CHILDREN from poorer families are more likely to have their teeth knocked out, scientists say.
Researchers said there are disparities in access to dental care that lead to tooth loss – but that it can be prevented.
The team from Queen Mary University of London compared the GP and hospital records of 600,000 children aged between five and 16.
All lived in North East London, but analysis of data for England showed similar trends.
During the five-year study period, one in 200 children had at least one tooth extracted under general anaesthetic, in hospital.
Most of these children had multiple teeth extracted.
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Children who lived in areas with the most low-income households were three times more likely to need tooth extractions, compared to those who lived in areas with the lowest percentage of low-income households.
When families struggle to access timely prevention and treatment services, dental problems can progress until children need more serious and costly interventions
Vanessa Muirhead
Those who were white Irish were twice as likely as white children to need exports.
Those who were Bangladeshi and Pakistani were 1.5 and 1.4 times more likely than white children, respectively.
The study highlights that lack of access to NHS dentistry is affecting children’s teeth.
The highest risk of tooth extraction in hospital was for children living in Tower Hamlets, who were the least likely children in North East London to have visited a dentist in the past year.
In December 2019, the proportion of children in Tower Hamlets who had seen an NHS dentist in the past year was 35.2 per cent.
In contrast, children living in Redbridge, Havering and Barking & Dagenham – with the highest proportion of five-year-olds who had access to a dentist – had the lowest risk of teething.
Tooth exports have deteriorated in England in recent years.
There were 47,581 tooth extractions in under-19s in NHS hospitals in England in 2022/23, according to figures from the Office for Health Improvement and Inequalities (OHID).
Two-thirds of exports were for the primary diagnosis of caries, a 17% increase on the previous 12 months.
Yorkshire and the Humber reported 405 cases per 100,000 children – the highest rate – and the East Midlands 80 per 100,000 – the lowest.
Co-author Vanessa Muirhead, Reader and Honorary Consultant in Dental Public Health at Queen Mary, said: “Unfortunately, our findings demonstrate wide socio-economic and ethnic inequalities associated with access to dental care and outcomes.
“Teeth extraction is a last resort, but when families have difficulty accessing timely prevention and treatment services, dental problems can progress until children need more serious and expensive interventions, such as multiple tooth extractions under general anesthesia.”
Nicola Firman, lead author and health data scientist at Queen Mary, said: “Our findings point to the urgent need for equitable access to preventive general dental services and interventions that target the wider determinants of dental health.”
The findings, in BMJ Public Health, also show that children with obesity were less likely to need a tooth extraction, although the researchers are not clear why.
It comes after new health secretary Wes Streeting met with dentists to discuss NHS dental contract reform.
After the meeting, the British Dental Association (BDA) said Mr Streeting acknowledged that “failed contracts and underfunding have fueled the current crisis”.
The BDA said it would “work constructively” with the new government to deliver on its commitment to 700,000 new emergency and urgent dental appointments.
Labor also pledged to create an extra 100,000 emergency dental appointments for children.
A government spokesman said: “Too many children are growing up in poverty and this is a stain on our society.
“We will work to give every child the best start in life, delivering on our manifesto commitment to deliver an ambitious strategy to reduce child poverty.
“We will launch a dental rescue plan, which includes 700,000 extra emergency dental appointments so more children can see a dentist.
“Prevention is better than cure, so we will also introduce supervised tooth brushing for three to five-year-olds, ban highly caffeinated energy drinks and remove junk food advertising aimed at children.”
Tips to help children brush their teeth
Dr. Khaled Kasem, Head Orthodontist of the leading orthodontist chain in Europe Impresstells Sun readers how to get their kids to brush their teeth.
1. Find the right time for you
“Kids need consistency to learn anything, so make sure you set a routine,” explained Dr. Kasem.
“Whether it’s right after breakfast or bath time or just before you put them to bed, make brushing part of their regular routine so they get used to it.”
2. Keep it in the bathroom
“Try to make it a habit to brush in the bathroom and make sure you do the same,” she said.
“Children often model the behavior of adults and if they see you brushing your teeth elsewhere, chances are they will want to do the same.”
It’s also a good idea to brush your teeth at the same time, as it might make your child want to do it too.
3. Take your time and let them learn
Dr Eyrumlu said it’s important to let children explore holding the toothbrush on their own.
“Getting the right angle to get to each tooth is tricky. You want to have the brush at a 45-degree angle to the teeth,” he said.
Dividing the mouth into four parts can help children get it right. Top half on the left, top half on the right, bottom half on the left, and bottom half on the right.
4. Add an element of fun
“Try to make brushing a fun activity rather than a chore, get them excited,” said Dr. Kasem.
“Whether you’re making up a song or naming each tooth something silly as you brush, keeping them engaged will spark excitement around the whole thing.”
The Hey Dugee toothbrush song is a great example of this as it encourages children to brush their teeth for a full two minutes – the recommended time.
Another option is to use your child’s favorite toy.
“Let them ‘brush’ the toy’s teeth (without toothpaste),” suggested Dr. Kasem.
“This will help them understand that it is a normal part of everyone’s routine and not just a punishment for them.
5. Use the time
It is important to brush for two full minutes, that is 30 seconds for each quarter of the mouth.
Dr. Eyrumlu suggests using a timer so kids can see or hear the time themselves.
“Encourage them to brush a quarter of the mouth and when the timer runs out they can move on to the next section,” she explained.
“Brush with them, brushing your teeth at the same time, enjoying the song.
“You can also try using a mirror so your child can see what they’re doing.”
6. Offer praise
Don’t forget to inspect your child’s mouth when they’re done to check they’ve done a good job.
“Then give lots of praise, high fives, whatever works,” Dr. Eyrumlu said.
“Bring the whole family to the experience if you can! It’s just about making the routine a fun experience they enjoy.”
