Agenda item

[Katie Spence, Consultant in Public Health, to give a presentation and briefing paper on the standard of oral health of children in Wolverhampton, the inequalities that exist, and what is being done to address this issue]

Katie Spence, Consultant in Public Health, introduced the presentation. The Consultant in Public Health introduced Anna Hunt-Smith, Consultant in Dental Public Health, Public Health England; who will provide further details about the work done to improve oral health in children.

The Consultant in Public Health outlined the responsibilities of Public Health to provide or commission oral health programmes and also to commission or provide oral health surveys. An oral survey is completed every two years which provides data to track and monitor changes in oral health of children under five.

The Consultant in Public Health advised the panel that a report on adult oral health could be presented to a future meeting, if the panel would find this useful.  The Consultant in Public Health advised the panel that tooth decay is preventable and nationally   trends show an improving situation.

The Consultant in Public Health outlined the main findings of the survey. The panel were advised that there was concern about the results as Wolverhampton has benefited from having water fluoridation, but despite this it performs poorly compared to other areas in the West Midland and England based on results of a survey of five year olds for the period 2014-15.

The panel commented on the results of analysis at local ward level who took part in the oral health survey. The Consultant in Public Health commented on the link between areas of high levels of deprivation and tooth decay. The panel discussed the need for more specific targeted work in the most affected areas.

The Consultant in Public Health on the damage done to children’s teeth caused by drinking fruit juices and fizzy drinks  which contain high concentrations of sugar. The panel queried the progress in the introduction of ‘sugar tax’. Ros Jervis, Service Director- Public Health and Wellbeing, briefed the panel on current proposals being considered by Government about the level of tax.

The Consultant in Public Health briefed the panel on the work of Wolverhampton Special Care Dental Service (WSCDS) (WSCDS provides dental care and treatment for special care patients including vulnerable and hard-to-reach groups in the area)

Anna Hunt-Smith, Consultant in Dental Public Health, commented on the introduction of the PHE toolkit for prevention and the positive response from health professionals who is it to have a positive  conversation with parents about improving dental care.

The Consultant in Dental Public Health updated the panel on ten key areas for action and progress to date.

Anna Hunt-Smith, Consultant in Dental Public Health commented on the importance of parents checking the concentration of fluoride in toothpaste and encouraged the use of fluoride varnish among vulnerable groups to protect teeth and gums. The amount of fluoride that's in the toothpaste can be found on the side of the tube and is measured in parts per million (ppm). Toothpastes containing 1350-1500ppm fluoride are the most effective.

The panel discussed the dental care needs of refugees and migrants and the work done to provide to improve dental care and the potential of social media to promote important messages. The panel were advised of the work done with NHS England to target vulnerable groups.

The pane queried the work done to encourage non-local authority nurseries to take part in supervised tooth brushing scheme, when the programme starts in September 2017. The panel were advised that the scheme will only cover children in local authority schools.

The panel queried the issue of hidden sugars in medicine and other foods and how the public can be better advised about how this can be checked.  The Consultant in Public Health advised the medicines labels do provide details of the content. Dr Hibbs advised the panel the prescribers of medicine should be provide the same information on labels when issuing them.

The panel queried the method used to collate the data presented and the findings that White British accounted for the highest proportion for extractions aged 2 to 16 years at New Cross Hospital. The panel requested more details to explain the reasons for this. The Consultant in Public Health agreed to respond directly to Cllr Rowley

The panel requested more details about the plans for the introduction of a sugar tax.  Ros Jervis, Service Director- Public Health and Wellbeing, advised the panel that the proposals will introduce two rates of tax on manufacturers of sugary drinks and foods.  The ‘sugar tax’ will be introduced in April 2018. The plans aim to reduce by 20% the amount of sugar in processed food products. The Service Director- Public Health and Wellbeing was hopeful that the plans will also look at the issue of hidden drinks in food stuffs such as orange juice, which can have high levels of sugar.

The panel queried which children would be included in the oral survey of 5 year old children. The Consultant in Public Health advised the panel that only children with a Wolverhampton post code would be included in the figures detailed in the presentation.

The panel commented on the issue of teaching young good teeth brushing skills and the opportunity to discuss the importance of this to parents of young children who visit Community Hubs. The Service Director- Public Health and Wellbeing advised the panel that health visitors are co-located in Community Hubs and will provide an opportunity to get across key messages about good dental care. 

The Service Director- Public Health and Wellbeing added that a recent conference to discuss the issue of child dental health, delegates were asked by the Chief Dental Officer of England to suggest ideas to get wider commitment across different agencies to improving dental care. The Service Director- Public Health and Wellbeing responded that that it is important to have really clear messages about actions that will improve the situation – for example – to maintain a focus on changing behaviours about dental care, reducing sugars in foods and drinks.

The panel thanked witnesses for their contributions.

Resolved:

1.    The Consultant in Public Health to present a progress report on child oral health in six months.

2.    The Consultant in Public Health to present a report on adult oral health to the panel in April 2018.

3.    The Consultant in Public Health to send a paper to Cllr Rowley to provide further information to explain the reason for the high number of tooth extractions among ‘White British’ among young people aged 2 to 16 years.