Dental disease is common in children and is the most common reason for children to be admitted to hospital. Children living in the most socially deprived areas are at highest risk and the most likely to have their teeth removed under general anaesthetic. Only this month the Royal College of Surgeons recommended that parents should supervise their children brushing their teeth up to the age of 14 – way beyond the usual recommended age of seven or eight.
While the actions that can be taken to help prevent tooth decay in children – such as brushing teeth regularly, not drinking sugary drinks from bottles, not putting children to bed with a bottle and positive attitudes to oral health and visiting the dentist – are known, the best ways to support parents to carry out these actions is unknown. This is what the pilot study will seek to address.
The study is led by Professor Elizabeth Kay, foundation dean for the Peninsula Dental School, Plymouth University. She said:“Each year around 25,000 young children attend hospital to have teeth extracted under anaesthetic, even though tooth decay is largely a preventable problem, and in my view that is a national outrage. Last autumn the National Institute for Health and Care excellence published guidelines recommending that local authorities focus their oral health promotion efforts on children’s early years – I was part of the group who put together those recommendations.”
“While there is plenty that the state in its many forms can do to promote oral health awareness and good oral health practices to children and their parents, at the end of the day children’s teeth need to be cared for at home.”
Cath Quinn, senior research fellow at Plymouth University Peninsula Schools of Medicine and Dentistry commented: “We know that parents need support to achieve good oral health for their children at home, we’re just not sure how best to provide that support. That’s why we have proposed this study and why we are pleased to have received the funding to take it forward.”
The research team will work with the Family Nurse Partnership (FNP) in Plymouth. This group is especially valuable to the study because its nurses work with first time young mothers. It offers intensive, structured home visits by specially trained nurses, from early pregnancy until the child is two.
The study will develop an intervention that links a dental nurse to the young mothers in the FNP project, offering them support, encouragement and the necessary materials to protect their child’s newly emerging teeth.
Abby Nelder is quality support officer at the FNP in Plymouth, which is run by Plymouth Community Healthcare. She said: “We will be using a model which is based on one which we already run successfully in Plymouth with a contraceptive nurse. This model, which will involve a dental nurse, will help us to develop a therapeutic relationship with our service users over a long period of time and that is what makes the model work – the gift of time which the nurse will have with our families.”
“The potential impact of this project on our families is huge. There is an assumption that everyone knows how to brush their teeth, owns a toothbrush and knows which toothpaste to use; but this is not always the case. The same goes for diet issues relating to teeth – who knew that apple or orange juice, so called healthy options, could damage children’s teeth? We believe that this role for the dental nurse will not only benefit young mothers and their infants, but the wider family too. Everyone wants to do the best for their children’s teeth and try to do the right thing, but the pressures of advertising and social media make it difficult to make the right choices. This has the potential to be rolled out across the national FNP network, and it is exciting to know that it is starting here in Plymouth.”
It is hoped that this pilot will lead to more funding for a trial to test the effectiveness of the identified methods and potential implementation.
A summary of the findings will be made available to everyone who took part, and communication in the community will be carried out by the award winning Peninsula Dental Social Enterprise. Dissemination to the wider South West region will be via the National Institute for Health Research Collaboration for Applied Health Research and Care South West Peninsula (NIHR PenCLAHRC).