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‘Sugar tax’ linked to fall in childhood hospital tooth extractions

Published: 17 November 2023

The UK ‘sugar tax’ may have reduced the amount of child hospital admissions for tooth extractions, finds NIHR-funded research.

The number of under-18s needing hospital extractions fell by 12%, since the legislation started in April 2018. This equates to an estimated 5,500 less children needing decayed teeth pulled out annually under general anaesthetic since it began. The largest reductions were in children aged up to 9 years old, researchers found.

Experts at Cambridge and Glasgow universities led the study, which is the first of its kind. The results are published in BMJ Nutrition, Prevention and Health.

Sugar-sweetened drinks account for around 30% of added sugars in diets of children aged 1-3 years. This rises to over 50% among older teenagers. In England, nearly 90% of all tooth extractions in young children are due to decay. It results in around 60,000 missed school days a year.

The World Health Organization (WHO) has recommended a tax on sugar-sweetened drinks to reduce sugar intake. More than 50 countries have implemented this.

The UK Government announced its Soft Drinks Industry Levy (SDIL) in March 2016. It aimed to reduce sugar intake by encouraging drinks manufacturers to reformulate their products. The tax started in April 2018.

The relationship between sugar-sweetened drinks and tooth decay is well established. But previously no real-world data studies had examined the relationship between the levy and dental health.

Researchers analysed hospital admissions data for childhood tooth decay extractions among under 18s in England from January 2014 to February 2020. This was four years before, and two years after the levy began. The team also broke the data down by age groups and by neighbourhood deprivation.

They found a drop of 3.7 admissions per 100,000 under-18s since 2018. This equated to a relative reduction of 12% compared to if the levy was not introduced. The trends means that an estimated 5,638 fewer children are having teeth extracted under general anaesthetic. The biggest falls were among children aged 0-4 years, and 5–9 years. This represented declines of 6.5 and 3.3 per 100,000 admissions respectively.

Dr Nina Rogers from the Medical Research Council (MRC) Epidemiology Unit at the University of Cambridge, the study’s first author, said: “This is an important finding given that children aged 5 to 9 are the most likely to be admitted to hospital for tooth extractions under general anaesthesia.”

No significant changes in admission rates were seen in older age groups of 10–14 years and 15–18 years. But reductions in hospital admissions were seen in children living in most areas regardless of deprivation.

This is an observational study so causality can’t be established, researchers say.

They conclude their study “provides evidence of possible benefits to children’s health from the UK soft drinks industry levy beyond obesity it was initially developed to address.”

Professor David Conway, co-author, and professor of dental public health at University of Glasgow said: “Tooth extractions under general anaesthesia are among the most common reasons for children to be admitted to hospital across the UK. This study shows that ambitious public health policies such as a tax on sugary drinks can impact on improving child oral health.”

Professor Sumantra Ray, Executive Director of the NNEdPro Global Centre for Nutrition and Health, said: “We welcome the publication of this research which attempts to draw the links between policy-level changes and the impact on early life oral and dental health outcomes which, if untoward, would produce a significant onward burden on dental services through the life course.”

NIHR's Public Health Research (PHR) Programme funded the study.

More information is on the study's project page.

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