Public Health England’s first national survey of oral health in special schools shows that while pupils have slightly lower levels of tooth decay than those in mainstream schools, they are more likely to have teeth extracted.
The research also shows that children with severe special education needs and disabilities (SEND) who experienced decay have more teeth affected and poorer oral hygiene.
The data reveals the same shocking regional and socio-economic variation in oral health seen in mainstream schools, with 41 per cent of 12 year olds in the North West experiencing decay, compared to 22 per cent in the South East.
Tooth decay remains the number one cause of hospital admissions among young children in Britain.
Anna Ireland, chair of the BDA’s Dental Public Health Committee, said:
“All tooth decay is preventable, and some of the most vulnerable children in our society are being let down. This new evidence makes for sobering reading, and shows again why government and other organisations must support dentists, teachers and parents to improve oral health.
“What’s striking is that we are seeing the very same variations based on region and income that we see in mainstream education. These inequalities aren’t inevitable, and will persist as long as government treats oral health as an afterthought.
“So let’s talk about prevention, targeted action and sugar controls. Let’s just not pretend the damage being done to our children’s oral health is going to stop of its own accord.”
Claire Stevens, spokesperson for the British Society of Paediatric Dentistry, said:
“We are pleased that Dr Sandra White, Director of Public Health England, has said that local authorities and NHS England should provide dental services with specially trained staff who can cater for the multiple complex needs of these children. Paediatric dentists have the skills and commitment – we just need enough of us and in the right locations.
“Our members provide a service for all children aged from birth to 16 and we are pleased to have this useful information about the oral health of this important group of vulnerable patients.”
“We also welcome the endorsement of our role from the Public Health England epidemiology team at a time when commissioning of services is front of mind. We hope that local health authorities, which now have responsibility for commissioning services will bear the needs of this cohort of patients in mind and ensure they can benefit from access to specialist services.”
Michaela ONeill, president of the BSDHT, said:
“This report highlights some very worrying trends in children with SEND. The fact that more than one in five (22 per cent) children in special support schools has tooth decay is particularly shocking, especially when you consider that every single one of these cases is entirely preventable.
“We are ready and willing to provide more support to authorities and schools alike. Giving dental hygienists and the dually qualified in hygiene and therapy more opportunity to provide preventative treatments is vitally important in stopping the vast majority of these cases.
“Currently all COT’s need to be opened by a dentist, which has implications on time spent and costs involved. Allowing hygienists and the dually qualified to do this for preventative treatments in particular, will make a significant difference to the number of children treated.
“Treating children with SEND at a preventative stage is much easier than further down the line when they have developed severe problems. It involves less invasive procedures, less time, lower costs and most importantly, children are not forced to suffer the distress and pain which can come with severe dental health problems.”
PHE’s key findings include:
- Around one in five (22 per cent) five year old children at special support schools has experienced tooth decay.
- Around one in four (29 per cent) 12 year old children at special support schools has experienced tooth decay.
- For five year olds, the North West has the highest level of tooth decay at 33 per cent; with those in the South West have the lowest at 10 per cent.
- For 12-year-olds, the North West has the highest level of tooth decay at 41 per cent and those in the South East have the lowest at 22 per cent.
- Those children with tooth decay have an average of four decayed teeth at age five and two decayed permanent teeth at age 12, which is greater than those attending mainstream schools.
- The number of five year old children at special support schools who have had one or more teeth extracted due to decay is double that of those in mainstream schools (6 per cent and 3 per cent respectively).
- Oral hygiene is generally poorer in children attending special support schools with more children having visible plaque at both age five and age 12 compared to their mainstream counterparts (4 per cent compared to 2 per cent and 20 per cent compared to 10 per cent respectively).
In both age groups those with a behavioural, emotional or social difficulty have the highest levels of tooth decay; 28 per cent of five year olds and 42 per cent of 12-year-olds.