A joint letter has been written to Joe FitzPatrick, the Minister for Public Health, Sport and Wellbeing in response to the announcement there has been a significant long-term decrease in the number of childhood fillings and tooth extractions in the Scotland since 2000-01.
The College’s Dental Faculty alongside Action on Sugar, Nourish Scotland, Obesity Action Scotland and British Dental Association Scotland wrote that although this decrease is encouraging, tooth decay, especially in children, is a public health concern not only in Scotland but worldwide.
To go into more detail, extraction rates of children’s teeth in hospital are still of major concern. NHS data shows there are still cases where children are having full teeth extractions. In addition, there are still significant inequalities with regards to dental health.
While the Child Smile Programme gets fluoride onto the teeth of children of all socio-economic backgrounds, more emphasis could be made on wider preventative measures including food and drink based recommendations, specifically the importance of reducing consumption of free sugars including fruit juice, juice based drinks and sugar sweetened drinks, but not to confuse the message with whole fruit.
The leading cause of tooth decay is a poor diet and more needs to be done to address the issue of excessive free sugar consumption especially amongst children and young people. While the oral health plan focuses on teeth hygiene practices and the use of fluoride there is limited mention of the importance of diet in relation to dental health.
There are concerns that the plans within the forthcoming revised nutritional standards for school could see diet soft drinks making a comeback to secondary school lunch halls. This would be significant retrograde step. The letter noted the following reasons for not permitting diet soft drinks:
- Allowing these products in schools normalises them, and although they are low in calories and sugar, they are discretionary and processed food and should not be promoted by schools
- Sugar free drinks introduce, adapt and normalise users to a very sweet taste, with implications for other subsequent food and drink choices
- Although these drinks are low in sugar they are acidic and therefore may negatively affect dental health
The soft drinks industry levy has made a huge difference to sugar consumption in Scotland. Emerging evidence is continuing to come to light on the beneficial impact of the use of fiscal measures to encourage reformulation and improve health outcomes. The voluntary sugar reduction programmes however, have made little progress to reduce the sugar content in foods contributing most sugar to children’s diets.
More nonetheless needs to be done to reduce health harms caused by excessive free sugar consumption. The creation of the new health body, Public Health Scotland, provides a unique opportunity to place both reducing sugar consumption in children and implementing water fluoridation high on the priority list.
There is no denying that too much free sugar in the diet contributes to the increasing risk of obesity, type 2 diabetes, various cancers, liver disease and tooth decay, all of which have devastating effects on the health and wellbeing of children in Scotland – and is of huge cost to the NHS.