Is it too easy to blame parents for children’s poor oral health?

Blaming parents for the condition of their children’s oral health doesn’t consider every part of the problem, Michael Watson says.

A story from Scotland caught my eye over the Easter weekend.

A leading paediatric dentist there has called for parents to take more responsibility for their children’s teeth.

Professor Nicola Innes, from the University of Dundee, says tooth-brushing programmes in schools have made a huge difference but more needs to be done.

Her call was a response to figures released by the Scottish government, which showed that their target for 60% of five-year-olds with no obvious decay reached only 55% in the most deprived areas, but in the least deprived parts of the country the figure was 82%.

Professor Innes said: ‘We have to come round to a system where we make it implicit on parents that it is their responsibility to look after their children.

‘Give them less sugar and more brushing.

‘Parents also need to take responsibility for their children’s diets.’


I am somewhat ambivalent about this approach.

Part of me says, yes, we must take responsibility for our own health, cut out smoking, reduce weight and take some exercise, all would help our general health.

And parents must take responsibility for their children’s health, teach them basic concepts of hygiene and good diet.

This will include teaching them about their toothbrush, when and how to use it.

There is only so much a dentist or anyone in the dental team can do if they only see the child a couple of times a year and nothing they can do if the child never attends.

Even the excellent Teeth Team programme, located in the City of Hull and the East Riding of Yorkshire, which takes dental education directly to children by going into local primary schools, is not the complete answer, unless backed up at home.

Thus far I agree with Professor Innes, but then niggling doubts come to mind.


It is all too easy to blame patients for their own conditions, smokers for the heart or respiratory diseases, obese for developing diabetes, alcoholics for having liver disease.

Or even those with poor oral hygiene for developing periodontal disease.

So, should we blame parents when their children develop dental decay?

Now I am not so sure and I am pretty certain that the parents involved may resent being blamed for the condition of the child’s teeth.

Social deprivation

I recently attended a lecture by Sir Michael Marmot, an epidemiologist whose life work has been the study of how social deprivation affects life expectancy in studies across the globe.

It was significant that in the data quoted above, oral health had an inverse correlation to social status.

‘The lower in hierarchy you are, the less likely it is that you will have full control over your life and opportunities for full social participation,’ says Sir Michael Marmot in his book.

Dentistry has an excellent record for treating and prevention for those that attend our surgeries.

Is it time though for a rethink to target those who stay away from us?

Difficult, yes but perhaps it is the way forward.

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