Toothbrushing, Easy Political Answer or Meaningful Prevention?

Toothbrushing, Easy Political Answer or Meaningful Prevention?

Governments and health providers, understandably, like simple solutions. They can be low cost, easy to set up, staff and run. As a bonus, a general public with short attention spans are more likely to understand and appreciate them than more complex or nuanced offerings. This might explain the renewed focus on tooth brushing in schools, with two new stories showing that rolling out brushing instruction is becoming an on-trend dental public health activity.

Though, as well as showing two different approaches, and two different sources of funding, there are some differences in the key messages that are being delivered.

On the Essex coast The Southend Echo has reported that Southend Council could introduce a supervised tooth brushing programme. The council is now advertising for a two year contract to show children “how to brush effectively and avoid tooth decay.” The contract is for a scheme that will reach four and five year olds in reception classes. Its key objectives are to reduce the prevalence of tooth decay, hospital admissions for dental caries, and reduce health inequalities in children.

According to the most recent figures, there were more than a dozen hospital admissions in Southend to remove children’s decayed teeth last year.

Southend councillor, Lesley Salter, who worked as a dentist before retiring, said: “It should be a priority for parents to teach their children how to brush their teeth. However, not all parents are able to do this, and if the child is not seeing a dentist, or hygienist regularly, they may never have learned. Working in Lewisham many years ago, we had a particular problem with oral hygiene in a primary school.”

Councillor Salter had then been involved in a programme with assistance from teachers and a company donating toothbrushes and tubes of toothpaste for the children. Brushing in school had become a skill as well as fun, she said. “I can’t comment on if it is more of an issue now as I am retired, though I understand it can be difficult to see an NHS dentist.”

Figures from the Office for Health Improvement and Disparities show there were an estimated 55 total hospital admissions in Southend for children’s tooth extraction in the year to March 2023. Of these, about 15 were extractions for tooth decay. Despite this, the rate of tooth extractions in Southend at 132 per 100,000 children is well below the national rate of 360 per 100,000.

The paper quoted local grandmother, Lesley Taylor, who said: "My two-year-old granddaughter cleans her teeth with her mum and has already been to the dentist twice for checks. That is a parents job to teach basic hygiene. Dental care is so important. School and nurseries should also encourage children to clean their teeth too, but that money should go on more important things. Are parents actually too lazy to clean their children’s teeth now?"

Within a couple of days tooth brushing was in the local papers again, 200 miles away in Wakefield. There, the Wakefield Express reported on local St Michael’s Orthodontics, part of the PortmanDentex group, visiting a school as part of National Smile Month.

Practice manager Carol Walter, treatment coordinator Dawn Rimmington, and dental nurse Gail Ward, delivered an oral health workshop for children as part of the annual event using an educational campaign created by national charity, the Oral Health Foundation.

The children from years 5 and 6 took part in a dental quiz and there was a presentation about tooth brushing, tooth decay and different types of orthodontic appliances. They also received goody bags containing a toothbrush, disclosing tablets, a notepad and pencil and information leaflet on tooth brushing to take home.

Carol Walter said: “It was the perfect opportunity to talk to the children about what we do, the importance of coming for a check-up and to help them really understand why it’s vital to adopt healthy habits when looking after their teeth.

“We know not all children have visited a dentist before, or might be hesitant, so it was the ideal chance to show them it’s not a scary experience and teach them some basic skills to help reduce the likelihood of them developing tooth decay in baby or adult teeth.”

The St Michaels team had used Dental Buddy a classroom programme designed to instil the value of good oral hygiene from a young age. Over the course of a year this programme is delivered across many schools throughout the UK.

The resurgent interest in school tooth brushing programmes was supported by Dr Nigel Carter, Chief executive of the Oral Health Foundation, who said: "Regular brushing twice a day with an appropriate fluoride toothpaste is highly effective in preventing dental decay and establishing good oral hygiene practice at an early phase in a child’s life, helping it become an integral part of normal daily hygiene later in life.”

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