The UK is at risk of raising ‘one of the unhealthiest generations of children in decades’ as roughly one quarter present with obvious tooth decay, a report into children’s oral health has said.
Released on 14 July, the State of Child Health 2026 report measures progress on children’s health according to 12 key indicators. As part of this research, the Royal College of Paediatrics and Child Health (RCPCH) published an extensive report on children’s oral health.
As of 2024, Scotland and Wales had the highest proportion of childhood decay, at 27%, while England’s levels sat at 22%. Northern Ireland had not collected oral health data since 2018 so was not included in the report.
While children’s oral health had improved over previous decades, there has been little reduction in tooth decay between 2020 and 2024.
Childhood tooth extractions remain a significant burden on the NHS, persisting as the leading cause of hospital admissions in five-to nine-year-olds in England. In Wales, more than 3,500 children underwent tooth extractions under general anaesthetic in 2023-24.
Risk factors in children’s oral health
Deprivation was a significant predictor of poor oral health across the UK. In Scotland, children in the most deprived areas had a 40% rate of tooth decay, falling to 16% in the most affluent areas.
England showed a similar disparity, with a 32% decay rate in the poorest areas compared to 14% in the richest.
The report also revealed significant ethnic inequalities. In England, Asian or Asian British children and those from other minority ethnic groups were the most likely to have tooth decay, at 37.7% and 45.4% respectively.
According to the report, potential factors behind the high decay levels may include:
- Limited access to NHS preventive dental services, particularly in deprived areas
- High sugar consumption, especially among children from lower-income households
- Commercial baby foods and drinks often contain more sugar than recommended
- Lack of early oral health habits, including regular supervised toothbrushing
- Unequal access to the benefits of water fluoridation, which has been shown to reduce tooth decay and hospital admissions.
The consequences of poor oral health
The RCPCH also emphasised the widespread impact of oral health on children’s lives. It cautioned that children with tooth decay may experience:
- Pain and infection
- Difficulty eating, sleeping and speaking
- Reduced ability to play and socialise
- More time off school
- Risk of serious complications, including dental abscesses and sepsis if left untreated.
In addition to affecting individual children’s lives, poor oral health comes at significant cost to the government. The report estimates that tooth extractions in children aged zero to 19 in England cost the NHS £74.8 million in 2024.
The RCPCH made several demands for the government to improve preventive action on children’s oral health:
- Increase NHS dental capacity so every child can have a dental visit by age one
- Expand community water fluoridation in England
- Extend supervised toothbrushing programmes, particularly through Scotland’s Childsmile programme
- Reduce sugar in commercial baby foods and drinks through regulation
- Invest in preventive dental services and tackle inequalities in access to care.
It also recommended that dental professionals encourage every child to see a dentist by their first birthday, promote early adoption of good oral hygiene habits and advise families to limit sugary foods and drinks.
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