Measures to Address Pediatric Tooth Decay in Liverpool

Liverpool’s director of public health has pledged to address the increasing problem of tooth decay among primary school children, following growing concerns. During a council meeting, Professor Matt Ashton stated that the city’s oral health status is “not in a good situation.” The most recent data from Liverpool City Council indicates that almost 50% of five-year-olds in the city exhibit “visually obvious dental decay.” This represents a 37% rise in “obvious dental decay” among children since 2019. Professor Ashton affirmed that the city would not “let the unacceptable situation” persist. A dental epidemiology survey conducted by Public Health England last year revealed that 20% of Year 6 children in the city also presented with visually obvious dental decay. This figure surpasses both the national average and the average for north-west England. For children aged five to nine in Liverpool, tooth extraction remains the most frequently performed hospital procedure. Preventable tooth decay accounts for nearly 90% of hospital tooth extractions performed on children up to five years old. Consequently, Prime Minister Sir Keir Starmer visited Alder Hey Children’s Hospital in Liverpool earlier this year to discuss his proposals for implementing teeth brushing programs in schools. Ian Ashworth, director of population health at NHS Cheshire and Merseyside, noted a connection between poor oral health and deprivation. He also highlighted that many families face difficulties in accessing dental services. “It’s well documented the challenges about getting access to dentistry,” he stated, acknowledging that “that isn’t getting solved overnight.” Ashworth mentioned that his team is distributing oral health packs to children in disadvantaged areas of Merseyside and Cheshire, in conjunction with other support services for parents, including foodbanks. He further emphasized the importance of lowering sugar consumption and promoting healthy eating habits. By June of this year, nearly 60% of children in Liverpool had visited a dentist within the preceding 12 months, while 36% of the adult population had done so in the previous 24 months. A council report identified several obstacles to accessing dental care, such as expenses, limited service availability, and services not being commissioned according to local requirements. Furthermore, the number of individuals contacting Healthwatch Liverpool, an independent advocacy group for users of health and social care services, regarding difficulties in obtaining dental treatments, rose by 354% between April 2021 and March 2022. Professor Ashton conceded that access to dental services “isn’t great” but noted that local efforts are underway. These efforts include distributing toothbrush and toothpaste packs to the most deprived communities, implementing supervised toothbrushing programs, and conducting dental screenings in 10 schools annually across Liverpool and Knowsley. Last month, children throughout Liverpool participated in Sugar Awareness Week, receiving Save Kids From Sugar water bottles to promote water consumption. Additional initiatives involve the application of fluoride varnish to all children twice a year during dental visits, increasing to three times for those identified as high-risk. Nevertheless, the effectiveness of these measures is contingent upon the child’s initial attendance at a dental appointment. Professor Ashton stated: “There are things we can and are doing locally, there are also things that need to happen in terms of more general NHS dental contract reform but we’re not going to sit back and let the unacceptable situation in dental health apply to our citizens so we’re going to work really, really hard to address this situation.”