Child education
young people among parents, carers and relevant professionals, and assist them in providing for their oral healthcare needs. Guidelines for use of the play resources
were inserted in each box and pack and a training programme was offered to staff and parents. This included information on how to make best use of the resources, guidance on play, anxiety reduction, oral health and children with additional support needs and links to other organisations and websites. The schools used the resources in differ-
ent ways. There were opportunities for medical play, using a mixture of real and toy equipment to assess and encourage infor- mation sharing – what the child will experience and how procedures will occur; opportunities for projective play, using toys such as Play-Doh or teddy patients to help children play out their experiences; oppor- tunities also for role-play, using the mini uniforms, masks, gloves and goggles, allow- ing them the chance to try on adult roles, giving them a sense of control which can help identify any hidden misunderstand- ings, fears or feelings. Some schools ran sessions purely on oral health promotion, and used the resources to refer to healthy teeth and diet. Others set up a dental surgery with chair and held role- play sessions in class using all the resources, while other schools used the resources for short-term projects on related themes. More than 700 hundred children in 29 schools had access to the resources over the period of the project. Because of the very complex needs of some of the children, it was difficult to measure any change in the children’s understanding using traditional methods, so there was a reliance on parents and carers to answer on their behalf using
FEEDBACK: Teachers and parents are all smiles
“The children loved dress- ing up and taking part in the role-play activities and at the end of the project all but one were able to indi- cate that they weren’t worried about going to the dentist.”
Isla MacDonald, Grange Primary School, Monifieth
“The children had been brushing teeth individually
before, but with Special Smiles, it became a group activity. I noted quite a big change. Even the most sensory defensive child
held a toothbrush.” Heather Miller, Nursery Teacher, Fairview School, Perth
“Heather now brushes her teeth two to four times a day and visits the dentist every three months. She is
before and after questionnaires, and on other means such as photographs, drawings and observation. The greatest amount of feedback came from the teaching staff who were universally in favour of the project with very positive feedback. The success of the Special Smiles Dental
Project is in no doubt, having been received enthusiastically by children, parents, car- ers and professionals. The Evaluation Report4
can be accessed on the ASC(S)
website. It concludes that the project met its main aims and that oral health under- standing and practices improved among staff, parents and children, and child den- tal anxiety was reduced. Research shows that dental anxiety can
prevent children from accessing dental treatment5
and highlights children with
additional and complex needs to be among the most vulnerable. Special Smiles staff received several reports of extremely anx- ious children who were initially totally
still slightly apprehensive, but will now have treat- ment. The resources, combined with an under- standing dentist, have
made a big difference.” Parent, Tulloch Primary School, Perth
“My child treats teeth cleaning more as a game now, so it is much easier to
help her.” Parent, Fairview School
non-compliant, but successfully complet- ed a course of dental treatment after using the Dental Playpack. It is hoped that by using the Special Smiles resources with the support of pro- fessionals, parents and carers, children will require less dental treatment and when they do, will have strategies in place reduc- ing the need for general anaesthesia for treatment, a costly and risky procedure. ASC(S) believes that Special Smiles could greatly enhance the Scottish Government’s ability to achieve their oral health targets for children in Scotland.
® Catherine Nelson is a Dental Playbox Co-ordinator. Further information about the project can be obtained from: Action for Sick Children (Scotland), 22 Laurie Street, Edinburgh EH6 7AB, tel 0131 553 6553,
enquiries@ascscotland.org.uk www.ascscotland.org.uk
References 1. Scottish Executive (2002) Towards Better Oral Health in Children. Edinburgh HMSO, 2002.
2. Russ, S. (2004) Play in child development and psychotherapy: Towards empirically supported practiced. Mahwah, NJ.: Lawrence Erlbaum Ass.
3. Scottish Executive (2005) An Action Plan for Improving Oral Health and Modernising NHS Dental Services in Scotland. Edinburgh HMSO, 2005.
4. Chambers, S., Turner, S. & Freeman, R. (2009) Special Smiles Dental Project Evaluation Report Dental Health Services Research Unit, University of Dundee, 2009
5. Howard, K.E. & Freeman, R. (2009) An evaluation of the passivity to activity through live symbol after treatment modelling intervention to reduce dental anxiety in child dental patients. International Journal of Paediatric Dentistry 2009.
Above: Special Smiles books help to reduce children’s anxiety over dental treatment Scottish Dental magazine 35
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