Report of the Director of Public Health attached

The Board considered the report of the Director of Public Health that provided update on the oral health of the children in Manchester and the services and programmes available. Data provided has shown that the prevalence of tooth decay and rate of teeth extractions remains higher for children and young people in Manchester than in Greater Manchester and England as a whole. However, there are positive signs arising from an increase in the number of children seen by an NHS dentist and the application of fluoride varnishing for Manchester children and young people in comparison to the previous year. Reference was made to the increase in the number of children being seen by an NHS dentist and the use of fluoride vanishing to protect children’s teeth.

The Board was addressed by Jenny Osborne, Assistant Director, Integration and Population Health and Vicky Brand, Oral Improvement Manager. It was explained that the report related to the oral health and children and the work to improve oral health to improve the of young people. The lack of NHS dentists has had a negative impact of oral health and tooth decay. Early intervention work is the priority in view of the level of tooth decay in young children. Hospital tooth extraction had reduced, however the reasons for this is at this time unknown and data for sections of young children across the city was limited in several areas. Reference was made to the need to address attitudes of some communities towards dental health and more work was needed to educate families on decay prevention as improving access a dentist for those in care and leaving care. 

It was reported that the first Children’s Oral Health Improvement Conference had taken place in October 2023 and a Steering Group has been established and an action plan will be produced to focus on work moving forward. A framework for Manchester is being developed and the work so far has demonstrated that the priorities are in place to help target resources at those most in need. The Board was informed that resources and with the support from Colgate, are providing parents of 0–2-year-old children with toothbrushes and toothpaste and support and advise to parents on selfcare. A further targeted approach to four areas of Manchester is also proposed via family hubs to evaluate a smart tool to promote behaviour change on selfcare and collect data to use in targeting resources to improve health inequality. Manchester is also unique for the use of a buddy programme where a number of dental practices are linked up with schools to allow children to access a dentist who have not seen a dentist before. The parent will be provided with advice and the child will receive a consultation and a referral for treatment. The process can provide further data on dental arrangements for children aged 0-5 years.   

The Chair commented that the data provided further demonstrates the importance of targeted intervention for dental services in the city and follows on from the lobbying that has taken place to provided further resources. Further work will continue to push and to provide evidence for the need for improved dental services.

The chair invited questions from Board Members.

Reference was made to the Buddy Programme and if this may include work to access younger children and if this is done via locality Hubs, PCNs or GP records. It was reported that the approach has targeted the deprived wards in Manchester and the schools included in the Kickstart scheme. The point was made that the Harpurhey and Charlestown wards do not have a dentist involved in the Buddy scheme and so there are ongoing gaps in dental support for children. Work is ongoing to contact and lobby dental practices to encourage their future involvement.

The Executive member commented on the current dental contract required review and difficulties in accessing a dentist and a focus by some practices on dental aesthetics instead of health promotion. Further work was also needed to address the advertising of sugary drinks and to promote a healthy diet and lifestyle. Reference was also made to the fluoridation of water and the impact this has made on levels of tooth decay in the Birmingham area.

The chair reported that fluoridation had been raised with the Secretary of State (Health) where the response received had stated that this is a local issue. Further discussion had also taken place with other Manchester health members and taking a proposal forward will require consideration at a Greater Manchester Authority.  

Members referred to the data available via the attendance at the Manchester Children’s Hospital when a child attends for a tooth extraction. Reference was made to the use of data on waiting lists and the offer of support from Colgate to GP practices in the offer of toothbrushes and toothpaste for children under 2 years and the opportunity this provides to advise parents on the importance of dental care and selfcare.

The chair thanked officers for the report and the comments made.

Decisions

The Health and Wellbeing Board:

1. Noted the activity to address oral health in the city and the early signs of improvement in oral health indicators.

2. Supports the sustained commitment to oral health improvement from system partners in the city with a focus on reducing health inequalities.