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UK-based Oral Health Foundation calls for action after a huge rise in childhood tooth extractions under general anaesthetic

UK-based Oral Health Foundation calls for action after a huge rise in childhood tooth extractions under general anaesthetic

The Oral Health Foundation calls for urgent action after a new report by the Office for Health Improvement and Disparities highlights a “catastrophic rise in childhood tooth extractions”.

Figures released by the UK-based charity reveal an 83% increase in the number of 0-19 year-olds being admitted to hospital for tooth extractions under general anaesthetic, due to tooth decay. In total, there were 26,741 tooth extractions on 0–19-year-olds, due to tooth decay between 2021-2022.

According to the report, there are large disparities between areas of the country, for example, Yorkshire and the Humber rates are over five times that of the East Midlands.

The charity believes more education and funding are needed, as well as improved awareness about tooth decay so it can be prevented. 

– It is unfair and unjust for even one child to experience dental disease and pain, let alone thousands, Dr Nigel Carter, CEO of the Oral Health Foundation said on the foundation’s website.

– Only 10% of the country has fluoride added to their water, so expanding water fluoridation schemes could help to reduce these disparities in all areas of the UK. Water fluoridation is one of the single most credible and impactful schemes that can have a significant impact on tooth decay.

– The data on children’s general anaesthetic, hospital extractions in non-fluoridated areas versus fluoridated areas is staggering – in fluoridated areas, hospital admissions fall by as much as 68%.

According to the report caries-related tooth extraction rate for children and young people living in the most deprived areas is nearly 3.5 times that of those living in the most affluent areas.

– These figures continue to suggest that the UK is turning into a postcode lottery when it comes to dental access, Dr Carter said in the article.

The differences have been increasingly apparent as NHS dentistry is put under more stress, Dr Carter notes.

– Less NHS dentists, rising populations and dental teams combined with an NHS dental contract that does not work have certainly not helped the situation around the UK.

Tooth removals during childhood cause problems later in in life

The Oral Health Foundation says the number of children and young adults having teeth removed in hospitals is unacceptable. The charity is concerned that too many people believe that having ‘baby’ teeth removed early does not have a long-term impact on the ‘adult’ or permanent teeth.

– If the baby teeth have to be removed early due to decay, this can cause problems with the adult teeth, in the future, Dr Carter says.

– The baby teeth hold the space open for the permanent teeth to move into when they are ready. Without the baby teeth to keep these spaces, the adult teeth often come through in the wrong position. If this happens, the child will need to have orthodontic (braces) treatment, in the future.

Oral Health Foundation recommends brushing teeth for two minutes, last thing at night and at least one other time during the day, using fluoride toothpaste. As children get older, they should start to clean in-between their teeth using interdental brushes, tape, or floss, once a day.

– Unless the proper steps are put in place to reduce the number of decay-related tooth extractions under general anaesthetic in hospitals, these numbers will continue to escalate and place a further strain on an already over-stretched NHS, adds Dr Carter. 

– The only way to reduce this burden is to educate all ages, on the causes of dental decay and how to prevent it, with a balanced, healthy diet that is low in sugar and maintain an effective dental hygiene routine at home, and keep an eye on their oral health by visiting their dentist regularly, as often as they recommend.


Read more: Severe Dental Problems in Children on the Rise: Finnish Innovation Keeps Tooth Decay at Bay




Severe Dental Problems in Children on the Rise: Finnish Innovation Keeps Tooth Decay at Bay

Severe Dental Problems in Children on the Rise: Finnish Innovation Keeps Tooth Decay at Bay

According to Swedish researchers, up to 20% of children have a particularly virulent strain of Streptococcus mutans (S. mutans) in their mouths, which has a greater-than-usual ability to cause severe tooth decay. Finnish health technology company Koite Health Oy – named one of the hottest European startups in 2022 – has launched a method for targeted removal of dental plaque to improve children’s declining oral health.

Lumoral Junior – is the latest technology on the market for improved oral health self-care developed to suit children's needs. Lumoral Junior improves children's oral care and provides a good starting point for oral health even in adulthood. The method was developed by Finnish researchers with the aim of eliminating harmful bacteria in the mouth to treat and prevent oral diseases.

Oral diseases differ from many other diseases in that they are largely preventable. Despite this, caries and gingivitis are very common diseases even in children. By influencing oral conditions through diet, oral hygiene and fluoride, children can be assured of good oral health through relatively simple daily activities. 

– Oral health is a balance between the factors that protect against disease and those that make it possible to contract it. Regular eating habits, thorough mechanical brushing of teeth to remove bacteria from the mouth and regular use of fluoride all protect against tooth decay, says Heikki Alapulli, a paediatric dentist at the New Children's Hospital of HUS (Finland's largest health care provider).

