Dental teams have a role to play as advocates for change to address inequalities in children's oral health, reports Caroline Holland, from the British Society of Paediatric Dentistry's annual conference.

Never has it been more important to reduce the appalling inequalities in oral health in the UK, said Professor Richard Watt, making the opening speech at the British Society of Paediatric Dentistry's (BSPD's) 2022 conference in Sheffield. He stressed the important role that dental teams have as advocates for change.

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The event was BSPD's first face-to-face conference in three years and the theme was ‘Rights from the start'. Professor Watt's presentation was entitled ‘All are equal but some are more equal than others: insights into children's oral health inequalities'.

Incoming BSPD President Dr Jenny Harris introduced Professor Watt as the best possible person to speak on the topic. He is Professor and Honorary Consultant in Dental Public Health at University College London (UCL) and Director of the World Health Organisation, Collaborating Centre on Oral Health Inequalities and Co-Chair of the Lancet Commission on Oral Health, a scientifically led international review established in 2020.

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The stark inequalities in health had reached a tipping point, he said, due to three factors:

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    The impact of the pandemic

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    The strains on NHS dentistry

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    The cost-of-living crisis.

Together, they had created a perfect storm representing a major threat to child wellbeing. Professor Watt outlined how perilously bad oral health is among the poorest communities in England: ‘We need to be moving the dial in a completely different direction. The evidence is strong that behaviour alone does not explain inequalities in disease patterns. They are just part of the pattern'.

He provided a run-through of the wealth of data for England which showed how poor oral health in children is closely associated with geography, social position and ethnicity, commenting: ‘Geographical inequalities have been around for a long time and have not really changed despite all our efforts. The geographical variation reflects socio-economic differences'.

He said there are complex associations between socio-economic status, ethnicity and oral diseases; it's not just about tackling extremes, but graduated fine-tuning of the differences across the social hierarchy. The social gradient is an important issue for policy makers, he continued, and if we concentrate only on the poorest, oral health across the population will not be improved. He described how he had contributed to broadening the oral health agenda through his work with The Lancet and how the World Health Organisation was now recognising that urgent action is required.

Urging his audience to engage, Professor Watt said: ‘Dental teams have a role to play as advocates for change. We should not forget the importance of water fluoridation and we need to look at placed based projects. It would be interesting to note how many of you are involved in local foodbanks and making sure there is healthy food and fluoride toothpaste available there. Let's avoid isolationism in dentistry'.

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Also speaking in the session ‘Better outcomes from difficult starts' to delegates packed into the largest auditorium of Sheffield's Cutlers Hall were Professor Julie Taylor and Lorna Stabler.

Julie Taylor is Professor of Child Neglect at the University of Birmingham and highlighted the work that needs to be done to identify children who are at risk. She said: ‘We have become desensitised to neglect because of high levels of poverty and deprivation. The higher the level of poverty, the lower the level of concern'.

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She said that social care teams might focus on practical aspects in helping children rather than see the context of the child or recognise that in some cases, parents are children themselves. There was also a tendency to get wrapped up in concerns around GDPR so that information is not shared. ‘We need to work better together,' she said.

Lorna Stabler is a research associate working with CASCADE, the Children's Social Care Research and Development Centre at Cardiff University. She presented a series of moving case studies to illustrate how hard it is for children in care to access dental services, concluding with her own story of a childhood spent moving between multiple foster homes and her ongoing dream to finish her orthodontic treatment.

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This first session was a reflection of the mission and concerns of BSPD's new President, Dr Jenny Harris, who took office at BSPD's annual meeting. A Consultant in Community Paediatric Dentistry at Sheffield Teaching Hospitals NHS Foundation Trust, she will be using her presidential role as a springboard to lead discussion on issues that affect children's lives, focusing on their right to:

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    Information that they can understand about their oral health and wellbeing

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    Be protected from harm and the role dental professionals should play in safeguarding them from maltreatment

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    Extra help and special care if they have a disability.

Cartoon by Harry Venning www.harryvenning.co.uk

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Photography by Vicky Matthers https://www.vickymatthers.com