Andrew Dismore

More than half of London children – nearly one million children in total – have not been seen by an NHS dentist in the past year even though such check-ups are free and NICE recommends they should take place at least once a year. That’s why I was pleased to see the London Assembly unanimously pass the motion I proposed, to raise the issue with the Mayor of London, Sadiq Khan; and to call on the Mayor to include oral health improvement measures in the London Health Inequalities Strategy. We also asked him to urge the Government to take action to reduce sugar consumption in children right across the country.

 

Despite dental decay being almost completely preventable, more than 10,000 children in London are admitted to hospital every year to have multiple decayed teeth removed under a general anaesthetic. This is despite the advice in Public Health England’s new guidance ‘Health matters: child dental health’ (www.gov.uk/government/publications/health-matters-child-dental-health), which points out that that targeted supervised tooth brushing programmes in nurseries and schools alone provides a return on investment of £3.06 for every £1 spent.

 

Of London’s 5-year-olds, 27% suffer from tooth decay, marginally higher than the 25% national average, but there are massive inequalities in oral health outcomes across the capital, which are very concerning, with just 16% of 5-year-olds suffering from decay in Bromley, whilst 39% of their peers are affected in Ealing. In my own constituency, 32% of this age cohort in Barnet have decay, compared with 24% in Camden.

 

London has the lowest rates of dental attendance of all the English regions. Nine out of ten of the local council areas with the lowest proportions of people attending NHS dental services are London boroughs. This is why it is important that the Mayor acts to raise awareness of the fact that NHS dentistry is free for under 18s and encourages parents in London to take advantage of this service to help keep their children’s teeth healthy. Whilst check-ups and any consequent treatment dental treatment for children is free of charge on the NHS, recent research by the British Dental Association reveals that more than 70% of parents are not even aware of the fact, so jeopardising their children’s oral health, possibly due to fears about affordability and cost. Of course, poor oral health impacts not just on children’s general health, but can also have a lasting impact on their school readiness, impair their nutrition, development, and ability to socialise with other children. Problems with oral health can also significantly affect confidence and self-esteem, and even hinder a person’s long-term life chances.

 

The Assembly called on the Mayor to include oral health improvement measures in his development of the London Health Inequalities Strategy and to take all possible steps to improve dental attendance and oral health outcomes in the capital. We also asked the Mayor to encourage all London boroughs to follow in the footsteps of the London Boroughs of Greenwich, Lewisham and Bexley by pledging to become ‘Sugar Smart’; and to make representations to the Government to take decisive legislative action to reduce sugar consumption in children across the country.

 

The Mayor, has given a positive response, outlining the action he is taking to promote preventative oral health to London’s children through his Healthy Schools London programme and the emerging Healthy Early Years programme. He has committed to working with local councils, schools and nurseries, especially in the areas of London with the worst rates of tooth decay. Further, he says he will absolutely work with boroughs, schools and nurseries to improve oral health, although it will be up to them to commission and decide which interventions work best for the needs of their own local communities. The successful Healthy Schools London programme, currently works with 28 of London’s 32 Boroughs and over 80% of London’s schools. The Mayor is currently piloting an extension of the initiative to Early Years settings, ensuring we cover the full life course of London’s children and young people.

 

According to the BDA an average 5-year-old eats the equivalent of their own weight in sugar every year, increasing obesity risks and contributing to increased caries. The Government’s Child Obesity Action Plan was a missed opportunity to show leadership and ambition in this area – and that extends to taking action on sugar reduction that matches the scale of the obesity and oral health problems. The Government needs to recognise that it is essential for more national action to reduce sugar consumption in children, and to consider introducing local measures to help people make healthier choices in schools, workplaces, shops, restaurants and cafés. The issue is linked to deprivation and the Mayor’s proposed response to tackling child obesity will be set out both in his forthcoming Health Inequalities Strategy and London Food Strategy.

 

City Hall, in partnership with its catering provider OSC, has led the way by introducing a ‘sugar tax’ on the sugary drinks it sells, a fiscal measure now due to be replicated nationally. Currently, the Healthy Schools London, Healthy Workplace Charter and emerging Healthy Early Years London programmes help children, young people and employees to make healthier choices. The Mayor has confirmed that his Healthy Early Years London programme will have a specific outcome measure on oral health and his Healthy Workplace Charter also encourages employers to provide accessible information to employees on healthy eating and to offer healthier options at on site catering facilities.

 

With the impact of poor oral health stretching beyond a child’s general health, often taking its toll on their school readiness, development and self-esteem, and long term life chances, we need that action sooner rather than later.

 

 

Andrew Dismore AM

Labour London Assembly Member for Barnet and Camden