Frequent consumption of high-carbohydrate foods or sugary drinks combined with poor oral hygiene are factors that contribute to dental and oral diseases. This is where the Lumoral Junior – an antibacterial oral cleaning method developed for children's needs – comes in helpful.

– We see a lot of young children with very bad teeth at our hospital. Any new ways to improve the self-care of children's teeth are therefore very welcome, Alapulli says.

Keeping oral bacteria under control

S. mutans is one of the most common bacterial species causing tooth decay. Good oral hygiene is essential to prevent these bacteria from multiplying and damaging a child's sensitive teeth. Careful mechanical brushing of teeth and the use of fluoride toothpaste are the foundation of children's oral hygiene. But even the most effective mechanical brushing is not always enough.

Lumoral Junior improves children's oral self-care and is particularly suitable for children who are prone to caries, have incipient caries or have a high S. mutans bacteria population in the mouth.

In a Swedish study published in 2017, up to 20% of children observed had a particularly virulent strain of S. mutans in their mouths. This has a greater-than-normal ability to attach to teeth surfaces, to tolerate acidic conditions in the mouth and cause more severe cases of caries, thus, challenging traditional caries methods.

– Antibacterial oral care does not replace traditional oral self-care, i.e., brushing with fluoride toothpaste and flossing, but the approach can inspire and enable children and parents to take better care of their teeth, says Alapulli.

The main responsibility for keeping children's teeth clean always lies with the adults – at least until the third grade of primary school, Alapulli notes.

– As children's hand motor skills develop, the responsibility for cleaning their teeth can gradually be transferred to them. But the child's oral hygiene must be monitored throughout primary school right up to the age of 12-13.

Heikki Alapulli, a paediatric dentist at the New Children's Hospital of HUS (Finland's largest health care provider)

Antibacterial treatment works when mechanical brushing is not enough

Lumoral Junior reduces plaque formation and can be used to prevent oral bacterial diseases such as tooth decay and gingivitis. It can also be used to prevent oral mucositis caused by chemotherapy. The device is intended for regular use. Recommended use for the prevention of tooth decay is at least twice a week.

Lumoral Junior is intended for children over 3 years of age – the typical age group for use of the device is children aged 4-12 years. Lumoral Junior is only intended to be used in combination with the light-activated Lumorinse mouth rinse that attaches to the plaque of the teeth.

– Lumoral Junior improves children's self-care of their teeth even when traditional methods are not enough or when an existing oral disease requires more than just mechanical brushing and flossing, says Tommi Pätilä, a surgeon at HUS New Children's Hospital in Helsinki, Finland, and one of the developers of the antibacterial oral care method.

– Mechanical teeth cleaning methods are the key to good oral health. However, it is important to remember that brushing only removes 50-60% of plaque at best. The Lumoral Junior antibacterial method is a very effective yet gentle way of removing plaque. It also slows down the formation of new plaque, Pätilä continues.

Tommi Pätilä, a surgeon at HUS New Children's Hospital in Helsinki, Finland, and one of the developers of the antibacterial oral care method.

Good oral health protects the heart

It is important that the child's permanent teeth can develop without having been infected by caries. This makes it very likely that the child will continue to have good oral health in the future. Studies show that it also protects the child from cardiovascular disease in adulthood as well.

– Later in life, a heart attack occurs when the blood supply is cut off from the heart muscle, usually because of a blood clot.  Researchers found dental bacteria in most of these clots.  Thus, the importance of good oral health in managing the risk of heart disease cannot be overemphasized, Pätilä explains.

Alapulli points out that many long-term illnesses are associated with an increased risk of oral disease and that most oral diseases originate in dental biofilms. Dental biofilm is precisely where the antibacterial effect of Lumoral Junior targets.

Alapulli adds that in addition to tooth decay, gingivitis is also common in children if teeth are not cleaned thoroughly enough. Good oral health is also good for the treatment of underlying diseases. However, poor oral hygiene in childhood can be a step on the road to serious gum disease in adulthood, known as periodontitis.

– Habits learned early in life are more likely to be maintained during adulthood and children quickly learn that brushing their teeth every morning and evening is part of their daily routine. It is vital to prevent dental disease especially in children with underlying health conditions. For instance, children with heart conditions are at a higher risk of developing caries. Good oral hygiene is also one of the most important steps in preventing endocarditis, an inflammation of the inner lining of the heart's chambers and valves.

According to Alapulli, one of the major advantages of antibacterial treatment is that it is selective. Lumoral Junior targets hidden plaque on the teeth without disrupting normal oral flora. This is where Lumoral differs from oral anti-inflammatory antimicrobials such as chlorhexidine.

– Chemical mouthwashes also kill the good bacteria in the mouth, and with prolonged use, the mouth gets used to them, Alapulli explains.

– The use of Lumoral Junior facilitates the mechanical removal of biofilm in the child's mouth. It is, therefore, one key component of a thorough oral self-care routine to maintain children’s oral health.

