Download 062-13-FOI Final Response

Ein cyf / Our ref:
062/13/FOI
You asked us:
1)
How many children have come to the attention of the Betsi Cadwaladr University
Health Board with poor dental health in the last 5 years?
2) How many of those children have had to have fillings as a result?
3) How many children have had to have teeth extracted due to cavities/poor oral
health?
4) For each child, how many teeth have been removed at any one time?
5) What is BCUHB doing to tackle the issue?
6) What treatment or advice is given to parents?
7) Is any advice given as to a child's diet to improve their dental health?
8) Is BCUHB supporting any initiatives to schools to educate children about looking after
their teeth?
9) How much does dental issues/removing teeth cost BCUHB per case?
10) What is the procedure for removing teeth? Are children put under anesthetic?
Response:
1) A national survey, co-ordinated by The British Association for the Study of Community
Dentistry, was conducted in 2005/2006 and was reported in the ‘North Wales Regional
Dental Public Health Report’ of 2006/07. The data which follows relates to the clinical
findings of that study and the response to a questionnaire issued to the parents of all
children examined (response rate 79%).
When dental attendance data was analysed it was found that, for Wales as a whole 7%
of children had never visited a dentist by the age of 5.
2) Despite being a preventable disease, more than half (53%) of children in Wales had
experienced dental cavities by the age of five. Although the north Wales figure, at 46%,
compared favourably with the Welsh average.
The prevalence of dental disease is measured using the decayed, missing and filled (dmf)
tooth index. In Wales, in 2005/06, the mean dmf (including those children who had never
experienced decay) was 2.4. Although a more favourable mean dmf of 1.9 was reported
for North Wales.
When the children who had experienced caries were considered separately, they were
found to have an average of more than four teeth decayed missing or filled (Wales, dmf
4.5; North Wales dmf 4.2)
Mean dmf in North Wales by dental planning area, survey of 5 year olds 2005/06
Cyfeiriad Gohebiaeth ar gyfer y Cadeirydd a'r Prif Weithredwr / Correspondence address for Chairman and Chief Executive:
Swyddfa'r Gweithredwyr / Executives’ Office,
Ysbyty Gwynedd, Penrhosgarnedd
Bangor, Gwynedd LL57 2PW
Gwefan: www.pbc.cymru.nhs.uk / Web: www.bcu.wales.nhs.uk
mean dmft
by dental planning area
2.94 to 4.49
2.49 to 2.94
1.99 to 2.49
1.59 to 1.99
0.86 to 1.59
(32)
(32)
(32)
(32)
(33)
Source: Welsh Oral Health Information Unit
3) In the survey quoted, almost a fifth (18%) of 5-year-old children in North Wales were
reported as having experienced toothache and 7% as having had extractions under
general anaesthesia.
4) We do not hold this information in a format which would enable us to provide the data.
5) Designed to Smile; a Welsh Government (WG) initiative which can be found at the
website below, also the Health Boards Child Learning Disability Programme.
www.designedtosmile.co.uk
Also, in November 2001, the Welsh Assembly Government (WAG) announced the
allocation of funding for a three year dental fissure sealant programme, targeted at 6-8
year-old children in economically deprived areas. A number of Local Health Boards in
North Wales also commissioned an extension of the programme. The initiative continued
until a new programme, ‘Designed to Smile’, was funded by WAG in 2008 as a superpilot in Cardiff and Vale and in North Wales. Following the success of the pilot, Designed
to Smile has been extended to all Health Board areas in Wales and the pilot expanded to
include the 0-3 age group in the targeted areas. Fluoride varnish applications have also
been introduced as part of the initiative. Current figures show an increased number of
schools and children from last year of 164 schools participating in the scheme in North
Wales and 14,607 children were brushing at school on a daily basis. Additionally 162
preschool groups and nurseries were engaged, with 3481 children aged 3 and under. In
Cyfeiriad Gohebiaeth ar gyfer y Cadeirydd a'r Prif Weithredwr / Correspondence address for Chairman and Chief Executive:
Swyddfa'r Gweithredwyr / Executives’ Office,
Ysbyty Gwynedd, Penrhosgarnedd
Bangor, Gwynedd LL57 2PW
Gwefan: www.pbc.cymru.nhs.uk / Web: www.bcu.wales.nhs.uk
Scotland, where daily brushing schemes have been operating for a number of years, there
is evidence that dental health has improved.
