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March 30, 2023
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ADPH lead consensus on child oral health

The Government must act urgently to reverse the increasing inequality in child oral health in England.

Last week, a survey of oral health in five-year-old children, produced as part of the National Dental Epidemiology Programme, found that in 2022, over 35% of children in areas of deprivation experienced dentinal decay in comparison to only 13.5% in more affluent areas.

With tooth decay the leading cause of hospital admissions for five-to-nine-year-olds, there is a significant, and preventable, knock-on cost to the NHS.

Families do need to be equipped with the knowledge to encourage and oversee good hygiene practice amongst children. However, this report’s worrying findings are not a result of behaviour, poor choices or a lack of education. Rather, they are a result of a wider system failure to take forward proven, cost-effective public health measures that prevent tooth decay and improve everyone’s health and wellbeing.

We therefore urge the Government to:

  • Impose further restrictions on the marketing and sale of sugary food and drinks.
  • Support policy across all departments to improve access to affordable, healthy food.
  • Increase the number of water fluoridation schemes, which are the single most effective public health measure for reducing tooth decay rates.
  • Improve access to fluoride varnish programmes.
  • Facilitate timely access to free child dental services for preventative advice and early diagnosis.
  • Ensure that the early years workforce are educated about the importance of child oral health.

Unfortunately, the failure to scale up successful local preventative initiatives – like using planning powers to limit the number of take away outlets – on a national level means that inequalities continue to widen.

This has been further exacerbated by pressures on public health funding streams as many oral health promotion services are paid for by the Public Health Grant, which has been cut in real terms by 26% over the past eight years.

If the Government continue to fail to act, the cost will be significant – not just to children’s health, but to the health of the NHS and economy, with an inevitable increase in demand for treatment services and ensuing time spent out of education and work.


Professor Jim McManus, President, Association of Directors of Public Health

Eddie Crouch, Chair, British Dental Association

Professor Kevin Fenton, President, Faculty of Public Health

Kim Roberts, Chief Executive, HENRY

Alison Morton, Chief Executive Officer, Institute of Health Visiting

Dr Nigel L Carter, Chief Executive, Oral Health Foundation

Dr Helen Stewart, Officer for Health Improvement, Royal College of Paediatrics and Child Health

William Roberts, Chief Executive Officer, Royal Society for Public Health

Sharon White OBE, Chief Executive Officer, School and Public Health Nurses Association

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