June 2008

Tooth decay rates among children have been falling in most European countries since the mid-1970s, with the gap between the countries with the highest and lowest average levels narrowing. Widespread use of fluoride toothpaste, high levels of educational achievement in the Scandinavian countries, and public health approaches such as the use of fluoridated salt in Switzerland, France and Germany, have all contributed to this welcome improvement. Whilst average tooth decay rates are down, those averages mask stubbornly high decay rates in some communities and in some social groups. Many young children in the UK still suffer from severe dental caries (BASCD, 2007). No one in public health could reasonably argue that dental caries in the UK is a battle already won. It is not. Even if we take the deceptively soothing average dmft scores (decayed, missing or filled teeth), we find a fivefold difference between the best and worst dental health. The average South Staffordshire five year old has 0.6 dmf teeth (the best dental health in England), while the average Blackburn five year old has 3.2 dmf teeth (the worst in England) (BASCD, 2007).