Q Exchange
We brush our teeth at nursery! Let’s change childcare culture
- Proposal
- 2023
Meet the team
Also:
- Tai Oyegunle (Oral Health Promotion Lead at Kings College Hospital)
What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?
Lambeth, the surrounding area of Kings College Hospital, is the 11th most deprived borough in London. In Lambeth, 10.1% of children have experienced tooth decay. Hospital Episode Statistics data shows between 2018/19 and 2020/21 300 per 100,000 children aged 0-5 years old in Lambeth were admitted to hospital for dental caries, compared to 221 per 100,000 in England (NHS Digital, 2022).
Children who have high levels of disease in baby teeth have an increased risk of disease in their adult teeth. If treated, these teeth will require long term maintenance throughout their adult life, putting pressure on budgets and waiting lists. Children from deprived areas are more likely to experience tooth decay than those in least deprived areas. It is of concern that inequalities in oral health are stark even by age 3.
What does your project aim to achieve?
Studies show the daily application of fluoride toothpaste to teeth reduces the incidence and severity of tooth decay in children. By adopting a downstream approach to this problem, supervised tooth brushing in childcare settings creates an opportunity to reduce dental extractions in hospital and lessen the demands on specialist care. This reduces the waiting list for those children who may have inevitably been referred to access these services, and often come from deprived areas.
At the end of year 1 an evaluation would ascertain whether the tooth brushing habits of young children in Lambeth improved and to what extent knowledge of oral hygiene among staff, parents and children improved.
The feedback and evaluation will measure the feasibility of running a supervised tooth brushing project across a larger number of settings. Thereafter, a full-scale scheme would be proposed to local commissioners’ in associated boroughs to secure the project’s sustainability across South London.
How will the project be delivered?
Our project will:
– Work directly with children to help them reach their developmental milestones. I.e. dental paediatric teams, nurseries, children centres, early intervention hubs, safeguarding teams
– Work with services supporting children indirectly, by working with parents, early year’s practitioners, and the wider community, so they are better equipped to provide the responsive relationships and positive experiences that children need.
– Complete a comprehensive audit of tooth brushing programmes running in England, to explore barriers and facilitators to the implementation of tooth brushing, the potential of bulk purchasing and prices of toothpaste/brushes and insight into Supporting materials required.
How is your project going to share learning?
King’s Oral Health Promotion is a ‘collective impact’ team, which means our services and oral health initiatives link together and work towards shared goals around improving oral health outcomes for vulnerable groups. The potential for sharing is across 9 out 13 boroughs of South London (Kingston, Richmond, Wandsworth, Merton, Sutton, Croydon, Lewisham, Southwark and Lambeth) that King’s covers.
Oral Health is seen as a marker of wider health and social care issues including strands encompassing nutrition, social and emotional well-being, obesity, communication and language. There is opportunity for our programme to complement wider childhood initiatives and share what we have learnt.
How you can contribute
- Making our project package for childcare providers more remote to meet the geographical demands.
- An online platform where childcare providers can access and complete the necessary supervised tooth brushing training with reassurances of a record of their attendance and proof that an adequate level of understanding was achieved. At the moment we train childcare staff face-to-face or through MS Teams and gain consent through paper notes which is often resource extensive.
- There also seems to be a need to educate parents, although many were receptive it may have guaranteed parents supervised brushing at home if we had established a video, social media presence and/or online resource with the emphasise of the importance of oral health and tooth brushing in relation to children’s overall health.
- If you are a parent or school worker, sign up to our design focus group on Hexitime: https://hexitime.com/campaign/share-your-expertise-to-support-the-2023-q-exchange-applications
Plan timeline
| 1 Sep 2023 | Develop surveys |
|---|---|
| 1 Nov 2023 | Stakeholder engagement |
| 1 Dec 2023 | Supervised Tooth brushing activity starts |
| 1 Jan 2024 | Co-design and implement toolkit/guidance |
| 1 Mar 2024 | Annual Audit |
| 1 Sep 2024 | Post Evaluation of programme’s progress |
| 1 Mar 2025 | Share learning |
Comments
Parya Rostami 28 Mar 2023
This sounds really great, it really helps to tackle culture issues long term rather than a short term fix.
