CHILDREN from poorer families are more likely to have their teeth pulled out, say scientists.
Researchers said there are disparities in accessing dental care leading to tooth loss – but that it can be prevented.
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The team at Queen Mary University of London compared the GP and hospital records of 600,000 children between the age of five and 16.
All were living in North East London, but data analysis for England has shown similar trends.
During the five-year study period, one in 200 children had at least one tooth removed under a general anaesthetic, in hospital.
Most of those children had multiple teeth extracted.
Children living in areas with the most low-income households were three times more likely to require a dental extraction, compared with those living in areas with the lowest proportion of low-income households.
When families have difficulty accessing timely preventive and treatment services, dental problems can progress until children need more serious and costly interventions
Vanessa Muirhead
Those who were white Irish were twice as likely than white children to need extractions.
Those who were Bangladeshi and Pakistani were 1.5 and 1.4 times more likely than white children, respectively.
The study highlights that lack of access to NHS dentistry impacts children’s teeth.
The highest risk of hospital dental extraction was for children living in Tower Hamlets, who were the least likely kids in North East London to have seen a dentist in the past year.
In December 2019, the proportion of children in Tower Hamlets who had seen an NHS dentist in the past year was 35.2 per cent.
Conversely, children living in Redbridge, Havering, and Barking & Dagenham – with the highest proportion of five-year-olds accessing a dentist – had the lowest risk of having teeth pulled out.
Tooth extractions have worsened in England in recent years.
There were 47,581 tooth extractions in under 19s in NHS hospitals in England in 2022/23, according to figures from the Office for Health Improvement and Disparities (OHID).
Two-thirds of extractions were down to a primary diagnosis of tooth decay, up 17 per cent from the previous 12 months.
Yorkshire and the Humber reported 405 cases per 100,000 children – the highest figure – and the East Midlands 80 per 100,000 – the lowest.
Co-author Vanessa Muirhead, Reader and Honorary Consultant in Dental Public Health at Queen Mary, said: “Sadly, our findings demonstrate wide socioeconomic and ethnic inequalities related to access to dental care and outcomes.
“Tooth extraction is a last resort, but when families have difficulty accessing timely preventive and treatment services, dental problems can progress until children need more serious and costly interventions such as multiple tooth extractions under general anaesthesia.”
Nicola Firman, lead author and Health Data Scientist at Queen Mary, said: “Our findings point to an urgent need for equitable access to preventive general dental services, and interventions that are targeted at the wider determinants of dental health.”
The findings, in BMJ Public Health, also show that children with obesity were less likely to need a dental extraction, though researchers are unclear why.
It comes after the new Health Secretary Wes Streeting met with dentists to discuss reforming the NHS dental contract.
After the meeting, the British Dental Association (BDA) said that Mr Streeting recognised that “failed contracts and underfunding have fuelled the current crisis”.
The BDA said it will “work constructively” with the new Government on delivery of its manifesto commitment of 700,000 new urgent and emergency dental appointments.
Labour also pledged to create an extra 100,000 urgent dental appointments for children.
Tips to help kids brush their teeth
Dr Khaled Kasem, Chief Orthodontist of Europe’s leading orthodontics chain Impress, tells Sun readers how to get their kids brushing their own teeth.
1. Find a time that’s right for you
“Children need consistency to learn anything, so make sure you set a routine,” Dr Kasem explained.
“Whether it’s immediately after breakfast or bath time or just before you tuck them into bed, make brushing a part of their normal schedule so they can get used to it.”
2. Keep it in the bathroom
“Try to make a habit of brushing in the bathroom, and make sure you’re doing the same,” he said.
“Children often model adult behaviour and if they see you brushing your teeth elsewhere, the likelihood is they’ll want to do the same.”
It’s also a good idea to brush your teeth at the same time, as it could make your child want to do it too.
3. Take your time and let them learn
Dr Eyrumlu said it’s important to let kids explore holding the toothbrush on their own.
“Angling it correctly to reach every tooth is tough. You want to have the brush at a 45 degree angle to the teeth,” he said.
Splitting the mouth into four sections can help kids get it right. The upper half on the left, the upper half on the right, the lower half on the left, and the lower half on the right.
4. Add an element of fun
“Try to make tooth brushing a fun activity rather than a chore, make them excited,” said Dr Kasem.
“Whether it’s making up a song or naming each tooth something silly as you brush it, keeping them engaged will generate excitement around the whole thing.”
The Hey Dugee toothbrush song is a great example of this as it encourages kids to brush their teeth for a full two minutes – the recommended time.
Another option is to use your child’s favourite toy.
“Let them ‘brush’ the toy’s teeth (without toothpaste),” Dr Kasem suggested.
“This will help them to understand that it’s a normal part of everyone’s routine, and not just a punishment for them.
5. Utilise time
It’s important to be brushing for a full two minutes, that’s 30 seconds for each quarter of the mouth.
Dr Eyrumlu suggests using a timer so kids can see or hear the time for themselves.
“Encourage them to brush one quarter of the mouth, and when the timer is up they can move on to the next section,” he explained.
“Brush along with them, doing your own teeth at the same time, enjoying the song.
“You can also try using a mirror so your child can see what they’re doing.”
6. Offer praise
Don’t forget to inspect your child’s mouth when they’re done to check they’ve done a good job.
“Then give lots of praise, high fives, whatever works,” said Dr Eyrumlu.
“Bring the whole family into the experience if you can! It’s all about making the routine a fun experience they enjoy.”