A whole systems approach to tackling childhood tooth decay

This report contains a whole range of examples of the steps that need to be taken to achieve success. Many of the areas included are places where there have traditionally been high rates of tooth decay, but where significant improvements are now being made.


Tooth decay remains the most common reason for hospital admission in children aged six to 10, with those from deprived areas most likely to suffer problems. Dental treatment under general anaesthetic presents a small but real risk of life-threatening complications.

What is more, poor oral health can affect children’s ability to sleep, eat, speak, play and socialise with other children. It can disrupt school attendance and lead to parents needing to take time off work.

Key statistics

  • 23 per cent of five-year-olds have some sign of tooth decay
  • 20-fold difference in levels of tooth decay between local authorities with best and worst outcomes
  • More than twice as likely that a child in a deprived area will have decay
  • 8,272 cases a year of children under five having teeth extracted in hospital
  • £50 million a year spent on teeth extractions among under 19s
  • 28 per cent less tooth decay if five year olds most at risk live in area with fluoridated water
  • £12.71 saving for every £1 spend on targeted tooth brushing after five years
  • £3.06 saving for every £1 spent on targeted tooth brushing after five years
  • £2.29 saving for every £1 spent on fluoride varnishing after five years