Are half of all children's teeth really rotten?

"Rotten teeth are secret reason why teens don't smile," revealed The Times today.

The Daily Mirror expressed shock over revelations that, "More than a quarter of British children are afraid to smile because they have such bad tooth decay".

It explained how "poverty and sugar" were to blame after evidence has emerged that the poorest in British society are "twice as likely" to suffer from oral disease.

Public Health England's director of dental public health, Dr Sandra White, said the survey highlighted "the need to urgently reduce the amount of sugary snacks and drinks in our children's diets".

She went on: "Fluoride is indisputable in preventing tooth decay, and by brushing teeth using fluoride toothpaste and also introducing water fluoridation where needed, we can significantly improve our children's dental health."

Quoted in The Independent, Professor Damien Walmsley, scientific adviser to the British Dental Association, said: "These inequalities [between rich and poor] are persistent, but avoidable, and both parents and government must accept their share of responsibility."

What is the basis for these current reports?

These figures were revealed in the latest of five large-scale Children's Dental Health Surveys covering England, Wales and Northern Ireland. These surveys have been carried out every 10 years since 1973 to monitor the oral health of the nation.

The new survey report outlines changes in oral health since the last survey in 2003, and provides information on the distribution and severity of oral diseases and conditions in 2013.

The latest survey gives estimates of the dental health of 5-, 8-, 12- and 15-year-olds using data collected on a random sample of children by NHS dentists and nurses at dental examinations in schools.

Information on the children's experiences, perceptions and behaviours relevant to their oral health was collected from parents and 12- and 15-year-old children using self-completion questionnaires.

What did it find?

There was some good news. There were reductions in the extent and severity of tooth decay present in the permanent teeth of 12- and 15-year-olds overall in England, Wales and Northern Ireland in the last 10 years (2003 to 2013).

Decay was found in around a third of 12-year-olds (down from 43% in 2003) and half of 15-year-olds (46%, reduced from 56% in 2003). Around a third of 5-year-olds and almost half of 8-year-olds were found to have decay in their milk teeth.

However, large proportions of children continue to be affected by poor oral health. This directly affects their lives in significant and serious ways, such as not wanting to smile or problems eating food.

Children from poor families (judged by eligibility for free school meals) were more likely to have oral disease than other children of the same age:

• a fifth (21%) of the 5-year-olds from poor backgrounds had severe or extensive tooth decay, compared with 11% of 5-year-olds whose families were richer
• a quarter (26%) of the 15-year-olds from poor backgrounds had severe or extensive tooth decay, compared with 12% of 15-year-olds who were not eligible for free school meals

Oral health affected the health and wellbeing of older children and their families, too:

• a fifth of 12- and 15-year-olds (22% and 19% respectively) reported experiencing difficulty eating in the past three months
• more than a third (35%) of 12-year-olds and more than a quarter (28%) of 15-year-olds reported being embarrassed to smile or laugh because of the condition of their teeth
• 58% of 12-year-olds and 45% of 15-year-olds reported that their daily life had been affected by problems with their teeth and mouth in the past three months

The majority of older children were positive about their oral health. About half of 12-year-olds (51%) and 60% of 15-year-olds were satisfied with the appearance of their teeth.

However, problems with oral health were common, and these impacted on children and their families:

• a fifth of 12- and 15-year-olds (22% and 19% respectively) reported having difficulty eating in the past three months, and 35% of 12-year-olds and 28% of 15-year-olds reported being embarrassed to smile or laugh because of the condition of their teeth
• nearly a quarter (23%) of the parents of 15-year-olds said they had taken time off work in the last six months because of their child's oral health, and 7% of parents of 5-year-olds said this

Severe or extensive decay was seen in around one in seven of the 5- and 15-year-old children (13% and 15% respectively).

How does this news affect me?

This study is a stark reminder to children, young people and parents of the importance of good oral health from the time a baby gets their first milk teeth. Poor oral health can have a significant impact on a person's life.

Today's report does not suggest or endorse ways to combat the issues raised, but we have covered stories in the past that offer potential solutions for discussion.

These include adding fluoride to water to prevent tooth decay, more consistent advice on how to brush teeth, and teaching and supervising tooth brushing in schools.

Read more about preventing tooth decay.