6) The key messages as standardised in the Designed to Smile programme are as below:
Tooth Brushing:
 From the time the first tooth appears, around 6 months of age, children should
have their teeth brushed twice a day with a smear of fluoride toothpaste
containing 1000 ppm fluoride
 From the age of 3, a pea sized amount of ‘family’ toothpaste, containing 13501500 ppm fluoride, should be used
 Spit don’t rinse after tooth brushing for 2 minutes to maximise the effect of fluoride
 Children need help and supervision with brushing until at least 8 years old
 Always brush teeth last thing before bed
7) Diet messages provided are:
 Avoid adding sugar to weaning foods
 Sweet foods and drinks should only be offered in small amounts at mealtimes.
Snacking on sweet foods or drinks between meals increases the number of
acid attacks.
 Limit drinks between meals to milk and water. Cow’s milk can normally be
offered from 12 months of age.
 Read labels and be aware of hidden sugars such as maltose and glucose
 Dried fruits are not a suitable snack because of their sugar content
 Milk given in a bottle before or during sleep can cause dental decay.
 Always brush teeth last thing before bed time.
 Fruit juice should not be given before 6 months old. It should always be diluted 1
part fruit juice to 10 parts water and offered at mealtimes in an open cup or
beaker
 Introduce a free flow feeding cup from 6 months of age
 Do not offer sweetened liquid in a bottle
 Discontinue the bottle from one year of age. Extending breastfeeding beyond
normal weaning age has also been linked to decay.
 Never dip dummies into anything sweet or teeth will decay and discontinue use
by 12 months
 Honey contains similar amounts of sugar as syrup and jam and can cause tooth
decay.
 Choose sugar free medicine when needed. Ask your doctor to prescribe sugar
free medicine if possible.
8) Yes by being part of the Designed to Smile Programme and Child Learning Disability
Programme
Cyfeiriad Gohebiaeth ar gyfer y Cadeirydd a'r Prif Weithredwr / Correspondence address for Chairman and Chief Executive:
Swyddfa'r Gweithredwyr / Executives’ Office,
Ysbyty Gwynedd, Penrhosgarnedd
Bangor, Gwynedd LL57 2PW
Gwefan: www.pbc.cymru.nhs.uk / Web: www.bcu.wales.nhs.uk
9) In 2011/12 the Health Board had 792 day case full cavity extractions (FCEs) at a cost
of £327,264 with an average cost of £413.21 per case. These figures include both
adults and children.
10) Local anaesthetic is employed for most cases and inhalation sedation can often
supplement this for anxious children. General anaesthetic may however be the only
option in some cases.
Please note, the information we have supplied to you is copyrighted to Betsi Cadwaladr
University Health Board and continues to be protected by the Copyright, Designs and
Patents Act 1988. You are free to use it for your own purposes, including any noncommercial research you are undertaking and for the purposes of news reporting.
If you are dissatisfied with the way the Health Board has handled your request for
information, you can request a review by writing to:
Freedom of Information Office
Betsi Cadwaladr University Local Health Board
Ysbyty Gwynedd, Penrhosgarnedd, Bangor LL57 2PW
If you remain dissatisfied with the handling of your request or complaint, you have a right
of appeal to the Information Commissioner at:
The Information Commissioner's Office,
Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.
Telephone: 08456 30 60 60 or 01625 54 57 45 Website: www.ico.org.uk
There is no charge for making an appeal.
Cyfeiriad Gohebiaeth ar gyfer y Cadeirydd a'r Prif Weithredwr / Correspondence address for Chairman and Chief Executive:
Swyddfa'r Gweithredwyr / Executives’ Office,
Ysbyty Gwynedd, Penrhosgarnedd
Bangor, Gwynedd LL57 2PW
Gwefan: www.pbc.cymru.nhs.uk / Web: www.bcu.wales.nhs.uk