Note: The article in the British Dental Journal, that is referenced below, states that the provision of free toothpaste should be “family strength toothpaste” containing 1450 ppm FLUORIDE for “very young children who have active disease and/or those who are at increased risk of developing decay.”


Families should receive free toothpaste and toothbrushes, pupils should be banned from sharing birthday cakes with friends and parents told not to sweeten babies’ feeding bottles if rising rates of child tooth decay are to be halted, dentists are urging.

Experts want a new approach to tackle the growing number of children, some as young as three, who have to undergo painful extractions. They also want schools to stop rewarding students who do well with chocolate; childminders and nursery staff to ensure that toddlers brush their teeth twice a day; and a big increase in the number of children receiving fluoride varnish.

The call comes from Dr Gill Davies and Dr Colette Bridgman, dental public health specialists who work for Manchester’s NHS primary care trust. Writing in the British Dental Journal, they demand that parents play the key role in getting their offspring into good dental hygiene habits from soon after they are born by not giving them high-sugar foods and drinks, ensuring they have regular check-ups and cleaning their teeth regularly.

“It is the parents who have influence over food and diet choices, purchasing and use of toothpaste and the making of appointments for dental care,” they write. “How many children are likely to insist that no more biscuits or sugary drinks be bought for a household?”

While tooth decay in 12- to 14-year-olds has fallen over the past 20 years, it has not improved among five-year-olds. “If the oral health of five-year-olds is to be tackled, then clearly health improvement interventions need to commence well before children start school. Action is required from the start to encourage breastfeeding, avoid unhealthy feeding practices and start with good toothbrushing habits,” the specialists add.

Davies said that parents who gave their babies bottles of sweet liquid, such as sugared milk, tea or even custard, risked them having a sugary substance washing over their teeth almost non-stop: “Sweetening bottles is a very damaging habit, especially giving a baby such a bottle at bedtime or letting it keep it in the cot overnight, which is ridiculous, because the child’s saliva flow is much reduced.”

Given that only 10% of the UK has fluoridated water, the authors want other steps taken, such as:

? Children using family fluoride toothpaste, not children’s toothpaste, which is low in fluoride;

? Schools and nurseries to stop giving children fruit squash at snack times;

? Every schoolchild to have fluoride varnish painted on their teeth at least twice a year. Currently less than 15% do so;

? “Meet the dentist” sessions at primary schools;

? An end to the practice of sharing birthday cakes at schools.

Their recommendations draw on the success of the Manchester Smiles dental health campaign, which began last year. Under it, 6,000 pupils at 80 primary schools have supervised brushing sessions twice daily and dental practices are “buddied” with schools. Under a different scheme, 200,000 families in Manchester have received free toothpaste and toothbrushes since 1999, a plan that Davies and Bridgman believe should be extended nationally.

The dentists warn against bringing back dental health lessons in schools, an idea the Tories backed in opposition, because it helps only middle-class children. Dental health is a stark health inequality: 20% of those from poorer backgrounds account for 80% of decay.

“It’s a tragedy that the poorest children have most of the worst dental health, especially as much decay is preventable,” said Professor Steve Field, the Birmingham GP who chairs the National Health Inclusion Board, which aims to improve the NHS care of vulnerable groups. “That means discomfort, pain, sleepless nights, days off school and speech problems”

The Department of Health said: “The government has wasted no time in setting out its plans to improve dental services. At their heart is improving preventative care for children. They need a service that helps them maintain good oral health and prevents decay, rather than one that is based solely on treatment.”