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Stop the rot! Why thousands of British children are having their teeth taken out in hospital

Dental experts and senior practitioners are calling on the Government to tackle the alarming level of tooth-loss among the very young

Sanchez Manning
Sunday 10 March 2013 01:00 GMT
Young patient: Imogen Whitaker had nine teeth out in hospital
Young patient: Imogen Whitaker had nine teeth out in hospital (Lorne Campbell)

Imogen Whitaker was just five years old when she went to hospital last August and had nine of her teeth extracted. Her mother, Julie, said she only discovered her young daughter had serious tooth decay when she noticed a small hole in one of her front teeth. It was then that she took Imogen for her very first visit to the dentist and was told that her daughter, now six, would have to be referred to hospital.

At Leeds Dental Hospital, Julie was told her daughter might need to have all of her teeth taken out due to decay. So she was actually relieved when a more senior dentist informed the mother-of-five that he would have to extract nine teeth but could save the rest.

This would be shocking enough were Imogen an isolated case, but every year thousands of children in Britain are having large numbers of teeth removed in hospital under general anaesthetic, according to a leading dental expert.

Kathryn Harley, dean of the faculty of dentistry at the Royal College of Surgeons, said she sees children at the Edinburgh hospital where she practises who need 16 or even more teeth removed due to decay. Latest NHS data shows that dental problems are now the fourth most common reason young people under 17 are admitted to hospital. According to other recent statistics, around 33 per cent of 12-year-olds have some kind of cavity.

Research published by the Office for National Statistics shows that 14 per cent of eight-year-olds have signs of decay in permanent teeth, with one in 100 losing a tooth to decay.

Meanwhile, a study by the consumer group Which? concluded in 2009 that British children could be consuming as much as 12 teaspoons of sugar through the items packed in their lunch boxes.

And the National Diet and Nutrition Survey showed that children aged four to 10 years old get about a fifth of their sugar from soft and fizzy drinks, with the figure rising to one third for 11 to 18-year-olds.

Experts called last night for the Government to launch a campaign to raise awareness about the dangers to children's oral health on the same scale as anti-smoking campaigns.

Kathryn Harley, a consultant paediatric dentist, said: "The first time a child sees the dentist might be at age six, seven or eight instead of 18 months or two years old.

"One of the problems is that children are referred to people like me not when they have a few tiny holes that I could manage with ease in the dental chair, but when dental disease is advanced and they require multiple extractions.

"Very small children aren't able to have multiple procedures in the chair; those children are managed by being put to sleep. Someone like me will always try not to put a child to sleep who requires, say, one tooth out. We are talking here about children needing four, eight, 12 or even 16 teeth [extracted]."

Dr Harley said she was concerned at the number of children who have to have so many teeth taken out when tooth decay can be prevented: "The patterns of disease that we're seeing are similar to what we were seeing in the hospital 10 or 20 years ago."

Paul Batchelor, an expert in dental public health and senior lecturer at University College London (UCL), added: "You're talking about thousands of children a year having teeth taken out under a general anaesthetic. It's appalling in the sense that it's an entirely preventable disease."

Tooth decay in children is caused by a range of factors including diet and a failure to brush properly. However, one of the major issues is the popularity of fizzy drinks and sugary, acidic fruit juices.

Dr Harley said that tooth wear is a common consequence of drinking acidic beverages, and has become a particular problem with many parents giving their children fruit juices as part of their five-a-day intake: "We still have a population who don't drink water as the natural thing that they pick up when they're thirsty.

"There are an awful lot of children still consuming squashes, diluted juices or pure juice in some shape or form such that they're continuing to do damage to their teeth."

Before her daughter's dental treatment Julie, 39, from Dewsbury, West Yorkshire, said Imogen often ate sweets and she preferred the soft drink Fanta to milk or water. She was also allowed to brush her own teeth or her grandmother would sometimes clean them. But after her extractions Imogen no longer brushes her teeth herself and only eats sweets as a treat, as well as cutting out the sugary fizzy drinks.

Professor Damien Walmsley, who is scientific adviser to the British Dental Association, said the issue had a social dimension too: "We know that a striking and persistent correlation exists between those children with the best and worst oral health and their social backgrounds. Tackling these inequalities and breaking the link between social deprivation and poor oral health is a significant challenge, but it is one that must be taken on.

"Dentists working in Britain's poorest communities are working with fundamental problems such as children not being taken to see a dentist, not being provided with toothbrushes and fluoride toothpaste and being fed irregular diets heavy with sugary and acidic food and drink. The result is that some children are being referred to hospitals for multiple extractions before they are even 10 years old."

Barry Cockcroft, the Chief Dental Officer for England, said: "Children in England generally have very good oral health and around 70 per cent are completely free of decay. However we know that decay rates are higher in deprived areas and that's why we are focusing on a more preventative approach to dental care."

Top tips for a big smile

Here are five tips for looking after your children's teeth from Kathryn Harley, dean of the faculty of dentistry at the Royal College of Surgeons

* Parents should brush their children's teeth twice a day; children are not able to brush on their own, until they have the manual dexterity to write their name, or at age seven.

* Children should start going to the dentist from 18 months.

* Children should only be given fizzy drinks and juice as a treat at the weekends.

* Stick to milk and water during the week.

* Restrict sweets to mealtimes only.

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