oral health promotion in the early years · fluoride • fluoride is an ion that remineralises...
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Oral Health Promotion in
the early years
Holly Owen
Dental Hygienist/Therapist and Oral
Health Promoter
Oral Health Promotion and Dental
Outreach in The Borough of
Hackney and The City of London
We are carrying out a number of schemes to improve oral
health and reduce oral health inequalities in Hackney and the
City of London:
• Screening and Fluoride varnish for all reception and year
one children in school (including Charedi Jewish
independent schools)
• Supervised lunchtime brushing in SENCO schools
• Oral Health training for the wider professional workforce-
vulnerable adults and children
• Working with other professions to ensure that public health
policies are conducive to good oral health
• ‘Brushing for life’ scheme- distributing over 10,000 free
toothbrushes and toothpaste via health visitors, children’s
centre staff, family nurses etc
Aims of Session
• Explain the importance of early years workers in promoting oral
health
• Explain importance of good oral health in pregnant mothers and
0-5 year olds
• Explain the cause and implications of oral conditions
• Most importantly- Caries (decay)
• Deliver evidence based preventative advice
• Give early years staff the confidence to deliver oral health
promotion and empower parents to improve the oral health of
their families
• Explain how the oral health promotion team can support your
setting in promoting good oral health
Good Oral Health
• Good oral health can be a reality for
every child
• Dental caries (decay) is a
completely preventable condition in
the vast majority of cases
• A health mouth is:
-Clean
-Free of disease
• Retaining primary teeth aids in the
eruption of a healthy permanent
teeth
• Habits formed in the early years will
lead to a healthy, decay free adult
dentition
Oral Health in Hackney
• According to the most recent Dental Health Survey of Five year olds
(PHE 2016)
• 27% of five year olds have decay
• This varies by ethnicity- 45% of Asian children, 32% of white children
and 23% of black children
• 9% have decayed front teeth
• 393 Hackney children had a GA in 2014-15 for extractions- £673 per
child
• Tooth extraction for decay is the most common reason for hospital
admissions in 5-9 year olds
• A small study of Charedi Jewish children in Hackney suggests that
decay is far more prevalent in this community- 58% of 5 year olds
examined were affected
Dental decay is
completely preventable
It is essential that parents
are encouraged to take
responsibility for their
child’s dental health
• Brush 2x daily
• Use fluoride toothpaste
• Reduce sugar frequency
• Visit dentist regularly
Preventing Dental Caries
• As soon as teeth erupt in mouth
• 2x daily for 2 minutes
• Do not eat or drink anything after brushing at night
• For the best protection the whole family should use at least
1350ppm toothpaste- children do not necessarily need a separate
toothpaste to parents
• Use smear of toothpaste for babies and pea size for children
• Supervise brushing- children under seven cannot brush effectively
alone
• Spit and don’t rinse
Toothbrushing
Fluoride
• Fluoride is an ion that remineralises teeth and is clinically proven to be very
effective in preventing decay
• Topical fluoride is found in toothpaste, mouthwash and fluoride varnish applied
by dental professionals
• Two applications of fluoride varnish in a year proven to reduce decay by 37%
• Systemic fluoride found in some water supplies- Hackney DOES NOT have
fluoridated water (it has a naturally occuring fluoride level of 0.2mg to 0.4mg
per litre- the optimal amount for decay prevention is 1mg per litre)
• Fluoride is very safe and effective in the correct doses
• Young children should never be allowed to lick or swallow toothpaste-
excessive amounts of fluoride swallowed can cause mottling of the teeth
known as fluorosis
• Avoid sugary snacks including hidden sugars in yogurt, cereal bars, dried fruit
• Swap for crackers, fresh fruit/veg
• Sugar should not be consumed more than four times a day
• Only give water between meals
Diet
Early Childhood Caries
• Affects front surfaces of upper teeth
• Caused by prolonged contact of sugary liquids
• Seen when children are given sugary liquids in
a bottle
• Particularly when sent to bed with a bottle
Prevention
• ONLY give water or milk in a bottle
• ‘Bin the bottle’ after one year
• NEVER send to bed with a bottle
Access to Dental Care
• Only 8.7% of 0-2 year olds in Hackney access dental services
compared to 13.3% in London and 19.9% in England
• Children should be taken to see a dentist as soon as teeth are
seen (from 6 months onwards)
• 55% of children living in Hackney access dental services
compared to 60% for London and 68% for England
• NHS dentistry is free for all under 18s
• The brushing for life packs include a list of local dentists
• Encourage parents to ask their dentist about fluoride varnish-
DOH recommends it is applied twice yearly to all over 3s
Oral Health in Pregnancy
• It is more important than ever to
maintain good oral health in
pregnancy- there are studies linking
periodontal (gum) disease and pre
term birth
• Pregnant women who smoke should
be warned about the links to
periodontal disease and early tooth
loss as part of smoking cessation-
smoking is the main risk factor in
periodontitis (advanced gum disease)
• Pregnant women and mothers of
babies aged under 12 months are
entitled to free NHS dental treatment
Teething
• Parents should be advised to brush teeth
twice daily with fluoride toothpaste as soon
as they erupt in the mouth
• Babies can be given a cooled (not frozen)
teething ring to chew on
• Ensure that any teething gels or painkilling
medications are sugar free
• 30-80% of children will have eruption cysts
which are usually symptomless and will
resolve on their own
• Natal or neonatal teeth may be present
which can interrupt feeding and may need to
be removed
Dummy Sucking
• Pronged dummy or
finger/thumb sucking can
lead to an open bite
• This is a particular risk in
children who maintain the
habit once they have
their permanent dentition
• Dummies should NEVER
be dipped in honey/jam
etc
Weaning
• Breastfeeding provides the
best nutrition for babies
• From six months infants
should be introduced to a free
flowing cup
• From one year feeding from a
bottle should be discouraged
• Children should only ever be
given milk or water in bottles
• Never add sugar to weaning
foods or drinks
Any Questions?
• Please feel free to email me with any queries you may
have
• Please contact me if you would like to book oral health
training for your staff or if you would like to join the
brushing for life scheme