Childsmile


“The main focus is the development of skills for life through support and encouragement of toothbrushing and healthy eating, as well as the application of fluoride varnish. “All EDDNs and DHSWs undertake an NHS Education Scotland delivered training course before performing any frontline Childsmile delivery. “To be able to apply fluoride


varnish, prospective EDDNs must also undertake a period of directly observed practice prior to being fully qualified. During this training phase they will be mentored by a dentist.” While Childsmile is now rolling


out nationally, it was actually conceived as a pilot back in 2005, when the then Scottish Executive pub- lished An Action Plan for Improving Oral Health and Modernising Dental Services. According to Peter, this high- lighted high levels of dental decay and, in particular, the fact that children from the most disadvantaged areas of Scotland commonly demonstrated the highest levels of decay. “By the age of three, over 60 per cent of children from areas of deprivation had dental disease,” he said. “A commitment was made to establish a comprehensive preventive care system for children and young people, which includes enhanced services for those most in need.” As a result, the Scottish


Government worked with partners that included health boards, schools and general dental practitioners across Scotland to develop the Childsmile programme.


“Overall, the programme has


developed considerably since the pilot stage,” said Peter. “The focus of the programme now is to consolidate on its developments so far and further support integration of all four parts of the Childsmile programme in all 14 health board areas. “A national structure is in place to support local delivery on a regional basis. A programme board provides guidance and input from a broad range of stakeholders across the country. “Strategic decision-making and


direction is provided by a National Executive. Among others, this involves three regional programme managers – for East, North and West


HOW IS CHILDSMILE BEING ROLLED OUT?


The integrated programme is being rolled out in all 14 Scottish health board areas throughout 2011-12. It is expected that NHS Boards: • work towards achieving


targets for toothbrushing • ensure that tooth- brushing packs and other resources are distributed to children as directed • meet target for involve- ment of 20 per cent of nurseries in Childsmile


Nursery Fluoride Varnish Programme • meet target for involvement of 20 per cent of schools in Childsmile School Fluoride Varnish Programme, to P4 by 2012 • record routine data systematically to allow monitoring and evaluation of the programme • have systems in place to ensure children referred to a Childsmile Dental Health Support Worker are seen • ensure all dental practices are approached and offered the opportunity to become Childsmile Practices • ensure practices are recruited and sup- ported to offer Childsmile interventions • ensure sufficient places are available to enable all children referred to Childsmile Practice, directly or via a DHSW, to be registered with a Childsmile Practice.


“Close partner- ships with education colleagues are vital to establish these


services” Peter King


– who have responsibility for sup- porting development in their region.” The 2010 NDIPkey results show that the mean number of obviously decayed, missing and filled teeth (d3mft) per P1 child in Scotland was 1.52, a continuing improvement over previous surveys. The NHS Board with the lowest


average number of teeth affected by dental disease was NHS Borders at 0.91, while NHS Greater Glasgow and Clyde had the most at 1.85. Across Scotland, 64 per cent of P1


children showed no signs of obvious decay experience in any of their pri- mary (first) teeth – the best result since surveys began. NHS Borders had the highest pro- portion at 77 per cent, while NHS Western Isles had the lowest propor- tion at 56 per cent. Overall, the proportion of children in 2010 with no obvious decay experience now exceeds for the first time the National Target of 60 per cent set for this child age group by the Scottish Government for the year 2010. There continues to be a strong


association between social depriva- tion and dental disease, with those in the least deprived areas having fewer teeth affected by dental decay than those in more deprived areas. However, across all deprivation cat- egories in Scotland, the percentage of P1 children with no obvious decay experience is continuing to increase.


® For more information, visit www.child-smile.org


Scottish Dental magazine 29


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