Open wide – supporting oral health during the pandemic

Claire Benzies, LEAP’s Oral Health Promotion Practitioner, describes why a healthy mouth is important for general health and wellbeing and how LEAP has been supporting families during the pandemic.

Why is oral health important in the early years?

Oral health is essential to general health and wellbeing, educational attainment and quality of life.

Tooth decay is the most common disease affecting children in England, yet it is largely preventable. While this has improved over the past 20 years, almost a quarter of five-year-olds still have tooth decay affecting multiple teeth (1).

Dental treatment is the single biggest reason children aged six to ten in England (2) are admitted to hospital; treatment under general anaesthesia presents a small, but real risk to life.

Unsurprisingly tooth decay in early childhood can negatively impact the life-course of those children affected and their families. It also places a significant burden on the NHS.

Tooth decay shares a common risk factor with obesity and yet, oral health is rarely considered in public health.

Oral health inequalities, like those in general health, are widening along with social deprivation. This has been exacerbated by Covid-19.

What is LEAP doing to address this in Lambeth?

Reviews of clinical effectiveness by NICE (3) and PHE (4) have found that the following programmes effectively reduced tooth decay in five-year-olds and represented a good return on investment (listed in order of greatest impact first):

Water fluoridation
Targeted provision of toothbrushes and toothpaste by post and by health visitors
Targeted supervised tooth brushing (STB)
A targeted fluoride varnish programme
Targeted provision of toothbrushes and paste by post

LEAP responded by commissioning a full-time expert in oral health promotion. We have worked collaboratively with the local community, academics and professionals to develop a bespoke oral health programme aligned with the evidence-base (5); focusing on increasing access to fluoride.

No one intervention is likely to provide a solution. Therefore, we partner with the community, other LEAP services and further afield to put oral health in all policies. We also join up oral health with other interventions addressing common risk factors to increase impact. Core to this, is promoting consistent evidence-based oral health messaging.

There are several ways a parent/carer can improve young children’s oral health (6):

Cut down on food and drinks that contain sugar.
Brush teeth twice daily with fluoride toothpaste (1350-1500ppm), last thing at night and at least on one other occasion.
Spit, don’t rinse, after brushing.
Take your child to the dentist when the first tooth appears, at about 6 months, and then on a regular basis.

How did we adapt the programme to help families during the pandemic?

LEAP delivered 400 family oral-health packs, including toothbrushes and toothpaste. We included these packs in emergency food drops, as part of our wider response to the pandemic.

The response was extremely positive:

“As soon as my son saw the toothbrush he wanted it and was very excited and keen to brush his teeth immediately.” – Local parent.

“Feedback has been positive and families have been really grateful to receive the oral health family packs. What has come back really strongly from a lot of families over this period is that they are so pleased that they are still being remembered and services are putting things in place in different ways to continue to provide them with support and information.” – Setting manager.

What are our next steps?

We quickly learnt how we can reach families in the hardest of times.

We spent time modelling our interventions in response to different lockdown scenarios and will continue to support families with their children’s oral health. We will do this through a blended offer of oral health packs, and virtual support for communities and the local workforce.

We feel well prepared to continue supporting families, whatever lockdown may bring next.

Claire Benzies is LEAP’s Oral Health Promotion Practitioner.

References

About A Better Start

A Better Start is a ten-year (2015-2025), £215 million programme set-up by The National Lottery Community Fund, the largest funder of community activity in the UK. Five A Better Start partnerships based in Blackpool, Bradford, Lambeth, Nottingham and Southend are supporting families to give their babies and very young children the best possible start in life. Working with local parents, the A Better Start partnerships are developing and testing ways to improve their children’s diet and nutrition, social and emotional development, and speech, language and communication.

The work of the programme is grounded in scientific evidence and research. A Better Start is place-based and enabling systems change. It aims to improve the way that organisations work together and with families to shift attitudes and spending towards preventing problems that can start in early life. It is one of five major programmes set up by The National Lottery Community Fund to test and learn from new approaches to designing services which aim to make people’s lives healthier and happier

The National Children’s Bureau is coordinating an ambitious programme of shared learning for A Better Start, disseminating the partnerships’ experiences in creating innovative services far and wide, so that others working in early childhood development or place-based systems change can benefit.

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