I feel nationally there will be places that would benefit from the learning such as Blackpool where I use to work and has 8 out of 10 of the most deprived boroughs nationally and we have some great Q members there who have been planning more work around better health starts for kids in the region!
I wish you the best of luck and look forward to hearing more!
Mary Salama 27 Mar 2023
What an important piece of work Hesham and Tai. There is such a difference in dietary patterns and dental care across both areas of deprivation and also spanning different cultures. That may be an area to look at when it comes to embedding practice outside the childcare setting. Take a look at the cardmedic communication tools. https://www.cardmedic.com
Love the use of Hexitime as a resource in this project. Will be following your progress closely and seeing what we can learn for application in Birmingham. Good luck.
Mary
Tai 20 Mar 2023
Thank you Cheryl! Its an area that is massively overlooked. Poor dental health impacts not just on the individual’s health but also their wellbeing and that of their family. We are hoping to gain some traction on our project by gaining the views of parents and childcare providers in the community.
https://hexitime.com/campaign/share-your-expertise-to-support-the-2023-q-exchange-applications
(This video shows how the timebank on Hexitime works: https://vimeo.com/617883668)
Dr Seema Srivastava MBE 17 Mar 2023
Great proposal Hesham and Team. Would love to link your team with our local hospital Paediatric Dentistry team who are working with one of our LAs on toothbrushing in schools.
Tai 18 Mar 2023
Hi Seema,
That would be great!
The Oral Health Promotion team at Kings College Hospital would love to.
No doubt the insight we would get from a dental team who have already been working with LAs to expand in schools would be invaluable
Rebecca Tulk 16 Mar 2023
Great idea! I can see the wide application for this if we get it working
katie walker 6 Mar 2023
I like the detailed review to understand what really works and the opportunity for collaboration & sharing!
Vincenta Leyden 3 Mar 2023
I like that this project is about empowering children and families to develop good oral health/ hygiene practices. It may also open discussions about the sorts of foods and drinks children consume - particularly in early years.
Tai 8 Mar 2023
Absolutely Vincenta! Given that excessive intake of free sugars and social deprivation are risk factors for dental caries and obesity, it has been hypothesised that these two outcomes may be more likely to co-exist within the same individuals or populations.
Laura-Jane Smith 3 Mar 2023
It’s great to see a project focused on prevention - we don’t put enough resource into this! And what a great example of an institution reaching out to empower and support the local community - again, we don’t do this enough! I would be really interested to see the impact of this project as an exemplar of tackling health inequalities. Are you including school workers and parents in your project planning group?
Hesham Abdalla 5 Mar 2023
Thanks Laura. We would love to work with parents and school workers interested in this issue. In fact anyone who would consider contributing to a 1 hour focus group to discuss the challenges and solutions can do so by responding to our Hexitime request here and get a credit for your time:
https://hexitime.com/campaign/share-your-expertise-to-support-the-2023-q-exchange-applications
(This video shows how the timebank on Hexitime works: https://vimeo.com/617883668)
Biba Stanton 1 Mar 2023
Have you thought about comparing outcomes in childcare settings where you deliver your intervention with a control group of childcare settings in Lambeth?
Tai 6 Mar 2023
Biba, Your response also made me think about perhaps evaluating the programme's outcome based on the waiting list information I could possible obtain information based on the King's dental community clinics that surround the selected nurseries.
Perhaps the nature of referrals, the rate of referrals, before and after...
Tai 3 Mar 2023
t is something we would consider after all without a control group it is impossible to confidently determine which changes or outcomes are due to the intervention as opposed to being due to some other variables. Thanks Biba
Agnese Lazzari 1 Mar 2023
I love the simplicity but potential high impact of this idea!
Tai 3 Mar 2023
yes! very impactful and very in keeping with the CORE20PLUS5 (Core 20 plus 5) that has been established to tackle health inequalities, ensuring the 20% most deprived and vulnerable get additional support in five clinical areas; importantly, the children's scheme includes oral health as one of the five clinical areas chosen for accelerated improvement.
Cheryl Levy 1 Mar 2023
As a colleague at King's College hospital and as an advocate for chldren, it is great to see teams working for the improvement of services for our community. To identify an area which has previously been overlooked, that will have a massive positive impact, to improve the long term health of all is amazing.
Comments are now closed for this post.