CDS IMT TEAM - Essex Child and Family Wellbeing Service
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Oral Health Training Children’s Services Online Toolkit Essex Oral Health Improvement Team Community Dental Services www.communitydentalservices.co.uk All of the information contained in this training is up to date as of 23/03/2021
Transcript of CDS IMT TEAM - Essex Child and Family Wellbeing Service
Oral Health Training
Children’s Services Online
Toolkit
Essex Oral Health Improvement Team
Community Dental Services
www.communitydentalservices.co.uk
All of the information contained in this training is up to date as of 23/03/2021
Before you start…
It is important to read all the slides and the accompanying notes
below the slides in order to complete this training fully.
If you cannot see the written notes below each slide you will
need to turn ‘notes’ on. This button is usually at the bottom of
your screen and says ‘Notes’. Click this to turn on if needed.
If you have any questions please feel free to email or call the
CDS Essex Oral Health Improvement Team. Our full contact
details can be found on slide 49.
We hope you enjoy this online training toolkit.
Who are CDS?
Community Dental Services has 8 clinics in Essex.
We provide a dental service for people with complex and additional needs (children and adults) including general anaesthetic & sedation clinics.
We provide a domiciliary service for bed bound patients.
We also have a clinic in Colchester with a tippy chair for wheelchairs.
To increase your confidence and knowledge in providing
oral health advice to parents/ carers and children.
Aims of the Training
Why oral care is important.
Update on the oral health recommendations from the
Department of Health.
Impact of bottles, dummies and thumb sucking on teeth.
Current brushing & toothpaste guidance.
Diet and its impact on oral health.
What is dental caries and dental erosion.
Safeguarding
Dental visits and practical advice.
Objectives
Useful Resource:
Evidence based
guidelines
Includes fluoride
recommendations for all
ages
Eatwell Guide
Brushing
Diet
Dentist
3 Steps to Good Oral
Health
We currently have approximately 300 child referrals a
month for GA or sedation!
Every year children have tooth extractions under General
Anaesthetic.
Facts & Statistics
Statistics!
25% of under 5s in the UK have tooth decay!
On average 3-4 teeth will be decayed!
In Essex 14% of under 5s need treatment.
In Southend and Thurrock 20% of under 5s
need treatment.
School Readiness & time off work/school.
Pain, discomfort, infection.
Disrupted sleep.
Speech development, self-confidence & socialisation.
Nutrition.
Why is oral health
important?
Why is oral health
important?
Damage/malocclusion of permanent teeth
Perception of seeing the dentist
Huge economic cost
Pregnancy – premature/low birth weight babies
Caring for babies’
teeth
Clean gums with gauze/muslin or soft silicone
brush with water before teeth come through.
Brush teeth with a smear of toothpaste as
soon as they erupt.
Sugar free teething medicine.
Regular dentist visits - All children should be
having a dental check by 1 year of age.
Video on ‘How to brush your baby’s teeth’:
https://www.youtube.com/watch?v=kyJo7vUpbT8 (NHS,2013)
Signs & Symptoms
of Teething
Rubbing face/touching ears
Flushed cheeks
Irritability
Excessive salivation
Trying to bite and chew
Difficulty sleeping
Swollen gums
Rejecting food
Reducing discomfort
during teething
Teething rings (Please read manufacturers instructions
before use and supervise child during use)
Dry excess saliva.
Sugar-free pain relief if needed.
Sugar free teething gel.
Comfort, distraction & massage.
Transferring from bottle
to cup
Prolonged bottle use has been linked to
tooth decay and nutritional deficiencies.
From 6 months a free-flow cup should
be introduced.
Aim to eliminate the bottle by one year
of age.
Open top/Doidy cups promote:
independence, coordination, speech &
language development, sipping rather
than sucking, no pooling around the
teeth
Bottle Caries
Dummies
‘Pacifier’
Never dip in sugary substances.
Can affect speech development.
Increases the chance of repeat
middle ear infections.
Dummies
Aim to discourage from 6 months
onwards and take it away
gradually.
Read books about it
Leave it for the ‘dummy fairy’ or
trade it in for a toy or day out.
Thumb sucking
Can affect speech and how the adult teeth grow
through.
Reward charts, praise and positive reinforcements
are important.
Nail biting solution from 3 years
applied to thumb nail only.
Brushing
Brushing
Brush before bedtime and at one other time.
Brush teeth in small circular motions for 2 minutes.
Spit don’t rinse.
