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Children’s Use of Non-Dental Services

Research conducted by more than half of pharmacies and nearly 7,000 parents in London found that most London children's pharmacies treat painkillers to treat oral pain.

Dr. Vanessa Muirhead, Principal Investigator from the Queen Mary Dental Equipment School, said: “Only 30% of children with oral pain see a dentist before going to the pharmacy, highlighting the fact that dental services are underused.

“Children with oral pain need to see a dentist for a definitive diagnosis and treat any caries. Failure to treat decayed teeth may result in more pain, abscesses, and possible damage to children’s permanent teeth.

“These children not only do not see the dentist until they visit the pharmacy. They see a general practitioner and a range of health professionals other than dentistry. The inappropriate and overuse of a variety of medical services, including A&E, has reduced waste. With the government’s priorities, the NHS has spent a lot of money.”

Nearly one-tenth of children have signs of dental emergency
Previous studies have found that the main reason for planning the admission of children aged 5 to 9 years is the extraction of dental caries under general anesthesia. At the same time, a quarter of Britain’s five-year-old children still have tooth decay in their infant’s teeth, and about one-fifth of the 12-year-old children have tooth decay in their adult teeth.

Although children under the age of 18 in the United Kingdom receive dental care free of charge, only 58% of children in the UK and 49% of children in London have visited dentists, and national guidelines recommend dental clinics to children at least annually.

This latest study was published on BMJ Open, funded by the Healthy London Partnership and the NHS in London, England. From 951 to January 2017, 951 pharmacies collected 6,915 parents whose children were seeking pain medication. Information, found that: Nearly two-thirds (65%) of parents seeking pain medications for their children are doing so to reduce children's oral pain.
Only 30% of oral pain children had seen the dentist before the pharmacy visit, while 28% saw 1-4 different health professionals (including GPs, health visitors, school nurses, and A&E departments - most Ordinary doctor).
Nearly one-tenth of children have signs and symptoms indicating dental emergency, and community pharmacy staff label them as emergency services.
During this period, the NHS fee for children who contacted health professionals outside of dentistry was £36,573 (a fee of £373,288 per year). Replicating these findings at all pharmacies in England may mean that NHS costs an estimated 2.3 million pounds per year when children with oral pain use inappropriate medical services.
41% of children had toothache; 20% had new episodes of tooth pain, and 15% had oral ulcer pain.
Saturdays and Sundays are the peak period for parents to go to the pharmacy to receive analgesics to treat children with oral pain. This may partly explain why some parents have not seen a dentist because of limited emergency dental care at the weekend.
General practitioners, pharmacists and dentists need to communicate with each other
Dr. Muirhead added:

“We need to develop an integrated system and referral process that allows GPs, community pharmacists and dentists to communicate with each other to ensure that toothache children see the dentist as soon as possible. We also need to better train community pharmacy workers and provide parents with Suggest and see how the dentist manages children with toothache. "

Researchers also stressed the need to work hard to prevent tooth decay. This includes the wider introduction of the Scotch Children's Drug And Dental Instruments Program, the distribution of fluoride toothpaste to all pre-school children, and the daily supervision of all nurseries for brushing teeth, early healthy low-sugar meals and snacks.

Research limitations include speculating on cost estimates that contain several assumptions. Researchers may also underestimate the amount of oral pain in London children because only community pharmacies are used as a means to identify children and parents.

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