As part of Access Summer School 2010 at the University of Dundee, the author was tasked with writing an essay based on one Health or Health related topic which was relevant in his community. To this end, the author will highlight the topic of Dental Hygiene in children, exploring issues and providing resolutions, specifically the Childsmile scheme.
The author’s area of residence is within the NHS Fife area, which is covered by Dunfermline & West Fife. This area has an estimated total population of one hundred and thirty nine thousand. The percentage of the population aged zero to fifteen years is higher than the Scotland average (nineteen point four percent compared to eighteen percent) so in effect, there are marginally over seven thousand one hundred children residing within this area.
On 1 April 2004, the Scottish Government requested a research programme of Scottish dentists, with a view to establishing the provision of National Health Service (NHS) dental services in Scotland as well as a demand and capacity model for the country. Several disturbing facts and figures were revealed during this research, which subsequently spurned action throughout all social and geographical areas of Scotland.
Research revealed that in 2003, of all the children within Scotland, by the age of three years old, over sixty percent from severely deprived areas had some form of dental disease and by five years of age, this figure was fifty five percent. By the time children reach fourteen years of age, sixty eight percent had some decay or disease within their adult teeth. In addition, tooth extraction remained the biggest reason for general anaesthesia in children within hospital with over two hundred and fifty thousand teeth being extracted each year. Statistics show that on first attending school, Scottish children had an average of 2.5 teeth affected by decay and of those and about twenty seven percent had had an extraction by the age of five. Youngsters in severely deprived areas in Scotland in comparison to the most affluent areas were three times more likely to have some tooth disease by the age of five and four times as many children of this age needed a tooth taken out. (Appendix Table 1)
Research within the west of Scotland, has consistently shown high levels of dental decay in very young children. Principally evident disease in the front teeth of babies is caused by excess sugar around the time of weaning, mainly caused by sweet drinks in baby bottles and the use of sugary products on dummies.
As children reach the age of six, adult teeth start to come in. By that time, damage in their teeth has already started and with no change of behaviour, by the time a child reaches fourteen years of age, sixty eight percent of children have already been victim of tooth decay or disease. This equates to about 2.75 decayed teeth per child.
From this study, it has been ascertained that there are two main factors causing such a high level of dental decay within children. Firstly a high sugar diet – specifically sweets, sugary drinks and sugar-sweetened foods, and secondly is the lack of care (poor tooth brushing) from children and parents. In both factors it has been shown that residing within a severely deprived area is significantly worse for a child’s teeth, showing heightened figures for tooth decay and gum disease.
It has been suggested that the amount of sugar consumed by an average twelve year old boy in a severely deprived area of Scotland during the course of twenty four hours can be up to sixty spoonfuls. This can be caused by ingestion of too many sweet treats as well as artificial sweeteners in foodstuffs and ‘full fat’ carbonated juice. The main issue with sugar and why it is responsible for these issues is that it encourages oral acid production, which gradually erodes teeth, leading to dental decay. Once a sugary foodstuff has been consumed, the acid within the mouth lasts in the...
Bibliography: I. Scottish Executive Health Department. An action plan for dental services in Scotland, 2000. Edinburgh, Scottish Executive.
II. Hinds K. National Diet and Nutrition Survey: children aged 1.5 to 4.5 years. Vol.2: Report of the dental survey: a survey carried out in Great Britain on behalf of the Departments of Health by the Social Survey Division of the Office of Population Censuses and Surveys. London:HMSO;1995.
III. Galbraith, S.,1999, Towards a Healthier Scotland, 1999, http://www.scotland.gov.uk/News/Releases/1999/02/51f0e0be-cf47-4e01-9526-6596e84b14e8 Accessed 10th July 2010 Accessed 11th July 2010
IV. HEBS, Healthy Teeth for Life – A Guide for 6 to 10 Year Olds, Edinburgh, 2001.
V. Scottish Intercollegiate Guidelines network, Guideline No. 83, Prevention and management of dental decay in the pre-school child, 2005
VI. Unknown Author and Year of publish, Childsmile Program Manual, http://child-smile.org.uk/uploads/documents/13064-ChildsmileProgrammeManual.pdf Accessed 11th July 2010
VII. Merrett, MCW et al., 2009, National Dental Inspection Programme of Scotland Report of the 2009 Survey of P7 Children. Edinburgh 2009.
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