Preventable Children’s Dentistry In Cornwall

Today, I had a very useful insight into Peninsula Community Health (PCH) excellent dental facilities at the Truro Health Park, and was allowed to attend theatre procedures at RCHT. Just to note, I will only be concentrating on the children’s aspect of dentistry in Cornwall. I said it was useful, because those medical staff who gave their time told me honestly that most of the extractions case that are carried out are preventable.

In fact, two senior dentists, who have over 75 years of professional experience between them, said 99% of cases were preventable. This is a shocking figure. If you look at the financial cost of treatment this is a staggering waste of money. It would be easy to blame the lack of NHS dentist, but this is not the case. As all the professionals I spoke to say the main culprits to poor dental are diet, and very poor dental hygiene.

Me in my scrubs and Neil who hosted me today

Me and Neil who hosted me today

Considering each general anaesthetic procedure costs an average of £500 the costs soon adds up. When the managers of PCH told me they carried out 1000 such routines each year you start to get into eye watering amounts of money that is being spent, but could be saved by better preventative work rather than having to spend it removing decayed teeth. This is in my opinion too late an action.

For me it really hit home when I attended the theatre procedures and witnessed the removal of many children’s teeth. All of the procedures today were for tooth decay. In fact, if parents were allowed to witness teeth being extracted, they might, just might, take a better interest in making sure children look after their teeth better. As the extractions are carried out by medical versions of pliers. For all the care the staff give to the patient, you cannot help wince as teeth are being pulled out.

The procedures I witnessed are repeated four times a week with each ‘list’ having at least six patients. If you thought the children who had GA’s today were of an older age range, you would be wrong. The ages were six to eight years old.

I am not saying parent should stop giving sweets and sugary treats to children, as this is not my place, and is the responsibility of the parents. But more care must be taken if children want to have healthy teeth not just as children, but into adulthood too. I know as a parent myself, it made me think.

However, it did strike me wrong when the professionals informed me of parents collecting their children from surgery will a bag of sweets or other such sugar rich products. You got to question the logic, especially when a child has had several teeth removed for decay, and the parent arrives with more sugar related products.

Going forward and actually trying to address this issue, I believe more work could be carried in schools and in the home on education and helping parents prevent their children having to have teeth removed for decay. Furthermore, I am pleased at a recent successful pilot of working in schools and will be working with the various organisations to see how this could be expanded across Cornwall.

I want to say a  huge thank you should go to the staff at PCH who were very willing to answer my questions. To the team in theatre who allowed me to watch today’s procedures and highlight the many concerns they have in this field. They are a credit to the hospital, and shows the dedication they have in providing a service that is nearly fully preventable.

It is only when you get to talk to professionals you really get a feel on how a service is functioning, but more importantly how to improve that service.

Launch of a children’s Oral Health Programme which will start to tackle tooth decay in Cornwall

Just over a year ago, I witnessed first-hand a number of dental procedures being carried out during a visit to PCH Dental and RCHT which could have been prevented by improved oral health (blog on the visit HERE).

When you see children as young a seven having teeth pulled out because of decay, it certainly highlights a problem that I felt as the Portfolio Holder for Children and Young People, something really had to change to address dental hygiene in Cornwall

The shocking statistic is an estimated 99% of cases of teeth extraction is due to poor diet and dental hygiene and considered preventable. It gets worse, with around 25% of five-year olds in Cornwall and the Isles of Scilly are found to have tooth decay. This is 99% preventable.

In 2011/2012, 830 young people under the age of 18 years in Cornwall and the Isles of Scilly had teeth extracted under general anaesthetic – with an average of three teeth per child.

From my visit, I arranged a meeting with various Health and Public Health partners to see how we could address the problem. The short version of the process is organisations came together, contributed with funding and started a pilot programme to start to address this issue.

The pilot programme took place over a three-month period from April 2015 and was run at St Meriadocs Infant School. The pilot proved to be a great success. Dental Therapists from PCH Dental worked with the school to give oral health education to around 100 children aged three to five years including introducing a supervised ‘tooth-brushing club’ for nursery children and applying fluoride varnish to the teeth of children in the reception classes.

With the success of the pilot, I am very pleased to say the Council has commissioned PCH Dental to deliver this programme. This next phase will target areas where children are at higher risk of poor oral health. One of the aims of this programme is to reduce this inequality.

The official launch of the Oral Health Programme took place at St Meriadocs Infant school. Children from this school were asked to come up with a logo for the programme, with the winner announced at the event.

The many entries from the children

The many entries from the children

It was great to see so many fantasitc entries, and it was very hard to pick a winner. However, a winner was duly picked and there was prizes for second and third places too. In fact, all the children who entered in the competition got a goodie bag (healthy one).

The top three entries. 1st, 2nd, 3rd left to right

The top three entries. 1st, 2nd, 3rd left to right

The Oral Health Programme will deliver tooth brushing clubs in 27 nurseries; oral health education programmes and tooth brushing demonstrations in 20 children’s centres and fluoride varnishing programme in 20 schools.

Highlighting the importance of keeping teeth and gums healthy at an early age will not only help reduce the need for teeth extraction as a result of decay in children, but also into adulthood.

The first two phases of this programme to raise awareness of the importance of good dental care from an early age have been very successful and I look forward to working in partnership with PCH Dental and Public Health to deliver this next phase. From this phase, I want the programme to be available county-wide in the near-future.

Thanks again to all who took the time to listen to me and help solve this issue. I could not have done this without you.


Helping children’s oral health in Cornwall

Back in April, I got a good insight to some of the issues surrounding children’s oral health in Cornwall. It was frankly shocking, and you can recap HERE. You have to ask yourself why so many children are having their teeth extracted for tooth decay. As an estimated 99% of teeth extraction are considered as preventable. The main causes are poor diet and dental hygiene.

To recap, 830 young people under the age of 18 in Cornwall had teeth extracted under general anaesthetic in 2011/12. The total number of teeth extracted as 2,503, which is an average of three teeth per child. Of these extracted teeth, 1,973 were first teeth and 530 second. Nationally more than a third of children have suffered tooth decay, missing teeth or fillings by age five, yes five! There is a clear link between tooth decay and poverty; with some parts of the UK seeing as many as three-quarters of children are affected. The Cornwall context, showed approximately a quarter[1] of five-year olds had tooth decay.

The Council, Public Health and PCH Dental recognise the issues and are working together to tackle tooth decay in Cornwall. There is no easy fix, as this is a long-term programme; but working in partnership will reduce tooth decay in Cornwall. I would like to say eradicate, but I am a realist.

This new joint programme will deliver oral health session in ten locations across Cornwall. The aim of the programme will give support, advice and information on how to look after oral health to local young families. The teams from PCH Dental and the Council will work with young parents groups to help keep their children’s teeth and gums healthy. It is no good just teaching the children, you have to tackle this issue in a family unit. This new joint venture builds on the successful programme with St Meriodoc which engaged 100 children during the three-month trail.

This programme is just the first stages of partnership working between the Council, Public Health and PCH Dental, as more is planned for the whole of Cornwall. I am heartened to see what can be achieved by us working together, and look forward to working with these organisations to tackle tooth decay in our young people.

[1] British Association for the study of community dentistry 2012