North Wales used to have fewer children with tooth decay than the rest of Wales. Not any more
The proportion of five-year-olds with tooth decay in the Betsi Cadwaladr University Health Board area has not improved since the last survey, even as the rate across Wales fell to its lowest level since records began.
New data from Public Health Wales shows 27.4% of five-year-olds in the BCUHB area had experience of tooth decay in 2024/25.
Across Wales, the figure fell to 27.2%, down from 32.4% in 2022/23, a statistically significant reduction.
In the BCUHB area, which covers Flintshire and the rest of north Wales, the change since 2022/23 was not statistically significant.
It is the first time the health board’s figure has been level with the national average.
In every previous survey going back to 2007/08, the proportion of five-year-olds with tooth decay in the BCUHB area was consistently below the Welsh average.
That gap has now closed, not because dental health in north Wales got worse, but because the rest of Wales improved and north Wales did not.
The two health boards that did record statistically significant reductions in prevalence since 2022/23 were Cardiff and Vale and Cwm Taf Morgannwg.
Four health boards, including BCUHB, recorded no significant change.
The BCUHB infographic, published alongside the national data, shows that approximately one in four children in the health board area, 22.6%, had untreated tooth decay.
On average, 0.96 teeth per child were affected.
Oral health had a negative impact on 18.0% of children examined in the BCUHB area, compared to 17.7% across Wales.
The survey examined 1,993 children from 165 state-maintained schools across the BCUHB area between winter 2024 and spring 2025.
Within the health board area, tooth decay prevalence varied from 20.2% to 33.5% across the six unitary authorities.
Betsi Cadwaladr University Health Board has been in special measures since February 2023.
The Welsh Government’s special measures priorities for the health board specifically list dentistry and oral health among the areas requiring improvement plans.
Across Wales, 8,526 children from 655 schools were examined.
In 2007/08, approaching one in two children had tooth decay.
In a class of 30, around eight children now have tooth decay, compared to 14 in 2007/08.
When children do have tooth decay, the impact is substantial.
Children with the condition had on average 3.51 teeth affected.
Almost 39% of parents of children with tooth decay said it had affected their child’s quality of life.
Pain was the most common effect, reported by 23.8% of parents of children with decay experience.
Across all children surveyed, 17.7% of parents reported some impact on quality of life.
Children from the most deprived communities were more likely to have tooth decay and to have more teeth affected.
The gap between the most and least deprived communities has not changed significantly since 2007/08.
Paul Brocklehurst, Consultant in Dental Public Health at Public Health Wales, said: “It is very encouraging to see continued reductions in both the number of children affected by tooth decay and the overall severity of disease.
“This represents a significant public health achievement. However, it is clear that too many children, particularly those living in more deprived areas, are still experiencing preventable dental disease.
“Establishing good habits early in life is vital. A diet low in sugar, brushing twice a day with an age-appropriate fluoride toothpaste, and regular dental attendance give children the best possible start.
“These findings show why continued investment in prevention and targeted support for families who need it most remains so important.”
The findings were produced by the NHS Wales Dental Epidemiology Programme, coordinated by Public Health Wales in partnership with the Welsh Oral Health Information Unit at Cardiff University.
The full 2024/25 report is published by Cardiff University on behalf of the programme.
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