Chris Moffatt looks behind the headlines to see if the UK’s oral health is really that bad.
With the introduction of the sugar tax and calls for tighter control on junk food advertising, health awareness is a hot topic. But newspapers and websites, such as www.telegraph.co.uk, regularly feature horror stories about our ‘oral health crisis’ with ‘170 youngsters a day [having] teeth extracted’ due to excessive sugars in their diet. So we thought we’d sort the facts from the fake news and take a look at the data on UK oral health – are things getting better, or worse? And what does this mean for dentistry?
Adult oral health
There’s no doubt that adult oral health has improved in recent decades. The NHS Adult Dental Health Survey shows a clear decrease in edentate patients across all age groups. The percentage of adults reporting dental health problems at the time of the survey dropped from 51% in 1998 to 39% in 2009 (NHS, 2014).
The number of patients seeing their dentist regularly has increased since 2008.
According to Karen Coates on treated.com (2016), oral health adviser for the BDHF, other key reasons for improvement are: ‘improved education of dental decay and gum disease, better diets, fluoride toothpaste… and a greater emphasis on oral hygiene’.
Children’s dental health
Talk of the sugar tax tends to focus on children’s teeth, but children’s dental health has also been improving over time. The proportion of five-year-olds with missing, filled or decayed teeth has decreased from over 70% in 1973 to under 30% in 2012 (PHE, 2016). Levels of tooth decay for UK children are among the lowest in the developed world; on average, our 12-year-olds have half the number of decayed, missing or filled teeth of US children (OECD, 2009).
While the national statistics all seem to be going in the right direction, there are big variations within this. Children in the north west are significantly more likely to experience tooth decay than those in the south east (PHE, 2016). Social deprivation is closely correlated with the rate of decay (PHE, 2016). Vulnerable populations such as the disabled and elderly require special attention.
Many people still believe that losing your teeth is something that occurs naturally with age, but that’s not the case. Hidden sugars in our food are considered the major contributory factor in decay (treated.com, 2016). Stopping smoking brings a wealth of benefits; among them is that tobacco is a major factor in 90% of cases of mouth cancer (PHE, 2014). Alcohol consumption can is also a contributory factor. Dentists are ideally placed to provide prevention and promotion messages to patients, such as healthy eating advice, information on sensible alcohol use, or smoking cessation advice.
The outlook for both Britain’s dentists and Britain’s teeth looks good. Our oral health is improving, and this is partly due to increasing practice attendance. With improving health there may be decreased need for some treatments in future, however interest in aesthetic treatments is increasing (www.hexaresearch.com, 2017) and patient satisfaction is also improving (NHS, 2017). Opportunities for health education allow the dentist to offer a more holistic patient service and add value to the experience.
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NHS (2014) Improving Dental Care and Oral Health – a call to action evidence resource pack
NHS (2017) Summary of the Dental Results from the GP Patient Survey – January to March 2017
OECD (2009) Health at a glance 2009
PHE (2014) Smokefree and Smiling: Helping dental patients to quit tobacco
PHE (2016) National Dental Epidemiology Programme for England: oral health survey of five-year-old children 2015
www.hexaresearch.com/press-release/global-teeth-whitening-products-market (2017) accessed 23/08/18
www.telegraph.co.uk/news/2018/01/13/uk-oral-health-crisis-170-youngsters-day-have-teeth-extractedas (2018) accessed 23/08/18
www.treated.com/blog/uk-oral-health-1968-2016-are-we-getting-better-at-caring-for-our-teeth (2016) accessed 23/08/18