- Tooth extraction, mainly under General Anaesthesia (GA), is the main reason for hospital admissions of 5–9 year old children in the UK
- Repeat treatments are frequent (20%-25% of cases).
So, the report interviewed 18 family dentists in the UK about this public health problem.
And what were the views expressed by these dentists? Here is a summary:
- The parents are to blame: The dentists perceived that parents of these children have negative attitudes towards dental care and lack oral health knowledge. In addition, they felt that those parents display what they view as poor parenting practices. They expressed frustration with their infrequent dental attendance and felt that those families view dental appointments as “emergency services” only, leading to late presentation and mounting to neglect.
- The insurance system is to blame: Funding of preventive care in primary practice was noted as a major issue. There was a consensus between dentists that the dental insurance system (the NHS England remuneration system) doesn’t provide enough support for preventive care for those children, and favours a treatment rather than prevention approach.
- The specialist (oral surgeon) in the hospital is to blame: The dentists reported issues in communication between the hospital and both referring dentists and families. Many of them found discharge letters lacking sufficient information. They reported that it will be useful, and potentially improve post-operative follow up, if more information was provided in these letters.
- Society is to blame: In an apparent call for change in wider public policies, the dentists noted that these high risk children are being surrounded by an unhealthy environment, making oral health promotion at the dentist alone difficult. For example, one dentist described the large amounts of sugary drinks being promoted for children at the local store.
The report concluded that high caries risk children and their families are being failed on multiple levels. Improving their oral health has proven to be a complex issue that intertwines various factors related to our social, economic and political environment.
Curiously, at no time did this research uncover the scientific fact that caries in early life is actually a communicable, infectious disease.
Blaming the victim, the family, the insurer and the corner store which offers candy, has done very little to address this unmet need. But examining the microbial origins of caries, its transmission, and how to manage this infection on the tooth surface is an evidence-based approach to getting somewhere.