Fears Covid-19 will increase inequality in children's dental health

The Covid-19 pandemic may increase inequality in the health of children’s teeth, senior dentistry figures have warned.

The British Dental Association Scotland has warned that “decades of progress” in closing the gap between child dental health in rich and poor areas could be undone by the effects of the Covid-19 pandemic.

The collapse of routine services, suspension of public health programmes and sugar-rich lockdown diets may all contribute to worse outcomes for children’s teeth, the association said.

Primary 1 children from the most deprived areas in Scotland experience more than four times the level of tooth decay than their counterparts in the least deprived areas, according to the latest National Dental Inspection Programme figures released on Tuesday.

Just only 58.1 per cent of P1 children in the poorest areas have no obvious decayed, missing or filled teeth, compared to 86.9 per cent in the wealthiest areas.

The Scottish Government Childsmile programme to improve children’s oral health and reduce inequalities has been paused since the country entered lockdown in March. Programme leaders are working on a remobilisation plan, but this has yet to be finalised.

"Covid risks undoing decades of progress in improving the dental health of our children,” said Robert Donald, chair of the British Dental Association’s Scottish Council. “Dentistry in Scotland is at a turning point. Routine check-ups remain off the cards for most families, our public health programmes are struggling, and high street practices face a deeply uncertain future.“The oral health gap between rich and poor - which has proved so stubborn - will widen unless we see real commitment from the Scottish Government.”

The results of the report showed a large improvement since the inspection programme began in 2003, with 73.5 per cent of P1 children overall showing no obvious decay, compared to 45 per cent in 2003.

This improvement rose sharply between 2003 and 2012, to 67 per cent, but has showed a more gradual improvement from 2012 to 2020.

Greater Glasgow and Clyde had the lowest percentage of P1 children with no missing, filled or decayed teeth, at 68.7 per cent, while Orkney had the highest, 84.6 per cent, followed by Shetland, 84.4 per cent.

In Greater Glasgow and Clyde 25 per cent of children had untreated decay, compared to 21 per cent of children in Scotland as a whole.

NHS dental services will resume in a limited capacity from November 1, Public Health Minister Joe FitzPatrick announced last week.

But dentistry figures warned that the restricted opening will not be enough to cope with the backlog caused by practice closures during the Covid-19 pandemic.

The need for enhanced cleaning measures and fallow periods will pose “real problems” for practices, said Professor Phil Taylor, Dean of the Faculty of Dental Surgery at the Royal College of Surgeons in Edinburgh.

The Scottish Government said it would support NHS dental services with additional funding, including a top-up for dental incomes to 80 per cent of levels before the pandemic, with a view to increasing this in the next stage of remobilisation.

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