Chronic disease amongst children

A finger in the dam of child tooth decay crisis

Discovering that their child has a chronic disease is every parent’s worst fear. Although common, conditions such as asthma and diabetes can be life threatening if they are not adequately managed, which is a frightening prospect.

But millions of children in the UK are walking around with a common chronic disease – one that can have a major and lifelong impact on their wellbeing – and their parents may not even be aware of it. What’s more, this disease is almost entirely preventable. And you’ve guessed it – that disease is tooth decay.

Tooth decay, or dental caries to give it its proper name, is the number one most common chronic disease affecting children worldwide, from the poorest nations to the most developed societies on earth.

While social deprivation is a key risk factor, the prevalence of sugar in 21^st century diets means the problem is widespread across all parts of society in the UK. A quarter of 5-year-olds have tooth decay, with an average of three or four teeth affected, and tooth extraction is the most common reason for hospital admission for children aged 5 to 9 years old.

Whilst it’s five times more common than asthma, tooth decay is often not viewed as ‘serious’ because it very rarely causes life threatening complications (although dental treatment under general anaesthesia presents a small but real risk of life-threatening complications for children and carries significant morbidity for children undergoing this procedure). Nevertheless, dental caries can have a major impact on a child’s overall health, and the effects can last for the rest of their life.

Children who have high levels of disease in primary teeth have an increased risk of disease in their permanent teeth. Even if decay is treated in adulthood with fillings, crowns and other reconstruction, the treated teeth will require long term maintenance and their life span is inevitably limited, increasing the risk of significant tooth loss in later life.

In the shorter term, tooth decay can cause problems with eating, which may lead to growth problems and even malnutrition. It can impact on the development of speech in very young children, and as kids grow, it may also affect their confidence, which can have consequences for their social skills and ultimately, their mental health.

The effect of tooth decay on education is well-documented. Research in the North West of England showed that 26% of children had missed days of school due to dental infections. 38% of parents reported that their child had been unable to sleep due to toothache, affecting their ability to concentrate in class. Missed school days not only affect the child, but the family as well, with parents needing time off work to care for a child in pain or recovering from an extraction. Missed learning opportunities and loss of earnings due to tooth decay only serve to exacerbate socioeconomic factors that may have contributed to decay in the first place – and so the cycle continues.

In the war on tooth decay, dentists are on the front line. Not only are they responsible for identifying and treating the physical decay, they’re also best placed to identify gaps in education around oral health, risk factors for decay in individual cases, and even situations where decay is as a result of wider safeguarding issues.

Funding for the NHS is a major stumbling block to tackling tooth decay in children, with experts predicting an inevitable crisis caused by a severe shortage of NHS dentists accepting new patients across England and Wales.

In the meantime, our industry can only do its best to keep a finger in the dam.