Section 1: Why good oral health matters

brushing-teethGood oral health exists when the mouth and its different parts, including teeth, are working normally and without any signs of disease. This aspect of overall health and wellbeing is important throughout our lifetime. Protecting our oral health can be affected by many factors. These include what we eat and drink, when we eat and drink, how we look after our teeth and how often we visit the dentist. Having exposure to fluoride and regular brushing, all play a part in keeping our teeth and bodies healthy

1.1 Background

The dental survey of the Devon Local Authority area in 2012 showed that nearly a quarter (23%) of the 1832 five year old children assessed  had experienced dental decay. Of these almost 2% (about 36 children) had one or more experiences of tooth extractions, with some requiring a hospital admission for general anaesthetic for the procedure (Public Health England, 2014).

brush-blurGiven that dental decay is mainly preventable, these findings show there is much opportunity for change in what we do to look after our teeth and gums. However, overall the dental health of five year olds in Devon is better than the average for England. In certain areas of Devon there is a higher proportion of children affectedby dental decay and it is in these parts of the county that this tooth brushing programme is targeted.

Regular visits to the dentist help everyone to get advice to protect the health of their teeth. Children should register with a dentist as soon as their first teeth emerge. Data from across the South West Peninsula during the two years to March 2014 shows that only 17% of 0-2 year olds and 69% of 3-5 year olds visited the dentist. Any tooth decay occurring in children tends to develop faster in primary teeth than in permanent teeth. Therefore regular visits to the dentists are very important to help the early identification of any problems and prevent early tooth decay.

1.2 The way forward

Several expert bodies have recently reviewed the evidence relating to what works well in promoting good oral health in people of all ages. These have made recommendations about what may be done at a local level. The range of bodies includes Public Health England (2014), The Faculty of Dental Surgery, The Royal College of Surgeons (2015), The Scientific Advisory Committee on Nutrition (2015) and The National Institute of Health and Care Excellence (NICE) (2014). In summary, these say:

  • that prevention is the top priority in improving peoples’ oral health
  • improvements are needed in children’s oral health in England – it’s a health and wellbeing priority
  • raising awareness  of the priority of oral health is important
  • oral health promotion can be integrated into existing services, including those led by other health professionals
  • additional initiatives may include supervised toothbrushing schemes for early years settings and selected primary schools, especially in areas with poor oral health
  • to encourage a diet that has a reduced amount of sugary food and drinks to protect oral health
  • to support improvements in peoples’ oral hygiene
  • to increase the availability of fluoride
  • to encourage regular visits to the dentist

Examples of effective oral health improvement programmes include Scotland’s national oral health education programme, ‘Childsmile’, which has been running in nurseries, schools and dental practices for 15 years. This programme of oral hygiene and dietary advice, combined with help to register children with an NHS dentist, has been evaluated as successful in reducing oral health inequalities and improving children’s access to dental services. Fewer children have needed dental treatment or tooth extractions. A similar oral health programme, the Design to Smile programme, was launched in Wales in 2009. These community-wide activities have usefully helped to shape the Toothbrushing in Devon initiative.

brushing-teeth2Local trials of supervised toothbrushing programmes in schools in Scotland in areas of high need showed a 56% reduction in development of dental decay, and over a four year period this was substantially maintained (39% reduction at 4 years).

In Devon, initiatives have included fluoride varnishing, parental education and oral health education visits to schools and early years’ settings. However, these have not generally been targeted at areas where it is known that poor oral health exists.

The best approach to improve oral health is for schools and early years’ settings to have a policy and a positive ethos towards hygiene, snacks and drinks. This should complement regular toothbrushing with a fluoride toothpaste. A toothbrushing programme or a healthy eating policy alone will not help to prevent tooth decay.

Last updated: September 11, 2015

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