Childsmile: The Child Oral Health Improvement Programme in Scotland

Macpherson, L. M. D.; Ball, G. E.; King, Peter; Chalmers, Kim; Gnich, Wendy

doi:10.1308/205016815816682236

Cited by 14 publications

(13 citation statements)

References 8 publications

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“…Their Global School Health Initiative promotes the concept of ‘Health Promoting Schools’, with oral health promotion a key aspect of this initiative due to the high global burden of preventable dental disease, and shared risk factors for oral and systemic disease [24]. Moreover, national programmes within the UK such as ChildSmile in Scotland [25], and Designed to Smile in Wales [26], have demonstrated the feasibility and efficacy of OHP programmes that combine community initiatives with nursery and school-based programmes. This systems approach may have the added benefit of protecting individual services from excessive additional workloads, as areas of deprivation often exhibit an inverse care law, where there is a mismatch between the high needs for healthcare and supply of healthcare [27].…”

Section: Discussionmentioning

confidence: 99%

Parenting and oral health in an inner-city environment: a qualitative pilot study

et al. 2018

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BackgroundPreventable oral diseases such as dental caries remain common in the United Kingdom. Clustering of poor health is observed within deprived communities, such as inner-city areas, where elevated levels of dental need are associated with lower uptake of dental care. Successful oral health promotion (OHP) initiatives are contingent upon effective community engagement. The aim of this pilot study was to engage with families with young children to explore community views on oral health and dental care and thus tailor OHP initiatives more effectively to their needs.MethodsQualitative research, involving individual interviews and triad focus groups with parents/caregivers, was conducted in a south London inner-city community as part of a ‘Well London’ programme initiative.ResultsSeventeen parents/caregivers participated in this pilot study. Parents/caregivers described a spectrum of oral health behaviours based on their social history, past dental experiences and cultural influences. All parents described a clear desire to create healthy lives for their children; however, two broad groups were apparent, termed ‘Oral Health Prioritisers’ and ‘Oral Health Non-prioritisers’. The former reported regularly accessing dental care for their children, believing that oral health contributes to systemic health. Non-prioritisers, however, preferentially used key services considered most beneficial to their child’s wellbeing. Dental services were considered a low priority for this group, where oral health was synonymous with absence of pain. Participants in both groups favoured OHP initiatives involving a range of health and social care services, with schools at the epicentre of programmes. First-time parents were proposed as an important group requiring support in future OHP initiatives with evidence suggesting that first-born children may have delayed presentation to a dentist.ConclusionsThe findings suggest that this inner-city community may contain sub-groups with contrasting perspectives on oral health and oral health behaviours; nevertheless, there was support for a systems approach to oral health promotion initiatives involving a range of health and social care services, including a critcal role for schools, and actively connecting with first-time parents. The findings provide the basis for further research.Electronic supplementary materialThe online version of this article (10.1186/s12903-018-0584-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Parenting and oral health in an inner-city environment: a qualitative pilot study

et al. 2018

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“…As the focus of the present study is to understand how dental professionals and parents’ behaviours encourage children’s participation in the consultation and their cooperation in receiving FVA, the coding scheme will be designed therefore to be sensitive enough to detect child’s responses to dental professional and parental behaviours. We will develop a new coding scheme that not only focuses on dental professionals’ encouragement and communication strategy and children’s responses but also on the mechanism of [ 1 ] whether or not dental professionals’ interactive behaviours can motivate child participation in oral health education and prepare them for receiving FVA and [ 2 ] whether or not the child-parent interaction can serve as a moderator to child’s cooperation of receiving FVA. Therefore, a communication behaviour coding scheme will be developed based on the St Andrews Behavioural Interaction Coding Scheme (SABICS) which was designed to record interactive behaviours between dental nurses and 3–5 year-old children in a nursery setting during the fluoride varnish application sessions of Childsmile Programme [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

“…Childsmile is a child oral health improvement programme in Scotland with components being delivered in the nursery, school, family home and dental practice settings [ 1 ]. It was introduced in 2006 due to the high prevalence of dental disease in pre-school children.…”

Section: Introductionmentioning

confidence: 99%

A mixed-methods feasibility study protocol to assess the communication behaviours within the dental health professional-parent-child triad in a general dental practice setting

