheme, fewer new patients have received appointments than before it was introduced.
“The failure to address the issues facing dentistry in England is a failure for all patients, but especially the most vulnerable. It is shocking, but sadly unsurprising, that further data published today shows almost a quarter of 5-year-olds in England have suffered painful tooth decay.
“Children living in the most deprived areas of the country are more than twice as likely to have experienced tooth decay as those living in the least deprived areas. And poor oral health affects whole families. It impacts a child’s ability to eat, smile, play and causes pain and infection, with days missed from school. Parents meanwhile are forced to miss work to take them to the dentist – if they can even find one.
“It is truly Dickensian that the most common reason children aged five to nine are admitted to hospital is to have their decayed teeth extracted. This shames our country, and illustrates the crisis in children’s oral health. We can, and we must, do better.
“This government is acting to turn NHS dentistry around, and make it fit for the future. We’re addressing the crisis in children’s oral health. We will deliver a national supervised toothbrushing programme, targeted at 3, 4 and 5 year olds living in the most disadvantaged areas in England.
“Prevention is better than cure – we will help kids stay healthy and out of hospital. We will scrap the previous government’s wasteful and totally ineffective New Patient Premium and instead we will deliver an extra 700,000 urgent and emergency dental appointments, for those most in need.
“And we will reform the dental contract to make NHS work more appealing to dentists and get patients better access to care. We will not stand by as children and patients continue to suffer. We will get NHS dentistry back on its feet and fit for the future once again.”