Members of the dental profession respond to new findings that children’s sugar intake fell ‘steeply’ after the Soft Drinks Industry Levy was introduced.
According to a recently published study, sugar intake among children reduced by almost one half in the year following the introduction of the ‘sugar tax’ in 2018. The tax requires manufacturers of drinks containing over 5g of sugar per 100ml to pay a levy.
While these findings have been well received by the dental profession, many believe that one year of data is not enough to be sure that the tax is effective. It has also been suggested that the levy does not go far enough in combatting children’s sugar intake.
Several dentists shared their thoughts on the new research and what other measures could be introduced to limit the impact of sugar on children’s oral health.
Nigel Carter, CEO of the Oral Health Foundation
It is very pleasing to have it confirmed that the sugar tax has been responsible for halving children’s level of sugar intake but there is much more that can be done.
Admission to hospital for tooth extraction remains the number one reason for hospital stays for the under 12s. At the Oral Health Foundation, we have been advocating for an extension of the tax to include milk products, both dairy and non-dairy, fruit juices with added sugar and cereals with the proceeds being specifically allocated to funding preventive oral health programmes.
Many drinks you can buy at independent coffee shops have more sugar than the daily adult allowance of sugar (30g) in just in one cup. However, they are exempt from the current Soft Drinks Industry Levy, more commonly known as the ‘sugar tax’. We also need to close the ‘loophole’ on ads for unhealthy food, especially during kids’ TV shows and video streaming platforms. We must expand this levy and encourage people to cut down on sugar.
The money from these taxes could offer extra funding for oral health programmes. Toothbrushing programmes can help children learn about correct brushing techniques, promoting good oral hygiene. More of these programmes can significantly reduce oral health issues, yielding cost savings on the treatment of childhood decay within the lifetime of a government.
James Goolnik, dentist
It’s always great to read about a reduction in sugar consumption as a dentist. Looking at the recent paper in the Journal of Epidemiology and Community Health, they examined data from the UK National Diet and Nutrition Survey between 2008 and 2019. This is a rolling survey that uses a four day self-reported food diary of a sample of around 1,000 people. It is a different sample of people each year.
The UK soft drink levy was announced in March 2016 and didn’t come into force until March 2018. Therefore this study compares one year of data after the levy came into effect. I feel this is too short a time to effectively measure behaviour change. All the reporting was self-reporting and we know people underreport their diets, especially with foods/drinks they know are unhealthy. I am looking forward to seeing the latest data in September as that will give a more representative period.
What still needs to change?
My recommendation is to expand the tax to milk based drinks, fruit or vegetable juices and most importantly infant formula and baby foods. There is no nutritional benefit from adding sugar to baby foods. The manufacturers want to get our children hooked on sweet foods from an early age.
I believe dental care goes beyond drilling and filling. We can significantly impact our patients’ overall wellbeing by incorporating these four strategies:
- Nutrition: diet profoundly affects our patients’ wellbeing. Most people know sugar is bad for them and causes tooth decay but still eat/drink loads of it as the effects on our body are further down the line. Let’s discuss the power of food to combat inflammation and empower patients to make positive dietary shifts
- Sleep as a foundation: poor sleep choices fuel poor dietary choices. Let’s assess sleep quality and explore options like overnight oxygen saturation monitoring, sleep appliances, or referrals to sleep specialists. Remember, improved sleep can mitigate risks for cognitive decline and Alzheimer’s disease
- Proactive screening: as a staple we should be carrying out blood pressure checks at each recall. We can perhaps look to also offer chairside tests for HbA1c (average blood glucose levels), Vitamin D, and even oral microbiome testing. Empowering patients with early detection allows for timely referrals and collaborative care
- Lifestyle: smoking cessation, exercise and mental health discussions are crucial. Let’s envision the future of dental practices working alongside health coaches to create a truly holistic approach to patient care.
Hannah Walsh, spokesperson for the British Society of Paediatric Dentistry (BSPD)
The news that children’s daily sugar consumption halved after just one year of the implementation of the sugar tax is great news for the oral health of our young – and in particular the vulnerable. BSPD had been campaigning on this issue for some time, since we know from clinical research that a preventively-focused approach is the most effective way to set children’s oral health on the right path for the long-term.
For children’s teeth, added sugar drinks are a particular threat, since the high sugar content and acidity levels can cause dental decay as well as enamel erosion. So, while this news is a good start, BSPD urges that next steps need to include support for the energy drink ban, as well as extending the sugar tax to milk-based drinks. Our insistence is also that clear and consistent labelling is needed so that informed decisions can be made when selecting a drink.
All these measures should be combined with other evidence-based interventions such as supervised toothbrushing and community water fluoridation initiatives targeted at children in areas of high dental need.
Sarah Mack, dentist
A positive shift in dietary habits is always something to be praised, and this study outlines how awareness of the Soft Drinks Industry Levy (SDIL) was found to be high amongst parents living in the UK. A consideration with this particular study is that the reduction observed is within 12 months of the SDIL implementation. We would need to see the results of much longer term studies to assess how this would impact specifically on dental health.
I also have concerns about the sample size for this study, analysing the dietary sugar consumption of 500 children per annum. There are 12.7 million children in the UK, therefore I would not consider it statistically significant.
It is important to consider that dietary free sugars are just one element which contributes to dental decay and we cannot use this as a single measure of success in our attempts to reduce the overall crisis with childhood decay and obesity. Education is essential and we need to do better to use this as a free tool to promote good oral health habits for our future generations.
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