The Government’s recently unveiled Childhood Obesity Strategy has faced criticism from Denplan, the UK’s leading dental payment plan provider. Denplan believes the strategy overlooks oral health and neglects whats it believes to be key issues such as junk food advertising. In this interview, Denplan’s Chief Dental Officer, Henry Clover provides some further insight into the response on the strategy. Henry offers an invaluable perspective having worked as a dentist for seventeen years prior to joining the Denplan team. He is now at the forefront of private dentistry liaising with more than 6,500 member dentists
The Obesity Strategy requests food manufacturers voluntarily reduce the sugar content of certain products by 20% by 2020. How vital do you think it is that this target becomes compulsory in order to achieve the desired level of sugar reduction?
The Government’s recently released Obesity strategy has failed in the eyes of many health experts, campaigners, and MPs to fully tackle the issue of unhealthy eating habits and at Denplan, we agree that it does not impose tough enough restrictions on manufacturers and retailers. We waited long enough for this to be released and many, including those of us in the dental profession, thought and hoped the strategy would be a lot more robust. We were especially disappointed that childhood tooth decay was only referenced once in the entire report.
Asking manufacturers and retailers to reduce sugar content on a voluntary basis may not achieve what is needed to both reduce childhood obesity and tooth decay – but we will have to wait and see how the food and drink industry reacts to these new guidelines. Compulsory restrictions may yet follow, albeit in the more distant future, if the government does not see the required changes by the manufacturers.
At Denplan, we remain highly concerned by the fact that far too many children experience tooth decay, and it remains the single most common reason for five to nine year olds in England to be admitted to hospital, with many of those children needing multiple tooth extractions under general anaesthetic.
You have mentioned that tooth decay is the most common reason for 5-9 year olds in England to be admitted to hospital. Do you think most people are currently unaware of the severity level of this issue for this age group?
The poor state of children’s oral health continues to dominate the headlines, so you would hope that the public are beginning to take serious note of the high rates of tooth decay in the child population. There are preventive oral healthcare initiatives such as Designed to Smile in Wales and Childsmile in Scotland which are helping to improve the situation. Sara Hurley, Chief Dental Officer for England also recently announced plans for a national programme to improve dental health in England called Smile 4 Life. These are all positive steps but there is still work to be done to raise awareness of the poor state of children’s oral health.
Denplan has also conducted some interesting research with parents about their general awareness of tooth decay in children and how sugar consumption can play a role in this.
The survey of parents of children aged 1-11 revealed that almost a third (30%) of parents think that it is acceptable for a child to have experienced tooth decay before they have reached their teenage years*.
According to the survey many parents try a multitude of methods to help their children manage their oral health effectively. However, 30% of parents surveyed stated that they think it is acceptable for a child to develop tooth decay due to the difficulty in controlling how effectively they clean their teeth on a daily basis.
Difficulties regulating children’s sugar consumption was also cited as a reason why many parents now accept tooth decay. Over a quarter (26%) of parents surveyed admit this with a further 29% of parents surveyed believing that potentially painful oral health conditions, such as tooth decay, are pre-determined by a family history of oral health complaints and weak teeth.
Worryingly, more than 1 in 10 parents (14%) claim that they think that decay in children’s teeth is acceptable as all children will inevitably lose their milk teeth as they develop.
Whilst parents have the best of intentions with their children’s dental health, the research which shows that it can be hard for parents to keep up good habits amongst a backdrop of hidden sugars in our food and drinks and children’s reluctance to follow a good oral health routine.
* OnePoll survey of 2,000 participants conducted in February 2016
The government has previously highlighted its sugar tax initiative. Is this something that you would like to see extend to higher taxation levels, or perhaps implemented in a wider, or different way?
There are a couple of fundamental outcomes we hope will happen as a result of the sugar tax. Firstly, it is hoped that the manufacturers will take action over the next two years to adapt their recipes and reduce the overall sugar content of their drinks. Secondly, it is hoped that they will pass on any tax to the consumer to ultimately make products more expensive, so they are less likely to buy sugary drinks and make healthier lower sugar choices.
