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“We are now putting the mouth back in the body”

Dr Claire Stevens (Photograph: DTI)

Fri. 20 October 2017


The nationwide Dental Check by One (DCby1) campaign aims to combat dental caries in British children by spreading awareness that dental check-ups should be performed even before a child’s first tooth appears. Dental Tribune Online spoke with Dr Claire Stevens, a consultant in paediatric dentistry at the University Dental Hospital of Manchester, about the programme.

While the oral health status of children seems to have improved in the UK in recent years, there are still record numbers of children presenting to hospitals to have their teeth extracted. How can this be explained?
The high number of general admissions for multiple extractions in children isn’t new. Current figures are taken from the Hospital Episode Statistics [a data warehouse containing details of all admissions, outpatient appointments, and accident and emergency attendances at NHS hospitals in England] gathered by NHS Digital and are probably more accurate than ever before owing to vastly improved data collection. When compared with previous methods of data collection, we think it’s likely, in fact, that general admissions are starting to go down.

Sadly, there are communities in which children are not taken to the dentist and there is a high level of unmet need, reflecting societal inequalities. This is one of the most challenging aspects we face as a society.

With £50.5 million spent annually on dental extractions in 0- to 19-year-olds on a disease that is nearly always preventable, downwards is the only way for these statistics to go.

When was DCby1 launched, and how did the idea come about?
The DCby1 concept has been nascent for some time. It’s in the Commissioning Guidelines for Paediatric Dentistry (still unpublished) and was one of the key aims to emerge from a stakeholders’ day organised by the British Society of Paediatric Dentistry (BSPD) last year.

Speaking at the British Dental Association conference in May this year, I spoke publicly of DCby1 for the first time. A new statistic had just emerged and this was that only 19 per cent of 0- to 2-year-olds in the UK had seen a dentist by the age of 2. I challenged my audience to see four extra children under 2. If every dentist took up the challenge, the number of children seeing a dentist before their second birthday would go up by 10 per cent. The campaign had its formal national launch at the BSPD conference in September.

The programme encourages parents and caregivers to take children to the dentist before they have reached their first birthday. What is the evidence regarding the benefits of seeing a child at that early age?
We know that an unacceptable number of children as young as 2 or 3 are suffering from early childhood caries. We also know that one in eight 3-year-olds have caries, so leaving interventions until school age is too late. The only way to change this is by getting in early with preventative advice. We know that a good diet and regular brushing with fluoride toothpaste can prevent dental disease.

Why do you think such a campaign is necessary?
We need a radical approach to bring about change. However, we are undertaking the campaign progressively. We are building awareness by reaching out to parents through health visitors, school and nursery nurses, doctors and pharmacists.

In other European countries, like Germany or France, it is common to have children see a dentist before they even reach the age of 1. Why is the UK still behind in this regard?
Somehow in this country, we have not placed a high enough value on oral health. I am glad to say that we are now putting the mouth back in the body.

What organisations are supporting the campaign and how?
We have had the most fantastic support across dentistry and health care generally. Countless organisations are getting on board with sharing the very simple DCby1 message. If parents hear this wherever they go, they will feel empowered to ask for a dental check and this will become the norm. We are making this issue everyone’s business, and we are glad to be seeing such a positive response.

What feedback did you receive after the launch of the campaign, and what do dentists have to do to join in?
Last week, I curated the @NHS Twitter handle and I took the opportunity to broadcast the DCby1 message. A typical response was the following from a mother: “Thank you for your tweets. Taking my 16-month-old to the dentist for her first appointment on Monday because of it.”

Support from the profession has also been heartening. Joining in is simple. All the information a dental practice needs is on the BSPD website.

Do you think that celebrities, such as Jamie Oliver, who publicly lobby for a sugar tax are creating more awareness around topics like diet and sugar intake and therefore maybe even have a positive influence on children and parents?
Definitely, yes. We live in a culture in which celebrities play an important role, and probably more than any other celebrity, Jamie Oliver has had a positive influence on healthy eating. He is also a parent, so his impact can be felt in schools and in homes. If Jamie was reading this, I am sure he too would be sharing the DCby1 message.

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