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TOWARDS BETTER ORAL HEALTH IN CHILDREN: ANALYSIS OF CONSULTATION RESPONSES
CHAPTER 12: BROADER SOCIAL JUSTICE ISSUES
The consultation stated:
By the age of 3, over 60% of children from areas of severe deprivation have dental disease. Children from the most deprived areas are 3 times more likely to have already had dental decay at the age of 5 years than children from the least deprived areas.
The 33% reduction in decayed and filled teeth among 5-year-olds achieved since 1983, while encouraging, is most evident among more affluent children.
Nurseries, playgroups and Family centres all provide a suitable environment for the dissemination and discussion or oral health messages and for practical measures to encourage good habits, especially among the most disadvantaged children.
Toothbrushing schemes in nursery schools are being targeted at deprived communities.
Consultees views were:
In Brief: Some respondents perceived poor oral health as a social injustice issue They considered that poverty contributed to the problem and needed to be tackled alongside oral health It was suggested that oral health campaigns especially tailored for deprived areas could be effective Dental costs were perceived by some as a problem for those on low incomes Consultees considered that oral health initiatives and associated funding could be more sharply targetted towards deprived areas
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In Detail:
A number of respondents stood back from the detail of the consultation to reflect on the broader social issues of oral health. The view that poor oral health was a "
social injustice issue" (S. Aryshire Council) was shared by many, who advocated tackling the major problems of poverty, rather than the "
sticking plaster" of say, fluoride in the water (Scottish Consumer Council). However, a dissenting voice argued that dental caries was the result of "
poor discipline, poor self-control and poor culture" rather than "
poor people" (Dental Surgeon 1362).
Some people advocated taking a different, customized approach to campaigning for oral health in deprived areas. For example, they thought that high truancy rates in these locations could make promotion through schools less effective (Paediatric Dental Specialist 214). In addition, lack of interest in health matters could be the norm when faced with poor quality of life and housing (indiv 542), making promotions more of a challenge and requiring especially designed and targeted information (Lothian Health Council).
Some respondents thought that the costs of maintaining oral health were more of an issue in deprived areas. The relatively high costs of toothbrushes and paste were questioned (e.g. indiv 353) with the suggestion made that these be available free of charge in some areas (Dental Surgeon 1292). There were some concerns expressed over the cost of dental charges (indiv 110) and the possible loss of wages incurred as a result of dental visits (Paediatric Dental Specialist 214). It was proposed that an alleviation of some costs could take the form of free school meals, with measures taken to address the current stigma associated with these (British Association for the Study of Community Dentistry, Community Dental service Lomond and Clyde PCT, indivs 861, 1251).
A focus of funding and initiatives on deprived areas was suggested, perhaps involving an increase in NHS dentists (Kiltearn Community Council, Westone/Riverside LHCC) the extension of breakfast clubs (e.g. Dental Surgeon 1292, NHS Lanarkshire) and the subsidisation of fruit and other health snacks (indiv 241).
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