What ever happened to the School Dentist?

Photo: School children

What ever happened to the School Dentist?

Open wide for the School Dentist

(by Cary Cray-Webb)

I have a very clear memory of ‘the School Dentist’ when I was at primary school. Each year a dentist and a dental nurse would set-up shop in some part of the school and inspect the teeth of every child in school on the appointed day. If they found an issue they would send a letter home to parents telling them to take their child to a dentist.

Personally, I never got a letter, but I know my husband got a couple because of the gloopy, sugar-filled medicine he regularly took for asthma. As a result, his Mum took him to the dentist regularly for check-ups and treatment.

As I grew up in London and he grew up in Bristol, I’m pretty sure that this was a national programme.

Roll forward 30 or 40 years. Between us, we’ve brought-up six kids (currently aged between 12 and 34). We have lived as parents in Cheshire, Essex, London and North Yorkshire. Neither of us can recall any of our children seeing a school dentist. I couldn’t even find information for in-school services for any of these places.

So is it a coincidence that about a quarter of under-5s have experienced tooth decay? Is it a coincidence that more children than ever before are being referred to hospital for extractions under sedation?

£50.5 million per year extracted from the NHS

According to Public Health England, during the financial year 2015/16, the NHS spent over £50,500,000 extracting the teeth (in a hospital) of children aged 19 or younger.

The average cost of each extraction is £836.

£7,800,000 of this was spent on procedures for children aged five years or younger. That’s well over 9,000 teeth extracted from children who haven’t even completed their first year at school. 7,926 of these extractions were due to tooth decay.

Just sugar?

It’s true that children today have too much sugar in their diets. But to be honest, I think I did too. Yet while I had a couple of fillings as a child, the regular inspections at primary school meant my Mum never forgot to take me to the dentist for treatment.

I firmly believe the problem stems (like so much in health care) from the way services are funded. So rather than council education departments paying for a cheap, early intervention and prevention service, the NHS is instead paying for 43,000 surgical procedures under anaesthetic.

Some councils and areas still do provide limited dental check-ups. For example, in Suffolk, nursery to Year 4 pupils receive basic dental examinations in school provided by the local community dental services.

My worries

As a Mum, I’m very fortunate that only one of my children and step-children have had any major dental treatment (and that was as the result of an accident with a scooter). As a GrandMa, I’m worried about the care of my grandson’s teeth. And as a dental nurse, I am angry and frustrated by some of the dreadful decay that I see in the teeth of young children.

It is a national trend that children are most likely to require Band 2 treatments. In fact, they seem to be more likely than adults to require Band 2 and Band 1 treatments (source: NHS Benchmark figures for contract performance). But given that only 58.2 % of children saw an NHS dentist in 2016/17, could re-establishing a more pro-active children’s dental service reduce an unnecessary load on NHS hospitals?

I would be very interested to hear the observations and thoughts on this subject from other nurses and dentists. Please email me to let me know what you think.

Key Facts about NHS \Dentistry

  • During 2016/17 the NHS delivered 39.9 million Courses of Treatment (CoT), an increase of  0.6 % over 2015-16.
  • NHS dentists saw 22.2 million adult patients in the two years ending 30th June 2017. This represents 51.4 % of the adult population.
  • NHS dentists also saw 6.8 million children in the 12 months up to 30th June 2017. This represents 58.2 % of the child population.
  • Excluding examinations, children who saw a dentist were most likely to receive a Fluoride Varnish Treatment. The NHS delivered 4.7 million during 2016-17. This is a 13.9 % increase from 2015-16.

Source: NHS Dental Statistics for England – 2016-17 (published by NHS Digital).

Cary Cray-Webb