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Dentistry: Children

Volume 795: debated on Tuesday 15 January 2019


Asked by

To ask Her Majesty’s Government what steps they are taking to reduce dental decay and gum disease in children.

My Lords, improving oral health outcomes, particularly for deprived children, is a Public Health England priority. PHE has established the Child Oral Health Improvement Programme Board to improve the oral health of children, with a substantial programme of work involving a wide range of partners. In addition, as the noble Lord will know, government measures to reduce sugar consumption, along with the soft drinks industry levy, will have a positive effect.

I thank the Minister. I was surprised and disappointed that when I asked her a Written Question about how many registered dental practices we have, she replied that the Government do not have the information available.

I want to talk about units of dental activity. The Minister will know, I hope, that if a child needs dental treatment but no NHS dentist is available, they can go to a private dentist under contract where there are units of dental activity. However, when those units are used up and there is no dental treatment available at all, the child goes untreated. Yet there might be other dentists who have spare capacity—spare units of dental activity. Why can the units not be transferred to the dentist who needs them to treat children? It is outrageous that 45,000 young people are going to hospital to have operations to deal with dental decay.

My Lords, I agree that it is outrageous that 45,000 children are requiring operations due to tooth decay but, as the noble Lord will know, tooth decay is a preventable disease. Access to dental services for children remains high. Although NHS England recognises that it has further to go in some hotspot areas, 6.9 million children were seen by a dentist in the 12-month period ending 30 September. NHS England has a legal duty to commission primary care NHS dental services to meet local needs and to help patients who cannot find a local dentist who is taking on new patients. Patients in this situation can contact NHS England’s customer contact centre for assistance.

My Lords, it is to be welcomed that the 10-year plan includes a commitment to seeing more children from a young age form good oral health habits to prevent tooth decay. It is, however, in conflict with the cuts to our public health budget. Does that commitment in the 10-year plan mean that the Government will be investing in children’s oral health and, if so, how much are they going to invest and when will that commence? If the noble Baroness does not have those figures to hand, I would be grateful if she would write and tell me what they are.

My Lords, I do not have those figures to hand, but will write to the noble Baroness with them. Under the NHS Long Term Plan, NHS England will invest to ensure that children with learning disabilities have their needs met by dental services and will work with partners to bring dental checks to children and young people with a learning disability, autism or both in special residential schools. That is part of the 10-year plan, but I do not have the figures that the noble Baroness requested and I will write to her with them.

My Lords, the leading reason for children aged between five and nine now going into hospital is to have teeth extracted, which I think we must all agree is quite shocking. There are many points on which I could ask a question, but I shall ask just one. Can the Minister update us on the implementation of phase 2 of the obesity plan, which will limit advertisements for sugary drinks or sweets, and on the limit on supermarkets using such products as promotions for selling cheaper food? At the end of the day, tooth decay is caused by sugar, and that is the problem.

The noble Baroness is absolutely right: sugar is a leading cause of tooth decay and we must do more to tackle it. Indeed, the Government are doing that. We published the second chapter of our world-leading childhood obesity plan in 2018. This builds on the real progress that we have made since publication of chapter 1 in 2016. The key measures in chapter 2 include restricting promotion deals on sugary and fatty products, introducing further advertising restrictions, mandating calorie labelling in restaurants and ending the sale to children of energy drinks which may be high in sugar.

My Lords, I am aware that the UDAs are not very popular with the dental profession. Can my noble friend update the House on the long-term plan for the NHS published earlier this month? A recent Written Answer revealed that only 108 practices are signed up to Starting Well. As far as I am aware, the scheme has received no new funding. I declare my interest as a retired dental surgeon and a fellow of the British Dental Association. Will the Government agree to examine the success of the tried and tested deals in Scotland and Wales and roll out a properly funded, universal oral health prevention programme to children across England?

I thank my noble friend for that question. NHS England’s Starting Well initiative is supporting dentists across England to see more children from a young age and form good oral health. Two hundred and thirteen practices in 13 identified areas are participating in the programme, of which 210 have preventive champions in place. In Hull, for the first time, each practice has identified a health visitor to work with it. In Ealing, early indications are that children who do not normally attend dental practices are reported to be doing so. However, it is early days. We are also looking at how we might put more preventive dental access into the dental contract, but that will take a little time.