Last week, a study suggested that the sugar tax may have reduced the number of children’s hospital admissions for tooth extractions. We spoke to the dental profession to find out what this means.
New research published in BMJ Nutrition, Prevention & Health suggests that the number of under-18s who have had a tooth removed due to tooth decay may have fallen by 12% as a result of the sugar tax.
Also known as the UK Soft Drinks Industry Levy, researchers analyzed data on hospital admissions for tooth extractions in a population of almost 13 million children under 18.
The biggest reduction in hospital admissions was in the under nine age group. There was a reduction of 6.5 admissions per 100,000 for children aged between zero and four. However, there was no significant change among 10- to 18-year-olds.
Overall, the researchers estimated that 5,638 hospital admissions for tooth decay were avoided. Reductions in admissions were seen among children living in most areas, regardless of level of deprivation.
Dr Kawther Hashem – campaign leader at Action on Sugar
This new research is certainly encouraging and further proof that the use of levies is an effective lever to not only help reduce the number of children being imported for tooth extraction, but push companies to reduce the sugar and calories in their products. We now need to see similar levies introduced in other food and drink categories to shift the market in a healthier direction.
Dr Saul Konviser – Dental Wellness Trust
While we support the use of levies as an effective lever to encourage companies to reduce sugar and calories in their products, other preventative measures are also urgently needed to help tackle Britain’s oral health crisis, especially among children.
From the work we do, we know that national strategies such as oral health prevention and tooth brushing programs in schools and nurseries are one way of supporting this long-term ‘prevention is better than cure’ ethos and we are calling on government and local authorities for more emergency funding and support. Tooth decay remains one of the most common non-communicable diseases worldwide, yet for too long many children have suffered needlessly
Catherine Rutland – dentist and clinical director at Denplan
Tooth extraction due to tooth decay is the number one reason children are admitted to hospital in the UK, which is unacceptable in this day and age. While it is encouraging to see that the sugar tax on soft drinks can reduce the number of children having to have teeth extracted, we cannot put the emphasis on nutritional issues alone. We need to consider the wider hygiene habits of children’s oral health.
One of the ways this can be tackled is through education in children’s wider support network, through schools and at home, to encourage proper preventative care routines from a young age – including brushing twice a day for two minutes and of their regular visit to the dentist for a check-up. oops.
However, we are very aware of the struggles that many face in accessing dental services, which means that children are accessing these services very late. Prevention, therefore, plays an essential role in maintaining children’s oral health, avoiding long-term problems and developing good habits. It is essential to improve access to dentistry – including looking at NHS contract reform and recognizing the role of mixed and private practices in communities – to protect our children’s oral health.
Samantha Watt – academic clinical associate in dental public health, University of Sheffield
The study showed the positive effect that the soft drinks industry levy (SDIL) had on the oral health of children, particularly younger children. The success of the levy in reducing the number of children admitted to hospital for tooth extractions highlights the importance of upstream public health actions such as taxation.
As children living in deprived areas usually bear the highest burden of caries (in terms of number of teeth affected and its impact on their lives), it was encouraging that SDIL reduced exports even in deprived areas and did not lead to in widening social inequalities.
Interestingly, the authors found that SDIL did not have the same oral health benefits in older children and speculated that this was because this group had more autonomy over their diet. Strategies to reduce dental caries in this age group potentially require a combination of upstream measures and perhaps more targeted behavior change interventions designed around sugar consumption patterns, including sugary drinks, in 10-18 year olds.
Overall, the success of SDIL is an encouraging first step in improving children’s (oral) health and should strengthen the case for supporting other public health measures, such as restrictions on television advertising, prevention of unhealthy food and drink promotions in stores and limiting the sale of energy drinks.
James Goolnik – dentist and founder of Bow Lane Dental
It is great to see any reduction in tooth extractions due to tooth decay. Looking at the paper in the BMJ they showed no reduction in children over the age of 10 needing tooth extractions. Then, analyzing the date range of the study, when they moved it, look at the cases from which the sugar tax was implemented, there was no statistical difference in dental exports before or after the tax was implemented. Therefore, the sugar tax has made no difference to tooth extraction in this study.
“The reduction was statistically different only in the date between the announcement of the tax in March 2016 and its implementation in April 2018. After 2018 no differences appeared. I’m not saying the tax isn’t a good idea, however to make the right difference I’d suggest expanding it. I would extend the tax to milk-based drinks, fruit or vegetable juices and especially baby formula and baby food.
Manufacturers want to hook our children to sweet foods from an early age. Let’s give our children a full range of tastes and not just sweets. Let’s give our children a full range of tastes and not just sweets. There is no nutritional benefit from adding sugar to baby food.
The food and beverage industry needs to make it easier for consumers to eat healthy. Stop counting calories. How your body burns calories depends on several factors, including the type of food you eat, your body’s metabolism, and the type of organism (microbiome) that lives in your gut. Two people can eat the exact same number of calories and have very different results.
Suggested strategies
I would suggest these four strategies where dental care professionals can help more people:
- Good sleep quality. We know that after we haven’t slept well, we make bad decisions and eat foods that are not good for us. Dental care professionals should be concerned with sleep with our patients. We screen our patients for sleep apnea and refer as needed
- Real food. We improve the quality of our nutrition and discuss nutrition with our patients. Make real food, fresh fruits and vegetables more available and affordable
- Screening for metabolic diseases. As a basic we should take our patients’ blood pressure at every appointment. I truly believe that the dental care professions could do so much more to impact the lives of our patients. There are direct chairside tests for HBA1c (diabetes control), salivary Ph, vitamin D and oral microbiome testing
- Lifestyle discussions such as smoking cessation, exercise and mental health.
Zara Shirvani – dental hygiene
I support the implementation of the sugar tax. Due to the decrease in children’s hospital imports for export, I believe it should be expanded to include other sugary products.
However, I also believe that more needs to be done to promote oral health education in schools. It is important for children to understand the connection between sugar consumption, inflammation in the body and tooth decay.
In addition, greater emphasis should be placed on tooth brushing, interdental cleaning and regular visits to dental health professionals.
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