Professional Summary

Dr Andrew Nesbitt (GDC No. 66007) holds qualifications including BDS, FDS-RCPS, MFGDP(UK) and a Master’s in Dental Implantology (M.Med.Sci). He is a registered specialist in oral surgery, with over two decades of clinical and surgical experience.

As Private Principal Dentist at Shenstone Dental Centre, he leads the surgical and implant dentistry services.

The Health Secretary has  caused a stir with an announcement that the government plans to reformulate the Soft Drinks Industry Levy, better known as the sugar tax.

First introduced in 2018 to tackle obesity, the levy currently applies to drinks with more than 5g of sugar per 100ml, impacting manufacturers and mass-importers. The new recipe? Lowering the threshold for which the levy applies from 5g to 4.5g per 100ml and scrapping the exemption for bottled milkshakes, flavoured milk, and milk substitute drinks. Open-cup drinks prepared in cafés and bars, plain cow's milk, and other milk drinks without added sugar remain exempt.

Why the shake-up? Sugar intake is still double recommended levels.

From my perspective as an oral surgeon, this matters profoundly. Every week in my practice at Shenstone Dental Centre, I see the direct consequences of excessive sugar consumption: advanced tooth decay in young adults, root canal emergencies that could have been prevented, and extraction cases where the damage has become irreversible. The link between sugar and oral disease isn't debatable—it's biochemical fact. When sugar interacts with bacteria in the mouth, it produces acid that erodes enamel. Frequent exposure, particularly from sugary drinks sipped throughout the day, creates a constant acidic environment that teeth simply can't recover from.

The inclusion of milkshakes and flavoured milk drinks is particularly significant. Many parents believe these are healthier choices for children compared to fizzy drinks, yet a single bottled milkshake can contain upwards of 30g of sugar—more than a child's entire recommended daily intake. These drinks are often consumed slowly, maximising the time teeth are bathed in sugar. I've treated teenagers who've never touched a can of cola but have severe decay from daily "healthy" smoothies and flavoured milk.

The changes are also set to sweeten the government's coffers by raising an extra £40–45m in tax receipts when the changes kick in on 1 January 2028.

The implementation date gives manufacturers time to decide—reformulate recipes, raise prices, shrink portions, or absorb the additional cost.

Depending on the actions taken, manufacturers will need to revisit:

• Recipes, which will require investment in research and development with the possibility of compromising on taste or quality of products. From a dental health standpoint, I hope manufacturers choose reformulation over price increases. Lower sugar content, even by half a gram per 100ml, reduces the cumulative acid attacks on tooth enamel. If industry can innovate around taste without relying on sugar, we all benefit.
• Labelling and classification for products. This is where patient education intersects with policy. Clearer labelling helps my patients make informed choices. When parents understand that a "fruit-flavoured milk drink" contains as much sugar as a dessert, behaviour changes. Transparency drives accountability—not just for manufacturers, but for consumers too.
• Contracts with suppliers and distributors, specifically in connection with potentially triggering price adjustment mechanisms. While I understand the commercial pressures, from a public health perspective, any friction that reduces impulse purchases of high-sugar drinks is a positive outcome. If a milkshake becomes slightly more expensive or harder to justify as an everyday item, consumption patterns shift. That shift translates directly into fewer emergency appointments, less childhood anxiety around dental procedures, and better long-term oral health outcomes.

The Clinical Reality

What concerns me most isn't the policy itself—it's the gap between policy implementation and patient awareness. Many people still don't connect their daily beverage choices with the state of their teeth. They'll ask me why they're getting cavities when they "brush twice a day," not realising that sipping a sugary latte mid-morning and a bottled smoothie at lunch has created a six-hour acid bath for their enamel.

This levy expansion is a step in the right direction, but it needs to be paired with robust public education. Patients need to understand why these changes matter, not just see them as another government revenue grab. Sugar isn't just about waistlines—it's about preserving the functional integrity of your teeth for life.

If this policy drives even a modest reduction in sugar consumption, particularly among children and adolescents, the long-term benefits will extend far beyond dental health. But it requires all of us—clinicians, policymakers, educators, and yes, manufacturers—to commit to putting health outcomes above convenience and profit.

Dr. Andrew Nesbitt says "I welcome any intervention that makes the healthier choice the easier choice. If that means my patients reach for water instead of a milkshake, I'll consider that a win for everyone involved."

Services & Expertise

• Oral surgery and complex extractions
• Dental implants and implant restorations
• Bone grafting and advanced bone management
• Full-mouth rehabilitation and restorative dentistry
• Cosmetic dentistry services — veneers, crowns, smile makeovers
• General preventative and family dentistry for all ages