Paediatric dentistry: North/south divide

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Sir, in 2017, I was approached by the British Society of Paediatric Dentistry (BSPD) to see if I could use the most recent FP17 data from NHS Digital to construct a map showing the percentage of children (0-2 years) within each Local Authority (LA) that attended an NHS practitioner in primary care in England. The NHS Digital data were based on local authorities (LAs) and these are sadly not coterminous with postal areas. This makes map construction based on postal areas quite complex, although less cluttered on an A4 sheet. The map shown in Figure 1 represents the distribution of this data according to the postal area. The BSPD request arose from the publication of a previous map showing the number of specialists in paediatric dentistry registered in each postal area.1 This first map highlighted a potential workforce issue with a noticeable shortage of specialists in some areas, while this map highlights attendance.

Figure 1

Percentage primary care dental attendance of 0–2-year-olds in England according to the postal area

There appears to be a north/south divide on the attendance map and it is potentially useful as a datum to be compared with future maps following the recent launch of Starting Well, Smile4Life and the Dental Check by 1 (DCby1) initiatives.

A north/south divide was also coincidentally highlighted in a recent joint report by Appleby et al. in November 2017 produced by The Health Foundation and The Nuffield Trust.2 Their findings told of poorer oral health in the north. The north/south divide in both the map and the report are interesting and there will many hypotheses to explain them.

These attendance figures, in any case, appear to raise a significant safeguarding issue. Let us hope that our legislators take note.


  1. 1

    Mills R W . Workforce planning: The specialist map. Br Dent J 2016; 220: 221.

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  2. 2

    QualityWatch. Root causes. Quality and inequality in dental health. Briefing. November 2017. Available at: (accessed February 2018).

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Mills, R. Paediatric dentistry: North/south divide. Br Dent J 224, 199 (2018).

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