Innovative policies needed to encourage more children to visit the dentist
The Scientific Advisory Committee on Nutrition (SACN) has today published its final report setting out advice to the English Government on carbohydrates and health. The Faculty of General Dental Practice (UK) very much welcomes the SACN recommendation that dietary sugar levels should be reduced to no more than 5% of total energy intake[i].
Mick Horton, Dean of the FGDP(UK), says “The impact of sugar on tooth decay remains a major health concern in the UK. It is without doubt that a reduction in sugar intake to the level proposed by the SACN would have a major impact on reducing the development of dental caries in the population. We now call on the Government to work with Public Health England and other stakeholders to develop a robust and effective strategy to help support this goal”.
“The profession, through general dental practice, delivers approximately 90% of dentistry carried out in the UK. Working with other key organisations, general dental practice is best placed to deliver the necessary advice to encourage both parents and children to better understand how to look after their teeth, whilst receiving their dental assessment which is essential for both their oral and overall health. “
Tooth decay, the softening and eventual loss of tooth enamel resulting in cavities, is caused by acid, produced when sugar and oral bacteria combine. A systematic review of studies over a 60-year period, undertaken on behalf of the World Health Organization and published 2014[ii], supported the link between the level of sugar consumed and the development of dental cavities. It concluded that the risk of tooth decay is lower when sugar intake is less than 10% of calorie intake, compared with more than 10%.
Whilst the oral health of the adult population has seen some improvement over the last 40 Years[iii], the trend in hospital admissions for extractions in children remains a serious concern[iv]. Also of great concern is the variation in the incidence of dental caries leading to hospital admissions dependent on area[v]. The FGDP(UK) believes that there is an urgent need for innovative approaches to encourage preschool and school-aged children to attend for dental check-ups, particularly in areas of social deprivation or where attendance figures are poor.
The most effective way to avoid the need for extractions and hospital admissions is through prevention and the early development of good oral health. A major weakness in the report is the lack of dietary recommendations for individuals aged below four and this must be addressed. Determinants of dental disease start at birth; the current high sugar diet simply predispose a child to problems even before teeth erupt, with the risk that such a diet becomes the norm. Recommendations need to be developed that allow parents of new born children, indeed even parents who are expecting a child, to make the best dietary choices.
The FGDP(UK) urges Government to work with schools and the dental profession to include dental advice and prompts as part of existing child health check programmes. We also call on the Government to support health visitors in providing information about dental caries and sugar consumption so that good dental care habits can begin from birth.
[i] Scientific Advisory Committee on Nutrition (SACN): Carbohydrates and Health. Published 17 July 2015
[ii] Moynihan PJ and Kelly SAM. Effect on caries of restricting sugars intake: Systematic review to inform WHO guidelines. J Dent Res. 2014
[iii] NHS England: Improving Dental Health and Oral Care – A Call to action. Published February 2014
[iv] Royal College of Surgeons of England Faculty of Dental Surgery: Actions for the Government to Improve Oral Health. Published July 2015
[v] Royal College of Surgeons of England Faculty of Dental Surgery: Actions for the Government to Improve Oral Health. Published July 2015