Child education Continued »
in the role of play in this regard and has long promoted the concept of hospital play as a way of helping children cope with the trau- ma of procedures, treatment and pain and to understand what is happening to them. So, following discussions with staff at the
Glasgow Dental Hospital and with funding from Boots Plc through their Community Investment Fund, ASC(S) developed 30 Dental Playboxes with the aims of encouraging children to attend the dentist, dispelling the anxieties associated with dental treatment, and promoting good oral health habits. The Playboxes contained books and toys about teeth and dentists, safe dental equipment, mini uniforms, worksheets, certificates and stickers. These Dental Playboxes were available on loan to nurseries, primary schools, school nurses and hospitals throughout Scotland and 18,500 children had access to the Playboxes over the two-year period. The feedback received from schools, par- ents, children and dental professionals was overwhelmingly positive and an evaluation by an independent consultant indicated that the aims had been successfully realised. A need was identified for a resource specif- ically geared for children with physical disability, sensory or learning impairment. At the same time, the Scottish Executive
was setting out a commitment to improv- ing children’s oral health in the Action Plan for Improving Oral Health and Modernising NHS Dental Services in Scotland.3
• many children with additional and com- plex support needs experiencing dental anxiety which makes dental care difficult to carry out. Children with additional and complex needs are therefore at a higher risk of need- ing specialist dental services than the general population and at the highest risk of having to undergo general anaesthesia for dental procedures. Despite the growing number of oral health initiatives for chil- dren in Scotland, it was found that none of them adequately addressed the needs of
treatment. It is with these issues in mind that the SSDP was designed and received funding from Boots Plc for ASC(S) to refine the Dental Playboxes into a specialised resource for use with children with addi- tional support needs. ASC(S) consulted and researched a wide range of individuals, organisations and publications during the course of this period and, in addition to the Dental Playboxes, developed a portable Dental Playpack for use at home by parents. The basis of the SSDP was to test out these specially developed play resources, by piloting them in schools for children and young people with additional and complex support needs in one Scottish Health Board area over a two-year period (2007-2009). Funding was secured from the Scottish
Above: Dental Playbox and portable Playpack A key principle of the Action Plan
was that: “Services for children and young people should be focused on prevention and meet the oral health needs of those in the most disadvantaged circumstances.”
The Action Plan also set oral health targets that: • 60 per cent of five-year-olds to show no signs of obvious dental disease by 2010
• 60 per cent of 11-12-year-olds to show no signs of obvious dental disease in their permanent teeth by 2010. Research evidence suggests that children with additional and complex support needs have poorer oral health and receive less preventive care and restorative treatment than children in the general population. Reasons put forward to explain this include: • children being unable to take care of their teeth
• children refusing to co-operate with carers with tasks such as tooth brushing
• children experiencing communication difficulties
• lack of experience among dentists in treating children with additional and complex support needs
34 Scottish Dental magazine
“Despite the grow- ing number of oral health initiatives, it was found that none of them addressed the needs of children with physical disability, sensory or learning impairment”
children with physical disability, sensory or learning impairment. Thus, it was acknowledged that children and adolescents with additional and com- plex support needs required a specialised oral health intervention which would raise their awareness and improve oral health practices, and that using a therapeutic play strategy would prepare them for dental
Government and resources were placed in 29 schools throughout Tayside. These included specialist nursery, primary and secondary schools, a sensory service and also units in mainstream schools with spe- cialist provision for pupils with additional and complex support needs which covered a range of conditions, such as Autistic Spectrum Disorders, as well as those with sensory and physical impairment. The proj- ect complemented the work of NHS Tayside as it implemented its Childsmile programme in mainstream schools. Each school received a Special Smiles Dental Playbox and a portable Playpack for home use and training was provided for teaching staff and carers in the use of the various resources in school, nursery and home settings. The Special Smiles resources included books, DVDs, puppets, games and toys about teeth and dentists, safe dental equipment and mini-uniforms, worksheets and stickers, together with tem- plates for social and multi-sensory stories which could be adapted to the individual needs of a child. Books, charts and work- sheets with Makaton and Boardmaker symbols were also included. Additional resources such as inflatable dentist chairs were made available and replacement dis- posable materials were also supplied as required. Two-minute timers were sup- plied for every child. Throughout the project, back-up support was provided by the project staff in the form of workshops with children, meetings with parents, activ- ity sessions and competitions and exchange of ideas through regular newsletters. The aims of the project were to improve
the oral hygiene understanding and prac- tices of these children and young people and reduce the anxiety associated with den- tal treatment by promoting learning through play using the dental play resources. It was also hoped that the proj- ect would heighten the awareness of the dental health needs of these children and
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