However, there is a danger that not every manufacturer of sugary soft drinks will do this. There is a chance that they try to absorb the costs by finding cheaper ways to make their products by squeezing suppliers and sourcing cheaper ingredients. That’s why we’d like the Government to closely monitor consumer buying habits and consider introducing a tax directly on the consumer at the point of purchase, if the industry tax does not prove effective.
Junk food advertising during prime television slots was not addressed by the strategy. Do you think television advertising of this nature is still the most important form of advertising to regulate in this respect? Or do other advertising mediums, such as social media, also present an equal threat?
A recent report from Ofcom* has revealed that as a nation, our television viewing habits are changing. Over the past five years, we have been watching less and less traditional ‘live’ television, with young viewers between 16-24 now receiving 64% of their content from on-demand, streaming or pre-recorded services. As our viewing habits change and evolve, it’s important to stay ahead of the curve and protect our children from potentially harmful advertising.
The issue is, current digital advertising platforms are ill-equipped to prevent certain adverts and inconsistent in their approach to protecting children. Youtube, for example, doesn’t allow for content creators to decide which pre-roll or banner ads are shown, and while the ‘Youtube Kids’ app does screen adverts to ensure they’re child-friendly, it still allows video content to be uploaded by the food industry, including from brands such as McDonalds.
Twitter and Facebook are, ostensibly, for adults only, but the age limits are routinely ignored. A recent study of children showed that 78% of under-13s were using at least one social media network, despite being below the age limit**. This means that in theory, adverts which meet Twitter and Facebook’s standards are still intended to be targeted at adults, but in reality, will also reach a large proportion of children.
In short, these new platforms do present a growing threat, and action will eventually need to be taken by industry and business to protect children from junk food advertising online. However, as a medium, digital advertising is more diverse, disparate, and will be harder to change. This means that while a ban on prime-time junk food ads is a meaningful first step towards tackling the UK’s childhood oral health and obesity crisis, it is far from a fix-all solution.
Do you think it is likely that tougher restrictions on sugar content, advertising etc will take place, or are we likely to see the current levels of regulation remain for the foreseeable future?
Key to the obesity strategy was the announcement that the government will launch a “broad, structured sugar reduction programme” to remove sugar from the products children eat most. All sectors of the food and drinks industry will be challenged to reduce overall sugar across a range of products that contribute to children’s sugar intakes by at least 20 per cent by 2020, including a 5 per cent reduction in year one. However, this “challenge” to the sector will merely be advisory for now, though if there has not been sufficient progress by 2020 the government “will use other levers” to achieve the same aims.
Also taking into account the economic uncertainty surrounding Brexit, it is probably unlikely that we will see any tougher restrictions on food and drink manufacturers for the foreseeable future. However, the obesity report did also mention that in light of the decision to leave the EU, the government wants to build on the success of the current food labelling scheme. This might include clearer visual labelling, such as teaspoons of sugar, to show consumers about the sugar content in packaged food and drink. We would welcome such measures that make it easier for people to make healthier food choices.
What would be your main piece of advice for parents with regard to trying to reduce tooth decay levels in children?
Parents certainly have a key role to play in giving their children the best start in life, it’s fair to say that no parent would ever wish for their child to experience tooth decay and most would probably feel that all-too-familiar sense of parental guilt when they find out their child has a cavity. It’s important that children learn to take care of teeth and understand how important they are from an early age. A good oral health routine in childhood makes it much more likely for them to continue these habits into teenage years and adulthood.
With the right guidance and support from parents and their dental team, every child should be able to learn to care for their teeth. For example an expectant mother should be given the opportunity to learn about the importance of a baby’s oral health when visiting her own dentist. Parents can start good oral care from a baby’s first day of life, set an example by taking care of their own dental health, and children should be encouraged to see their dentist regularly, to prevent early onset of disease, and to make sure they are cleaning their teeth effectively!
Denplan promotes oral health care messages and education for children, with PR and practice campaigns designed to encourage families to sign up for regular dental checks. A good example of this is the ‘Little Book of Healthy Smiles’, produced by Denplan, containing handy advice from dentists and tips on how to enthuse unwilling children to brush up on cleaning teeth, written for parents by parents.
For more information on Denplan visit www.denplan.co.uk