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Nottinghamshire County Council health scrutiny committee discuss ‘shameful’ number of children suffering with tooth decay





A fifth of five-year-olds in the county have experienced tooth decay, a meeting to discuss the county’s healthcare heard.

Nottinghamshire County Council heard levels of tooth decay in local children are better than the England average but there are still “significant inequalities” in oral health in the county.

The issue was discussed at the authority’s health scrutiny committee on Tuesday, January 16, and the rate of tooth decay in children under five in Nottinghamshire was branded as ‘shameful’.

Nottinghamshire County Council's County Hall headquarters. Credit: LDRS
Nottinghamshire County Council's County Hall headquarters. Credit: LDRS

Nottingham and Nottinghamshire Integrated Care Board (ICB) has responsibility for organising dental services in the city and county.

The board told the meeting that more than a third — 34.2% — of five-year-olds in Nottingham City have visual signs of tooth decay, and a fifth of five-year-olds in the county have experienced tooth decay.

Adding fluoride to water into tap water in the city and county has been supported by councils to improve oral health — but this could take up to 10 years to implement.

There are 107 NHS general dental practices in Nottinghamshire. Two practices have closed since March 2023, in Newark and Bassetlaw.

There major problems with recruiting new dentists nationally, and very few surgeries are accepting new NHS patients without referrals.

The shortages are partly due to the current NHS dental contract, which was introduced in 2006.

Rose Lynch, senior commissioning manager at the ICB, said: “We aren’t going to sit back and wait for the contract because the inequalities will be devastating.”

Michelle Welsh said: “Health inequalities are increasing in Nottinghamshire without a doubt and I would suggest those children with tooth decay problems are some of the poorest in our county.

“That is shameful. That needs dealing with urgently. What isn’t the answer is fluoridating water. A consultation to get that started has not even started yet.

“Sometimes we need to have a bit of reality as to what is going on. It is a slippery slope when children get tooth decay.”

Dr Pavni Lakhani, local dental network chair, said: “I completely agree with you on every single point.

“Water fluoridation will take a long time and it will not address this issue.

“The reason we are talking about it is prevention.

“In terms of the imminent issue, we are acutely aware of this. We are working with the ICB and engaging with that population who a dentist may never have access to.”

Bethan Eddy added: “I’ve been having conversations with people involved in children’s services. One of the main things that comes up is access to dentistry for children.

“In the report only 54.8% of children have been seen by a dentist. In 2016 it was 61%. It’s such an important thing to start while they’re young.

“What more can be done to encourage it?”

Ms Lynch replied: “Challenges have always been there and its been exacerbated by the pandemic unfortunately.

“It’s about educating practitioners in terms of how to treat children.

“It is ultimately about expanding capacity. Even if you do incentivise a practice to take on more activity, there are challenges with the workforce.”

Dr Lakhani said there is a national initiative called ‘first check by one’ to encourage parents to take their children to the dentist before the child is one.

She said: “The challenge is that parents are aware of this but can’t get in with a dentist.

“We also have an oral health promotion team and they have engagement with the healthcare workforce and they go into schools to get the education in with children early on.”

John Wilmott added: “There is still a crisis in NHS dental care.

“People are saying they can’t see a dentist. It is a real problem.

“In Hucknall, getting access to an NHS dentist is like finding a needle in a haystack.

“Practices have to prioritise urgent dental care, vulnerable patients including children and those at higher risk of oral health issues — how can you do this if you haven’t got the dentists?”



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