Preventing tooth decay in young Calderdale children key target for health board

Calderdale Council’s Adults, Health and Social Care Scrutiny Board heard Dr Stefan Serban present an update on the council’s Oral Health Strategy and Action Plan, which councillors had considered in November, 2019.

Councillors expressed frustration at NHS England’s level of engagement with the strategy and their concerns.

Services were commissioned by NHS England, with Public Health England supporting some actions.

Issues remained about access to services but these had been discussed with NHS England.

Dr Serban, of University of Leeds School of Dentistry, who authored the 2019 report, said when it came to prevention it was important to see what happened before people saw the dentist, including high sugar diets, inappropriate infant feeding and issues such as sugar-free medication being provided where needed.

By the time they were five, a child would have four decayed teeth in their mouth, but there were things the council could potentially do to prevent this, he said.

Areas which suffered deprivation were worst affected, said Dr Serban – sometimes up to 20 percentage points difference in rates.

Main interventions were reducing sugar consumption, urging the use of fluoridated toothpaste and visits to the dentist.

Coun Mike Barnes (Lab, Skircoat) said it was disappointing NHS England had stopped engaging with the council on these issues.

One of the concerns was the apparent disconnect between the NHS units of dental activity (UDA) given to Calderdale and the figures – how the NHS decided Calderdale needed “x” amount of UDA treatment.

UDAs are a measure of the amount of work done during dental treatment and more complex treatments count for more UDAs than simpler ones.

“It seems to be someone puts their finger in the air and goes ‘that much’,” he said.

He asked if Dr Serban’s report would feed into NHS England. Dr Serban said he hoped NHS England would be involved with health discussions.

Coun Amanda Parsons-Hulse said in the past school dentists used to visit and if this happened again now would they pick up problems?

But officer Sandra Wilson said it did not have much impact – in rough terms out of 100 letters which might be sant to parents suggested further treatment for their child, only two or three would take up and then complete treatment.

Better outcomes were being obtained by working with mothers to get their children into practices early.

Board Chair, Coun Howard Blagbrough (Con, Brighouse) said there was also the question of the water fluoridation debate – there had been one a while back, and he could imagine mixed views would still be held.