Parents are being urged to take their children to the dentist, after it was revealed that Tower Hamlets is one of the worst places for dental health in the country.
Alongside nine other boroughs in London (including Hackney), the rates show that more than 50 per cent of children have not seen a dentist in the last year.
A spokesperson for Professor Nigel Hunt, Dean of the Faculty of Dental Surgery at the Royal College of Surgeons, said to ELL: “It is utterly unacceptable that more than a third of children aged 5 years old in Tower Hamlets suffer from tooth decay and that for every 100,000 children aged 0-10 in the borough, 916 had teeth extracted because of tooth decay.
“It is hardly surprising, though, given over 60% of children in the borough did not see a dentist in 2016. Tower Hamlets is the third worst borough in London for tooth decay and well above the national average of 24.7%.”
Although it is preventable, tooth decay is one of the most common oral diseases affecting children and young people.
Children living in deprived communities– particularly those with disabilities– have poorer oral health than those living in more affluent communities. This can affect a child’s ability to sleep, eat and even speak in more extreme cases.
Professor Hunt says tooth decay can be prevented by regularly brushing teeth with fluoride toothpaste, reducing sugar consumption and ensuring routine dental visits.
He said: “When children visit the dentist regularly, problems are picked up more quickly and the need for more aggressive treatment, such as tooth extraction in hospital, can be avoided.
“Many parents don’t realise that they should be taking children to the dentist by age one and then regularly thereafter. There is really no excuse not to as NHS dentistry for under-18s is free.”
To tackle the issue, Tower Hamlets Council is implementing multiple programmes, such as Smiling Start, Brushing for Life, School Fluoride Varnish, Healthy Teeth in Schools and Happy Smiles, which all aim to educate parents and children about the importance of dental care.
The council is also promoting oral health in all parts of the community, with support and training for care leavers, carers and service providers for elderly people, homeless people, those in sheltered housing and those with learning disabilities.
In 2014, The National Institute for Health and Care Excellence published guidance on oral health.
Shalu Kanal, who works with NICE, said to ELL: “The guidance provides advice to local authorities to improve their whole community’s health through better advice and support in oral hygiene, encouraging people to visit the dentist regularly, and through eating and drinking more healthily.”
Hunt stressed the importance of having children develop good oral hygiene habits from an early age. He told ELL: “Early years practitioners, such as health visitors and community midwives have an important role to play and oral health should be part of their training and professional development.”
Anyone living, studying or working in Tower Hamlets can access good-quality NHS dental services. To find your nearest dentist please call the health hotline on 020 7364 5016 or search online at www.nhs.uk/Service-Search/Dentists/LocationSearch/3.
Four-hour accident and emergency waits rise 300% at some hospitals
The number of patients waiting four or more hours at A&E has risen more than 300% at some hospitals, it has emerged.
In total, 2.2 million patients were not seen within the target time in 2015-16 - more than double the one million figure in 2013-2014.
The Royal College for Emergency Medicine (RCEM) says there is a "large and systemic problem" caused by a lack of hospital beds.
NHS England said hospitals were under pressure but continuing to cope.
The expert's view
Dr Simon Howse, policy research manager at RCEM, said there was no evidence more people were wrongly using A&E compared with a decade ago.
"In any health system some people turn up who are not in great need but studies show the level of unnecessary visits in the UK is very, very low."
The problem in hospitals, he said, was "a large and systemic problem" in which "hospitals are being asked to do something they are not resourced to do.
"They are trying to treat a growing and more needy population with fewer and fewer beds.
"There has also been continuous growth in people over 75 years old with complex needs and they tend to take longer to treat than, say, a 25-year-old."
In terms of hospital beds per capita, he said, the NHS in England now has fewer than Chile, Estonia and Turkey.
Across England in 2015-2016, 85% of patients were seen within four hours. The lowest level was at The Hillingdon Hospitals in London at 68%.
But Dr Howse warned some hospitals were currently recording - in figures not yet published - rates in the 50s and 60s.
These rates matter, he said, because "people are being seriously put at risk" at rates of below 80%.
Neil Carvey, of Leatherhead in Surrey, was advised to go to accident and emergency by a GP after he awoke shivering and in pain following an operation on his spine last December.
His partner Ivanel Petrenkov told how they ended up waiting 16 hours at Epsom Hospital on Christmas Day despite there "being barely anybody there".
It has since emerged Mr Carvey suffered a spinal infection as a result of complications. He is still in hospital.
Mr Petrenkov, who has friends who work in health care, said: "We have lost all faith in accident and emergency."
The hospital trust - which has seen a 97% rise over three years in patients waiting more than four hours, disputes the couple's 16-hour wait claim, saying: "During December, no patient waited in A&E for 16 hours to be seen."
