The second National Epidemiology survey of the oral health of three-year-olds1 shows virtually no change since the first survey in 2013. Members of the British Society of Paediatric Dentistry (BSPD), the UK's society dedicated to the oral health of children, are deeply frustrated by the findings and are calling for more initiatives to drive down the levels of dental decay which are blighting young lives.

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In some of the most deprived areas of the UK, as many as 27% of three-year-olds have visible signs of dental decay compared to a national average of 10%.

BSPD spokesperson Claire Stevens said: 'These findings underscore once again that it's children from lower socio-economic and particular ethnic groups who suffer the greatest burden of dental decay. The survey is incomplete due to the impact of COVID-19 but I anticipate that a post-pandemic survey would show more concerning results.

'Our experience as clinicians is that decay in a significant minority of children is both prevalent and severe. Pitifully, a full clearance of teeth in a three-year-old is not a rare event and this is a shocking indictment on our society.'

Dr Stevens stressed the importance of working with Managed Clinical Networks to develop transformational commissioning, also known as flexible commissioning, to deliver targeted prevention to children. A scheme in Yorkshire and Humber2 increased the number of children accessing preventive dentistry, demonstrating it can work.

Dr Stevens expressed her support for proposed reforms to the GDS dental contract,3 just announced, with a commitment to:

  • Increase incentives to undertake preventive dentistry, prioritise evidence-based care for patients with the most needs and reduce incentives to deliver care that is of low clinical value

  • Improve patient access to NHS care, with a specific focus on addressing inequalities, particularly deprivation and ethnicity.

Dr Stevens said: 'The current contract is not working. Children's oral health needs to be re-thought with new models of care, including the upskilling of primary care colleagues to provide oral health interventions. This is already happening in some parts of the country but more needs to happen on a greater scale and more urgently'.