Use a small headed toothbrush.
Replace toothbrush once bristles become splayed, or every 3 months.
Children under 8 should be supervised.
Interdental cleaning should be introduced from 12 years.
Please read through this slide if you are unable to get the video
to play in the previous slide. All of the information is repeated
here again.
Toothpaste guidance
Children aged up to 3 years: Use fluoridated
toothpaste containing no less than 1,000 ppm fluoride.
Use a smear of toothpaste. Whitening toothpaste
unsuitable
All children aged 3-6 years: Use fluoridated
toothpaste containing more than 1,000 ppm fluoride.
Use a pea size amount if they can spit out. If a child is
not able to spit or has swallowing difficulties only use a
smear. Whitening toothpaste unsuitable.
Children aged 0-6 years giving concern: Use fluoridated toothpaste
containing 1,350 -1,500 ppm fluoride. It is good practice to use only a smear
or pea size amount - this is dependent on age, ability to spit out & whether
there are any swallowing difficulties. See above guidance.
Children aged from 7 years and adults:
Use fluoridated toothpaste (1,350 – 1,500 ppm
fluoride).
Use pea size amount if able to spit. (If a child or
adult is unable to spit or they have swallowing
difficulties only use a smear of toothpaste).
Spit out after brushing and do not rinse to maintain
fluoride concentration levels
Toothpaste guidance
What is the best
toothpaste?
Mouthwash
Mouthwash is not recommended for children under 6 years old.
Children under 6 years should avoid fluoride rinses due to the risk of excess fluoride exposure and developing fluorosis.
Mouthwash is not necessary but for some children it may be beneficial, this is a decision that should come from their dentist.
Mouthwash for children between the ages of 6-12 years should be assessed on an individual basis and they must be able to spit out.
Children between the ages 6 -12 years should only use a mouth rinse under close supervision of an adult due to the risk of swallowing it. They must be able to spit out.
Mouthwash
If a mouthwash is used, always use at a different time
to brushing teeth, once daily. The best time to use a
fluoride rinse is after lunch.
Mouthwash should never be used as a substitute for
brushing the teeth.
Mouthwash should be alcohol free.
Dental Caries
Largest cause of hospital admissions for 5–9 year olds.
Decay is caused by the frequency of sugar.
Milk from a bottle can cause decay (bottle caries).
Safeguarding
Dental neglect is defined by the British Society of Paediatric Dentistry as:
‘the persistent failure to meet a child’s basic oral health needs, likely to result in the serious impairment of a child’s oral or general health
or development.’
Dental neglect may occur in isolation or may be an indicator of a wider picture of the child’s maltreatment.
The term dental neglect should be reserved for situations where there is a failure to respond to a known significant problem.
Look out for :
Obvious dental disease – such as: disease which is clearly obvious to a non-dental health professional.
Impact on the child – such as: reported toothache, difficulty eating.
Situations where acceptable care has been offered but the child is not receiving treatment – such as: missed appointments.
Safeguarding cont’d
What to do if you have concerns:
Refer/liaise to your safeguarding lead and manager.
Use a tiered response depending on the level of concern.
Raise concerns with parents/guardians, offering support, help with contacting/finding a dentist. Keep records and monitor progress.
Preventive multi-agency management – liaise with health visitor, GP, social worker to ask if concerns are shared and what further steps are needed. (Follow safeguarding policy regarding gaining consent before sharing information).
Child protection referral – if the situation is too complex or is deteriorating and there is concern that the child is suffering significant harm. (Follow safeguarding policy regarding gaining consent before referring to social services and sharing information).
Diet
Important for oral and general health.
Important to be mindful of the sugar
content of the food and drink we are
consuming.
Anything sweet or fizzy is best with a
main meal.
Look for traffic light markings on
packaging.
Our Mouth PH
Tooth friendly
foods/drinks
Tooth unfriendly
foods/drinks
Keep to mealtimes!
Hidden Sugars
Ideally water is best.
Milk during the day.
No added sugar drinks are not the
same as sugar free (opt for sugar free).
Tea and coffee without sugar.
Tooth friendly drinks
Dental erosion
Caused by frequent consumption of acidic drinks and
foods.
Pain and sensitivity.
Irreversible.
Fizzy/ carbonated drinks can cause dental erosion as they
are higher in acidity.
Some fizzy drinks are also high in sugar which can lead to
tooth decay.
Vitamin D works with calcium and phosphorus for healthy bones, muscles & teeth.
