Wednesday, 11 January 2017

Recycled dental scaremongering

 From the Guardian...

Child 'sugar scourge': thousands having teeth removed in hospital

Experts say annual figures for England obtained by LGA show need for tougher curbs on sugar in children’s diets

More than 40,000 children and young people a year are having rotten teeth removed in hospital in further evidence of what doctors call the “costly scourge of sugar”.

New NHS figures obtained by the Local Government Association (LGA) show that 40,800 under-18s in England had at least one tooth taken out last year under general anaesthetic because of decay. Performing the procedures cost £35.6m.

If this story sounds familiar it is because it is virtually identical to this Guardian news report from last April which said:

The Local Government Association (LGA) says £35m was spent on extracting rotting teeth from under-18s in 2014-15, amounting to 40,970 procedures, compared with 32,457 in 2010-11.

That was based on 2014/15's figure. Today's report was based on 2015/16's figure. Note that the number of extractions has gone down (slightly) in the last year. The Guardian doesn't mention this, nor does it mention the fact that the government banned dentists from taking out more than one tooth in 2000 so all multiple extractions have to be taken out in hospital. The publication of new figures is news of sorts, but it's hard to believe the Guardian would treat it as such if the LGA hadn't made it all about sugar.

The LGA is yet another state-funded lobby group with a bee in its bonnet about sugar and a penchant for higher taxes, hence these attempts to alarm people about childhood teeth extractions without putting the figures in any context. I wrote about this last year but if the LGA can recycle material, so can I...

The LGA’s ‘community wellbeing spokeswoman’ says her figures prove that ‘we don’t just have a child obesity crisis, but a children’s oral health crisis too’.

But do we? We are no longer a nation of Austin Powers. ‘The dental health of the majority of British children has improved dramatically since the early 1970s,’ according to a 2005 study, which also noted that ‘levels of dental decay in UK children at five and 12 years are among the lowest in the world.’ A further study in 2011 also found that ‘since the 1970s, the oral health of the population, both children’s dental decay experience and the decline [in] adult tooth loss, has improved steadily and substantially’.
This was confirmed in a report from the Faculty of Dental Surgery last year.

The Office for National Statistics has run the Children’s Dental Health Survey since 1983 and the figures are striking. The number of 12-year-olds who exhibited clear signs of tooth decay fell from 81 per cent in 1983 to 28 per cent in 2013. One in three kids of this age had a cavity in 1983 but by 2013 this had fallen to one in nine. The survey does not look at younger children but in Scotland the prevalence of tooth decay among four-year-olds nearly halved between 1994 and 2014, from 62 per cent in 1994 to 32 per cent in 2014.

The rise in hospital admissions for childhood teeth extraction does not, therefore, reflect a general rise in childhood tooth decay. Quite the opposite. Nor does it reflect a rise in the consumption of sugar or sugary drinks (both have been falling).

There has been no rise in childhood or adult tooth decay as a result of fizzy drinks or anything else. On the contrary, there has been a dramatic decline in tooth decay across all age groups.

Yes, there are still too many kids with bad teeth but a sugar tax is not going to change that. However, there are things that local authorities could do but don't because it requires more than writing press releases. As I said last year...

The Faculty of Dental Surgery (FDS) has suggested that hospitals are being used as a last resort for children who have not been registered with a dentist or are ‘seeking dental treatment when the caries [ie cavity] is already at an advanced stage so must be referred to specialist services’. This is certainly plausible. Tooth decay is most common in inner cities and among low-income families. More could be done to encourage ‘hard to reach’ groups, including the foreign born, to take their kids to the dentist. The FDS would like to see a public campaign to this effect, along with education about the effect of sugar on teeth and the promotion of water fluoridation.

Local authorities could do any of this without having to lobby central government. Instead it is grabbing headlines with Jamie Oliver-style anti-obesity policies which are unlikely to make a dent in obesity rates and are even less suited to reducing rates of tooth decay. Sugar is an important cause of tooth decay, but it is the frequency of consumption that matters, not the overall intake. Saliva naturally removes sugar from teeth within 20 minutes. Drinking a can of pop or scoffing a bag of sweets once a day might not be advisable from an obesity perspective but it is trivial in relation to tooth decay. The problem comes when you make the bag of sweets (or the piece of fruit) last all day. Reducing sugar content in individual items, as the LGA wants to do, would make no difference because the issue is the frequency, not the volume.

The bottom line is that there has been a dramatic improvement in children’s teeth in recent decades as a result of tooth-brushing, fluoridation and dental check-ups. If more kids visited the dentist and brushed their teeth, rates of tooth decay would fall further. Local authorities would have to do some work to achieve this behavioural change but, unlike putting little pictures of teaspoons on lemonade bottles, it would actually work.

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