Yuan

Humphris

Ross

et al. 2018

Pilot Feasibility Stud

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BackgroundThe promotion of twice yearly application of fluoride varnish (FVA) to the teeth of pre-school children in the dental practice is one component of Scotland’s child oral health improvement programme (Childsmile). Nevertheless, evidence shows that application rates of FVA are variable and below optimal levels. The reasons are complex, with many contextual factors influencing activity. However, we propose that one possible reason may be related to the communication challenges when interacting with younger children. Therefore, the primary aim of the study is to assess the feasibility of conducting a video observational study in primary dental care. The secondary aim is to assess the communication behaviours of dental professionals and those of the parents to predict child cooperation when receiving FVA using this video observational study design.MethodsApproximately 50 eligible pairs of parents and child patients aged between 2 years and 5 years from general dental practices will be recruited to participate in the study. The consecutive mixed-method study will consist of two parts. The first part will be cross-sectional observations of the dental health professional-child-parent communication during dental appointments conducted in the general dental practice setting, using video recording. The second part will be a post-observation, semi-structured interview with parents and dental health professionals respectively. This will be implemented to explore their views on the acceptability and feasibility of being observed using video cameras during treatment provision.DiscussionThe mixed-methods study will allow for directly observing the communication behaviours in the clinical setting and uncovering the views of participating dental health professionals and parents. Therefore, the study will enable us to [i] explore new ways to study the nature of triadic interaction of dental health professional-child-parent, [ii] identify dental health professionals’ effective communication behaviours that promote child patient and parent’s experience of using preventive dental service and [iii] to assess the feasibility of the study through uncovering the views of dental health professionals and parents.

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“…An oral health improvement programme for children in Scotland (Childsmile) was developed, with pilots commencing in 2006. The components of Childsmile included: daily supervised toothbrushing (with 1,000 ppm F toothpaste) in nursery school; free toothpaste and toothbrush packs for home use; toothbrushing in the first 2 years of primary education in the more deprived areas; community-based dental health support workers; and preventive care including fluoride varnish (FV) and oral health advice within primary dental services [Macpherson et al, 2010[Macpherson et al, , 2015[Macpherson et al, , 2019a.…”

Section: Introductionmentioning

confidence: 99%

Fluoride Varnish in Nursery Schools: A Randomised Controlled Trial – Protecting Teeth @3

et al. 2020

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Studies suggest that fluoride varnish (FV) application can reduce dental caries in child populations. The multiple-component national child oral health improvement programme in Scotland (Childsmile) includes nursery-based universal supervised toothbrushing and deprivation-targeted FV applications, together with community and dental practice prevention interventions. This trial, a double-blind, two-arm randomised control trial, aimed to assess the effectiveness and cost-effectiveness of the nursery-based FV applications plus treatment-as-usual (TAU) Childsmile programme interventions, compared to TAU Childsmile interventions alone, in children not targeted to receive nursery FV as part of the programme. Participating children in the first year of nursery (aged three), with or without existing caries, were randomised to either FV or TAU and followed up for 24 months until the first year of primary school. Treatments were administered at six-monthly intervals. The primary endpoint was “worsening of d3mft” from baseline to 24 months. Secondary endpoints were worsening of d3mfs, d3t, mt, and ft. Individual record-linkage captured wider programme activities and tertiary endpoints. A total of 1,284 children were randomised, leading to 1,150 evaluable children (n = 577 FV, n = 573 TAU, 10% dropouts). Mean age was 3.5 years, 50% were female (n = 576), 17% had caries at baseline (n = 195), all balanced between the groups. Most children received three/four treatments. Overall, 26.9% (n = 155) had worsened d3mft in the FV group, and 31.6% (n = 181) in the TAU group, with an odds ratio (OR) of 0.80 (0.62–1.03), p = 0.078. The results for worsening of the secondary endpoints were: d3mfs 0.79 (0.61–1.01) p = 0.063, d3t 0.75 (0.57–0.99) p = 0.043, mt 1.34 (0.75–2.39) p = 0.319, and ft 0.77 (0.53–1.14) p = 0.191. We calculated a number needed to treat of 21 and a cost of GBP 686 to prevent a single worsening of d3mft. There was a modest non-significant reduction in the worsening of d3mft in the nursery FV group compared to TAU, suggesting that this intervention is unlikely to represent an effective or cost-effective addition to the population oral health improvement programme.

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Childsmile: The Child Oral Health Improvement Programme in Scotland

Cited by 14 publications

References 8 publications

Parenting and oral health in an inner-city environment: a qualitative pilot study

Parenting and oral health in an inner-city environment: a qualitative pilot study

A mixed-methods feasibility study protocol to assess the communication behaviours within the dental health professional-parent-child triad in a general dental practice setting

Fluoride Varnish in Nursery Schools: A Randomised Controlled Trial – Protecting Teeth @3

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