Pets bring balance to a top athlete’s everyday life

Pets bring balance to a top athlete’s everyday life

For a top athlete, sport is the number one thing in life – everything else is on its terms. Annimari Korte's days consist almost entirely of training, eating, and resting. Her two Siberian Huskies named Tokyo and Cairo and mixed-breed dog friend Raad provide a counterbalance to her sports-filled everyday life.

– Competitive sport is an everyday mental stress and rush for an athlete, Annimari surprises when asked if sport is a good counterbalance to the mental stress and rush of everyday life.

– Sport is often very stressful; every single training session and training day is meaningful to an athlete and can affect the whole year. Of course, it also brings the most joy to an athlete’s life, and that's why you do it, she explains.

Annimari knows what she is talking about. She is the fastest Finnish 100m hurdler of all time holding a national record of 12.72. She has run the qualifying standard to the Tokyo Olympics eight times, more than any other Finnish athlete, and represented Finland several times in world championships.

However, she has not had an easy career. Success has required determination and a positive attitude – a major dose of Finnish sisu as well when a bout of illness forced her to take a five-year break from competing in 2012.

Health comes first

– For a top athlete, sport is often the biggest content in life, but it's good to have other counterbalances, such as family and friends. Family is also a big help to me hen my dogs need someone to look after them during races and training camps.

Annimari now trains six days a week. She used to train 12 times a week, but since the autumn – after she started making her own training schedule – she has switched to a new training routine. Less is sometimes more.

– We usually start at 9.30 a.m. and finish between 12 and 1 p.m. I started planning my own training programme in August, and I have a coach who supervises all my training, says Korte.

Korte admits that although sacrifices are required in elite sport, it's up to you to decide what you consider to be sacrifices.

– There are many things an athlete can't do because they would take away from recovery or risk injury. When you succeed or achieve the results you've always dreamed of, it's worth all the sacrifices, pain, and stress, however.

Annimari's career has been marred by numerous health problems, the most challenging being eosinophilic esophagitis, an allergic inflammation of the esophagus, and Tietze syndrome, which causes chest pain.

– Allergies have had a huge impact on my daily life. Because of them, there is always a low-grade inflammation in my body. Because of the eosinophilic esophagitis, I also had to take a break from sports.

Because of the health challenges, Annimari must be particularly careful with her diet. Adequate rest is also essential to stay fit for training and competitions.

– I eat a lot of meat, cooked vegetables, and gluten-free carbohydrates. The importance of rest as an athlete increases with age. Now, I've been resting up to three days on my “light trainings weeks” since this fall, whereas before a light week meant two days of rest.

Oral health supports an athlete’s performance

Top-level sport creates special demands on oral health. Not only the body but also the teeth are often put to the test, because high levels of training require sufficient energy to pass through the mouth. This in turn can be reflected in the number of times you eat.

In addition, heavy breathing during hard training reduces oral saliva secretion and dries out the athlete's mouth. Saliva naturally provides good protection for the teeth. When this is no longer present, bacteria can enter the mouth to form caries.

Annimari brushes her teeth with an electric brush twice a day, as recommended by professionals. She also flosses regularly. Even with a good oral hygiene routine, Annimari's teeth have still been a problem for her – frequent gum problems and a few years ago two of her teeth chipped completely.

This is where Lumoral, a treatment developed by Finns, comes in handy as it improves dental self-care and oral health even when traditional methods fail. Lumoral is a new oral hygiene method developed by Finnish researchers that can remove 99.99% of plaque bacteria from the surface of teeth. Lumoral is a targeted treatment, which means that the normal, important bacterial flora of the mouth is preserved. At the same time, gingivitis is treated.

– I've been using Lumoral for a while now and have noticed how my gums no longer bleed when I clean the spaces between my teeth. It's great that a device has been invented to help keep the mouth healthy.

– Many people don't realise how much oral health affects health in general and sporting performance especially. I think sports organisations should do more to make sure that everyone from top athletes to children are aware of the importance of oral health! she stresses.

A positive attitude to life is the way forward

Annimari returned to competing in 2017 and since her return she has achieved almost all of her dreams she thought were impossible. In addition to the Finnish record, she has broken the Kalevala record and was undefeated in Finland in 2020 and 2021.

– I broke the Tokyo Olympic barrier eight times, more than any other Finnish athlete, she says.

Annimari was named the Most Positive Finn of the Year 2020.

– Positivity helps when times are difficult. My goal is to see my limits as a hurdler and inspire others not to give up and to believe in their dreams. I want to show that nothing is impossible. Positivity has certainly helped me to reach the top after all the difficulties!

Last Autum, Annimari told her Instagram followers that she recently graduated as a dog trainer.

– In the summer, when I couldn't compete, I thought what better thing to do than study. Everyone probably knows that dogs are the most important thing to me besides hurdling. I could start running various dog training courses, but they'll have to wait for a couple of years, Korte posted on her website.