Falling into decay: the sorry state of our children's teeth

Like all the best tips, the information was given to me in a pub. But this wasn’t a sordid secret about one of our elected representatives, or allegations of bullying at a reputable local business. My companion and I are data journalists — we tend to steer clear of all that stuff. “Have you looked at the numbers on Sheffield’s children’s teeth?” he asked me. 

I hadn’t. A new dataset! What a rush. I got home and dived down the rabbit hole. It didn’t take long for me to see why he’d brought it to my attention.

The chart below shows the rate of hospital-based tooth extractions among 0-19 year olds in local authorities across England. These are children and adolescents whose teeth have decayed to the point where the tooth needs to be taken out, and is drawn from a dataset of hospital episode statistics.

You’ll notice that Sheffield doesn’t just lead the pack. It positively romps home. In 2023, more than one tooth was pulled in hospital for every one hundred children — the only place this is true. The rates are more than 3.5 times the English average. 

And that’s just for 2023, which was not a blip. The 2022 data shows Sheffield once again topping the charts. South Yorkshire looks like it has a particular problem — Doncaster and Rotherham also make the top ten, with Barnsley just outside it.

Tooth extraction is a fairly extreme measure. In the first instance, decay should be treated with fluoride mouthwashes, fluoride varnish, diet advice and oral hygiene. The next step would be to use fillings to stop the decay setting in further. It’s only when the decay has set deep into the nerve of the tooth that the final step — removing the tooth altogether — has to be taken. Without action, pain and abscesses are the likely result (root canal treatments are rarely carried out on children).

So why are so many kids’ teeth being pulled in Sheffield’s hospitals? And, more importantly, what can we do to change it?