The leading cause of hospitalsation in five to nine year olds


Every year, tens of thousands of children will be admitted to hospitals in this country to have decayed teeth removed under general anaesthesia. In fact, dental decay remains the leading cause for hospital admissions in five to nine year old children in England. This is at significant cost to the family in terms of pain, infection, psychological impact and sleep disturbance experienced by the child, but also impacts on parents who may need time off to provide care. The cost to the NHS is also significant with £50.5 million spent extracting decayed teeth in children and young people aged 0 to 19 years in 2015/161.

Ironically, given all of the above, the general picture is one of improving oral health. The latest National surveys2 show us that nearly a third of five year olds and nearly half of eight year olds have decayed teeth, which is actually a significant improvement since the 1970s, when around 70 per cent of children started school with experience of dental decay. This is largely attributed to the widespread use of fluoride toothpaste. 

"Oral health is a marker of wider health and social care issues, including poor nutrition and obesity."

Interventions that reduce the number of sugar intakes have the potential to improve dental health and reduce obesity.

Dental decay remains a significant public health burden in terms of prevalence, impact and cost of treatment; so why is there no public outcry? When will we, as a society, start to take oral health seriously? Children’s oral health is everybody’s business but societal change will require partnership working between all healthcare professionals, parents, early years educators and government.


So what can parents do?


Get regular dental checks

Children should be brought to the dentist as soon as their first teeth come through and certainly by their first birthday. This message is central to the British Society of Paediatric Dentistry’s3 Dental Check by One campaign and is key to ensuring that preventive messages are delivered and that the family are supported with weaning. This visit is not just about looking in a child’s mouth – it should be the start of a positive, lifelong relationship with dentistry. Remember NHS dentistry is free for children.


Brush twice per day, every day

Children should brush their teeth twice a day – last thing at night and at one other time of day, and spit, not rinse their toothpaste after brushing. Children up to the age of three should use a flat smear of toothpaste containing at least 1,350 ppm (parts per million) of fluoride. After the age of three, a small pea-sized amount can be used.


Keep sweet treats to mealtimes

Sweet foods and drinks should be kept to mealtimes and avoided in the golden hour before bed.


Stop the bottle

Bottle use should not continue past a baby’s first birthday and nothing aside from milk or water should ever be put in a baby’s bottle. An open top, or free flow cup, can be introduced at six months.

There is lots more information in BSPD’s Practical Guide to Children’s Teeth4.