The Claim

“Our children have the best dental health in Europe.”
Ann Keen, health minister, 25 September 2007

The background

Our teeth, it seems, are a sore point. It might be easier to get someone to replace your hip these days, but getting someone to examine your molars is (ahem) like pulling teeth.

At the recent round of party conferences, dental dissatisfaction kept making itself felt like a nagging toothache – it was one of the hottest topics in the fringe debates on health.

And this month we saw figures pointing out just how hard it is to get dental treatment on the NHS.

But government ministers have been able to point to one positive sign – our children may not all have Hollywood smiles, but even in this land of deep fried Mars bars and fizzy cola bottles, young Britons enjoy better health than our continental cousins.

Alan Johnson said it at one fringe meeting at the Labour Party conference, (inserting the all-important caveat ‘among’) and health minister Ann Keen repeated it at another meeting the next day.

So, is it true?

The analysis

An Office of National Statistics report suggests that this is true – but only for 12-year-olds. For five-year-olds, we are actually seventh in Europe.

This is based on a slightly outdated survey, too. The numbers date from a 2003 ONS study, which is only updated every 10 years.

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There has been a decline in the number of five-year-olds who are having their teeth filled – this is mainly due to changes in dental practice, which challenge whether it’s worth filling teeth which are about to be pulled out anyway.
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The historical comparison suggests that the current government’s record is not perfect. Eight, 12 and 15 year-old children have seen an improvement in the state of their permanent teeth over the past decade, but five-year-olds have not.

Likewise eight-year-olds’ milk teeth have not improved in 20 years.

The report notes that “there were no statistically significant changes between the 1993 and 2003 surveys in the proportion of five and eight-year-olds with obvious decay experience, or in the proportion having teeth with cavities, in the primary (‘milk’) teeth.”

There has been a decline in the number of five-year-olds who are having their teeth filled – this is mainly due to changes in dental practice, which challenge whether it’s worth filling teeth which are about to be pulled out anyway.

In 1994, the government set a target for the improvement of the state of five-year-olds’ teeth. At that time, the government aimed to increase the percentage of children without obvious decay to 70 by 2003.

The target was missed – the figure achieved was 59 per cent.

At the same time, the government planned to reduce the average number of filled teeth to one. It is stuck at 1.5.

A Department of Health spokesman admitted that there is now no central government target for improving the health of young children’s teeth. “There is currently no departmental national target for dental health (decay) in five-year-olds. It is up to individual PCTs [Primary Care Trusts] to decide whether they wanted to set targets,” he said.

Of course, averages always tend to gloss over what’s happening among different groups. And poorer socio-economic groups in Britain have much worse teeth than the rest of the nation – adults and children.

“Fifty per cent of the decayed surfaces of teeth are found in 10 per cent of the population,” says Professor Ivor Chestnutt, of Cardiff University Dental School.

These are also the groups that are likely to experience the most serious consequences of dental decay, such as abcesses requiring general anaesthetic treatment.

Also, the main reason for the improvement in dental health over the past 40 years has been the availability of fluoride toothpaste, says Professor Chestnutt. But the government has done little to promote the fluoridation of water, which more than any other measure could improve the dental health of children and adults.

The verdict

The state of older children’s teeth is good, in comparison to Europe – but that of young children is still lagging behind.

Having failed to meet earlier targets to improve them, the government has now dropped them – a fact which sits at odds with government ministers’ claims to lead Europe on childhood dental care.

Furthermore, the government has done little to promote the fluoridation of water, which is many experts believe is the simplest and most obvious way to improve the situation.

FactCheck rating: 3

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