It is important for preventing Rickets, Osteomalacia and falls.
Most vitamin D comes from sunshine, not food.
In the UK the sun is only strong enough to make vit D on exposed skin (face, hands, arms, legs).
It is recommended that all adults and children over the age of 1 should consider taking a daily supplement of 10 micrograms particularly over the autumn & winter months.
All babies under one year should be given a daily supplement of 8.5-10 micrograms unless they have more than 500mls of fortified formula milk.
There are some at risk groups who are recommended to take daily vitamin D supplements all year round, check with your GP, HV or Dietician if your are concerned.
Vitamin D
Tooth Friendly
Celebrations
Wear a special birthday hat.
Wooden birthday cake & sing
happy birthday.
Photo put onto a wall in the
classroom.
Birthday child gets to choose a
story…or gets to sweep up!
Buy a book.
Consider other celebrations.
Consider developing own policy
within school/nurseries
Dental visits
Children should have seen a Dentist
before their 1st birthday and 6 monthly
thereafter.
Free from decay before starting school.
Normal tooth development checked.
Children may not cooperate on the first
few visits.
Desensitising to the environment.
Dental visits
Fluoride varnish from the age of 3 years to prevent decay.
Can be applied 6 monthly if needed.
A high fluoride toothpaste can be prescribed if the patient is at high risk of caries.
Fissure sealants can be applied to permanent molars to prevent decay.
Important to remember:
Dental care for children is free until their 18th
Birthday or 19th if in full time education.
Pregnant women and new mothers are
exempt from payment up until their child's first
birthday.
There is NHS availability.
NHS 111 and www.nhs.uk for advice.
Supporting Oral
Health Promotion
Encourage parents to take their children to the dentist.
Regular activities throughout the year to highlight oral
health e.g. supporting national campaigns like National
Smile Month.
Regular updates in newsletters highlighting the importance
of oral health and dental check ups.
Oral Health Training and awareness
Oral Health Activities
for Children
Making a brushing chart
Smiles photo display
Painting with toothbrushes
Make a giant toothbrush
Dentist role play in play area
Activities for children
cont’d…..Food tasting game.
Tooth brushing Apps: Aquafresh, Oral-B, Disney
app, Pokemon Smile app
https://smile.pokemon.com/en-us/
www.nationalsmilemonth.org
https://communitydentalservices.co.uk/oral-
health/family-fun/ for fun children’s activities &
videos.
Activities for children
How we can support you:
Provide oral health resources.
Advice and Support.
Oral Health Training.
Supervised Toothbrushing
Training.
Lots of Oral Health information & resources on our website: www.communitydentalservices.co.uk
Contact the
Oral Health Team
07919290631
07443499333
Please complete the short quiz and evaluation form using the links below. A certificate will be sent out to you on completion of these.
Quiz:https://forms.office.com/Pages/ResponsePage.aspx?id=BGTVb1eNdkuheiLEHw6uPemj0uKHIaBDnO-NigVx3RZUNURUNkpBQzFaR0VCREgzSU45Ukg4U0YxVy4u
Evaluation Form:
https://forms.office.com/Pages/ResponsePage.aspx?id=BGTVb1eNdkuh
eiLEHw6uPemj0uKHIaBDnO-
NigVx3RZUQ1dBQ0JaSFQxRDIxQjlRTlkzOEhCNjJVUC4u
Thank you for completing
our training!
References
Delivering Better Oral Health- An evidence based toolkit for
prevention. 2017. Third edition. Public Health England. Online at:
https://www.gov.uk/government/publications/delivering-better-oral-
health-an-evidence-based-toolkit-for-prevention
Public Health England, (2017). Health matters: child dental
health. https://www.gov.uk/government/publications/health-
matters-child-dental-health/health-matters-child-dental-health
Public Health England, (2018) Consistent Messaging to Promote
a Healthy Weight.
Dental Neglect
https://www.bda.org/childprotection/Recognising/Pages/Dental-neglect.aspx.aspx
References
https://www.dentalhealth.org/drugs-alcohol-and-your-oral-health (Oral Health Foundation 2021)
Wrigley Oral Healthcare, (2016). The Stephan Curve. http://www.wrigleyoralhealthcare.co.uk/clinical-research/the-stephan-curve
British Society of Paediatric Dentistry, (2018). Dental Check by One. http://bspd.co.uk/Patients/Dental-Check-by-One
CDS Resources, www.communitydentalservices.co.uk
