Stephen Fayle, a Paediatric Dental Consultant and member of the British Society of Paediatric Dentistry, was one of a panel of five giving evidence to the inquiry. Asked by MP Andrew Percy whether there was a crisis in the oral health of children in England, Mr Fayle said that the crisis was in the decline in specialist paediatric dentistry services within primary care in some regions. This was contributing to dental decay being the most common reason for a child between the ages of five and nine to be admitted to hospital in England.
The problem of high levels of decay in young children has been around for a long time, he said, but the number of specialists has fallen and this has coincided with a rising number of referrals to hospital of children with dental decay, in some areas needing an average of nine teeth extracted.
Barry Cockcroft, Chief Dental Officer for England concurred that there had been a reduction in specialists but denied that there was an actual shortage in total numbers. He said there should be better distribution of these specialists so that they could lead multi-disciplinary teams to ensure equitable access for children needing more complex care.
“The other part of the crisis is that children are waiting 18 weeks plus for a first consultation. Imagine a child with toothache and infection and they are waiting for four months to see a specialist and then sometimes it takes over a year to get treated. Then it could take a further 18 weeks to have a general anaesthetic,” Mr Fayle said. He stressed to the panel that hospital services were being severely stretched and the situation was becoming worse with the recent rise in referrals.
Professor Nigel Hunt, Dean of the Faculty of Dental Surgery of the Royal College of Surgeons said: “Finite resources have been diverted away from children’s dentistry so that it’s no longer a priority in some areas, which it should be.” The inquiry spent some time discussing the successful Childsmile programme in Scotland, a preventive programme which targets children in nursery and primary schools.
Mr Fayle said that in 2004, 50 per cent of five year olds in Scotland had dental caries. A decade later, the percentage had declined to 32 per cent of five year olds. He said that the Scottish Government claimed to have saved £6m as a result of the success of Childsmile, a point which appeared to be well received by the Select Committee’s Chair, Dr Sarah Wollaston.
MP Grahame Morris challenged the representatives of NHS England Barry Cockcroft (Chief Dental Officer) and Peter Howitt (Deputy Director, Legislation and Policy Unit) as well as Public Health England’s Director of Public Health, Sandra White. He said that 30 per cent of children hadn’t seen a dentist in the last two years and this surely indicated a failure; he wanted to know what they were going to do about it?
Sandra White and Barry Cockcroft argued that children’s oral health was not wholly a dental issue but a societal issue and professionals working in all areas, from midwifery to education, should be involved in helping improve awareness of the importance of good dental health. Mr Fayle added that an important key message was for all children to see a dentist before the age of one.
Speaking after the inquiry, Mr Fayle said it was disappointing that eight of the 11 MPs who sit on the Health Select Committee did not attend although the three who did were engaged and interested. He also paid tribute to Professor Helen Rodd, who compiled the BSPD’s submission to the inquiry and BSPD’s Vice President, Robin Mills who had produced compelling and robust data demonstrating the geographical insufficiencies in the specialist paediatric dentistry workforce across England.