A spokeswoman for the hospital said it had "an excellent track record" of meeting a 95% target for dealing with patients within four hours.
"That said, in recent weeks we have seen unprecedented levels of demand on our services and in some cases, that has meant some people have experienced longer waiting times," she said.
The largest increase percentage-wise in waits of four hours or more were seen at North Middlesex University Hospital, with a 380% rise, the Royal Free Hospital in London, with a 366% rise and Mid Yorkshire Hospitals at 351.5%.
Pennine Acute Hospitals has experienced the biggest rise in patients waiting more than four hours. In 2013-2014, 13,867 people were not dealt with in four hours. In 2015-2016, that number rose 296% to 54,945.
The trust's medical director Prof Matt Makin said: "Our (three) accident and emergency departments have continued to face real pressures throughout the year and we know demand on our services further increases over winter.
"Like most trusts across the country, we are finding this a challenge due to the flow of patients in and out of hospitals and the large numbers of admissions of patients, particularly those who are elderly and with complex and chronic health conditions.
"We are sorry that some patients have to wait longer than we would like to be seen by a doctor and also those who are waiting to be admitted and taken to the ward."
In January, some patients at the Shrewsbury and Telford Hospital NHS Trust ended up waiting 20 hours or more to be dealt with.
The hospital said the situation arose out of "incredibly high levels of demand", but none of those waiting 20 hours were "serious" cases.
In an open letter, the hospital's chief executive Simon Wright said: "It's a fact that our acute emergency service has been frail for some time. It is no secret that health budgets - nationally and locally - are stretched."
NHS England did not respond to the RCEM's claims that the rise in delays was largely caused by a shortage of hospital beds and resources.
In a statement, a spokesman for NHS England blamed delays in being able to discharge patients as a result of pressures in social care.
"Hospitals report this affects their ability to quickly admit emergency A&E patients, so the NHS is working closely with local councils and community health services to enable older patients to get the support they need after a hospital stay, back at home," he said.
"Hospitals are coming under increasing pressure but in the main are continuing to cope."
New drug for one in five breast cancers
- Many more women could be helped by a new type of breast cancer drug, say experts
- Biological therapies are currently only available as part of clinical trials, but hold great promise
- Experts estimate as many as one in five patients might benefit
Around 10,000 women a year in the UK might benefit from a new type of breast cancer treatment, say scientists.
Biological therapies can help fight breast cancers caused by rare, inherited genetic errors like the BRCA one actress Angelina Jolie carries.
Now a new study by experts at the Wellcome Trust Sanger Institute suggests these targeted drugs may also work in many other women who do not have these risky genes.
The drugs could be effective in one in five breast cancers, say the researchers.
That's 20% of patients - far more than the 1 to 5% who develop the cancer alongside having faulty BRCA genes.
One biological therapy or PARP inhibitor, called olaparib, is already used on the NHS to treat advanced ovarian cancer.
It is not yet approved as a breast cancer drug, although some UK women are taking it in clinical trials.
For the latest work, published in the journal Nature Medicine, the researchers looked at the genetic make-up of breast cancer in 560 different patients.
They found a significant proportion of them had genetic errors or "mutational signatures" that were very similar to faulty BRCA.
Given the close similarity, these cancers might be treatable with biological therapies too, they reasoned.
They recommended clinical trials to confirm this.
Baroness Delyth Morgan, from Breast Cancer Now, called the early results "a revelation".
"We hope it could now lead to a watershed moment for the use of mutational signatures in treating the disease," she said.
One of the researchers, Dr Helen Davies, said there was also the potential to treat other types of cancers with these drugs.
Biological therapies have already had some promising results for treating prostate cancer.
They change the way cells work and help the body control the growth of cancer.
Carrying certain gene mutations, like faulty BRCA, increases a woman's risk of developing breast cancer, although it does not mean she will definitely go on to get cancer.
Some women - like Angelina Jolie - opt to have surgery to have their breasts removed to lower their lifetime risk.
Vicki Gilbert, 54 and from Swindon, found out she was carrying high-risk genes - but only after she developed breast cancer.
"I had been thinking about getting tested anyway because there was quite a lot of cancer on one side of my family. But then I was diagnosed with breast cancer out of the blue, before I even had a chance to go for the genetic screening."
She says finding out, even after the event, was helpful.
"When you get cancer you do think 'Why me?' I don't know for sure if it was because of the genes that I inherited. That would be impossible to say. But, for practical reasons, it is useful to know that I carry these genes."
Vicki has been free of cancer for around seven years, but still has regular checks because of her increased genetic risk.
Women can lower their lifetime risk of breast cancer by exercising regularly, eating a good diet, maintaining a healthy weight, avoiding cigarettes and limiting how much alcohol they drink.