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Children: Oral Health

Volume 776: debated on Monday 31 October 2016


Asked by

My Lords, Public Health England continues to lead a wide-ranging programme to improve children’s oral health. The childhood obesity plan has also introduced two important measures for oral health: a soft drinks industry levy and a sugar reduction programme.

My Lords, I thank the noble Lord for that Answer but oral health is not mentioned in the Government’s childhood obesity plan, even though there is an epidemic of child tooth decay along with hospital admissions for extractions. The state of the nation’s children’s teeth is shocking and a huge cost to the NHS. Common sense says that we need targeted action now. Can the Minister tell the House what is happening with the 10 pilot oral health improvement programmes announced in May and whether the Government will at least consider making oral health part of the daily school regime as a preventive measure?

The noble Baroness is right to say that childhood oral health is very poor, but it is getting better. Some 75% of children no longer have tooth decay compared with 69% in only 2008, but it is still not good enough. The Government’s policy is very much around prevention rather than treatment. The new contract being discussed with dentists will put this work on to more of a capitated basis rather than an activity basis. NHS England has identified 10 areas of deprivation for special treatment and we are looking at a new programme with Public Health England to improve education in this area. Quite a lot is happening.

My Lords, surely the way to prevent this is by introducing fluoride into the water supply and to ignore those people who think it is a bad thing. Does not all the evidence seem to suggest that it would be very good, especially for deprived communities?

My Lords, the evidence for fluoride is incontrovertible: it is good for teeth. There may be other issues attached to fluoride, but in terms of dental health it is unquestionably a good thing. It is interesting to note that in Birmingham, which has been adding fluoride to its water for many years, the incidence of child tooth decay is 29% whereas in Blackburn it is 57% and in Hull, which is considering fluoridation, it is 37.8%. The evidence is very strong, but it is up to local authorities to decide.

My Lords, when I have asked Questions, as I have done repeatedly, mainly for Written Answer, about the difference in health between Birmingham and Manchester, with people in Manchester having the worst teeth in the whole of the UK—that was where the problem was with blocking hospital beds—the answer has always been that the only difference in health pattern is in teeth. I have had that point queried and asked what research the Government have done and whether they can really substantiate that fact. I am very much in favour of fluoridation, but I think that people are confused and want to be clear that there is no other health implication of fluoridation. I respect that view. What action will the Minister take to ensure that thorough, general health tests, as compared with the two arrangements referred to, are undertaken?

My noble friend has slightly confused me, I am afraid. There is no question that fluoride has an impact on oral health. I am not aware of any evidence to suggest that it has other, detrimental impacts on children’s or other people’s health. We have huge inequalities throughout the United Kingdom, most of which are as a result of social deprivation, poor housing, high unemployment and the like. Those are the fundamental drivers of health inequalities, rather than health systems per se.

My Lords, given the harm caused by high levels of sugar added to some processed foods, does the Minister agree that the present restraints on the food industry are woefully inadequate? Does he further agree that much tougher measures need to be taken if the Government are to meet their own public health objectives on oral health, diabetes and obesity?

My Lords, the introduction of the sugar levy is evidence that the Government take this matter extremely seriously and believe that it cannot be left solely to industry to reduce sugar levels. The Treasury is due to report on the extent of the sugar levy on 6 December. As part of the obesity strategy, targets are being set for nine key categories of food eaten predominantly by children. The results of reduction over time will be made transparent and open. A combination of those measures should have an impact.

My Lords, although dental decay can easily be prevented by reducing sugar consumption, regular brushing and adequate exposure to fluoride, it has been shown to be the number one reason why children aged five to nine are admitted to hospital. It is painful, can be dangerous and wastes millions of pounds of NHS resources. When will the Government reverse those statistics and facilitate the fluoridation of all public water supplies?

My Lords, I think that I have already answered my noble friend’s question on fluoridation. On his second point about regular tooth-brushing, Scotland has a scheme called Childsmile, where there is supervised tooth-brushing in primary schools and nurseries, as well as a fluoride varnish twice a year. We can learn something from Scotland in that regard. It is expensive, but Public Health England is nevertheless looking at it and we may adopt it in our country soon.

My Lords, do the nine categories of food to which the Minister referred also include baby foods, which are packed with sugar? I declare an interest, having a granddaughter, Imaan, who has allowed me to taste the enormous amount of harmful sugar contained even in organic baby food. Will the Minister consider adding baby food to his basket list of things to look at?

My Lords, I cannot recall whether baby food is one of those nine categories that have been identified in the obesity strategy, but I will look into that and write to the noble Baroness.