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Tooth decay rates in children in Wales fall, but issues remain

Published: 1st February 2024

Dental public health experts at Public Health Wales have welcomed the findings from a recent child dental health inspection programme which shows that the proportion of young children in Wales with experience of tooth decay has continued to fall since the start of reporting in 2007/08. 

The report, which looked at 9,300 children in school year one (aged 5-6 years) in all areas of Wales, shows that both the prevalence and severity of tooth decay has reduced, but that more needs to be done to address inequalities that remain and the level of decay is still a cause for concern. 

The prevalence – the percentage of children examined in the study who have decayed, missing or filled teeth - has reduced from 47.6 per cent in 2007/08 to 32.4 per cent in 2022/23.  The severity – the average number of teeth per child which are decayed, missing or filled – has fallen from 1.98 in 2007/08 to 1.11 in 2022/23.   

However, the prevalence of decayed, missing or filled teeth is substantially higher in the areas of highest deprivation. The prevalence rate in the most deprived areas is 43.4 per cent (down from 57.6 per cent in 2007/08) compared to 20.7 per cent (down from 34.5 per cent in 2007/08) in the least deprived areas. 

The national Designed to Smile programme aims to reduce the differences seen across areas in Wales. It involves NHS Community Dental Services working with early years services, nurseries and schools to help start good habits, with supervised toothbrushing and fluoride varnish visits to help protect teeth against decay. 

A diet that is low in sugar, along with regular brushing with an age-appropriate fluoride toothpaste has the biggest impact on children’s teeth and will help prevent decay. 

Paul Brocklehurst, Consultant in Dental Health at Public Health Wales, said: “While it is really encouraging to see the decrease in both the prevalence and severity of dental caries in young children in Wales, it is concerning that children in less well-off areas in Wales are more likely to experience higher levels of disease. 

“In children of this age, establishing good dental habits is extremely important. Giving your children a healthy diet that is low in sugar and supervising their brushing with a fluoride toothpaste twice a day, will give them the best possible start. All health, social, education and childcare teams and organisations need to work with parents and children, especially in deprived areas in Wales, to ensure families have food and drinks that are low in sugar. 

“This survey has looked at nearly 10,000 children across Wales, which is a fantastic effort from our dedicated teams in the health boards and participating schools across Wales. I would like to take this opportunity to thank them for their hard work in ensuring that this ongoing survey provides a comprehensive picture of children’s teeth in Wales.” 

Chief Dental Officer for Wales, Andrew Dickenson said: 

“It is reassuring to see the falling rates of tooth decay in children in Wales, with both the severity and prevalence of decay being reduced. But we want to continue helping children avoid experiencing tooth decay in the first instance. 

“Prevention is key here. And it will take a combined effort from parents, guardians and the services provided by our dental practices, in partnership with teams in schools and childcare for children to maintain the best oral health.  

“Healthy eating is vital to our oral health, so ensuing that children have a low sugar diet from birth is essential in giving them the best possible start in life. 

“We also encourage parents to ensure their children continue to attend a dental practice for check-ups, as this will continue the good progress seen in this report.”