key: cord-0931674-7fai241l
authors: Liu, Chi Wing Natalie; Onudiwe, Favour
title: The 'new normal' in oral health promotion
date: 2020-11-27
journal: Br Dent J
DOI: 10.1038/s41415-020-2428-3
sha: 09a7ea21506cdf25994155f4a7e9b96881540465
doc_id: 931674
cord_uid: 7fai241l

nan

C OVID-19 has presented unprecedented challenges in many aspects of dentistry. At the time of writing, when a second wave in the UK is highly likely, uncertainties are felt by all and continue to grow.

As dental students at Barts and The London, Queen Mary University of London, we have launched a student volunteering initiative, Barts Community Smiles (BCS). Our group aims to broaden the public's knowledge in oral health and disease, correct common misconceptions and reinforce the importance of good oral hygiene.

Our work is primarily based in the London Borough of Tower Hamlets, where dental diseases are a serious problem. The latest Public Health England's Public Health Profiles revealed that the proportion of children in Tower Hamlets having visually obvious dental decay far exceeds the national average, ranking 7th in the whole of England. 1 Similarly, rates of tooth decay and gum disease in adults were higher compared to the rest of the country. 2 Poor oral health not only impairs function, but also affects wellbeing and is of course associated with other chronic diseases, as well as leading to absences from work and school. Given that fewer people were accessing dental services in Tower Hamlets, front-line preventive work is crucial as a first step to avoid oral diseases.

We use a combination of approaches to reach out to different age groups in the community. Through local school visits and participation in community festivals, we previously interacted with children and teenagers to provide advice for healthy living and mouth. In addition, we placed huge emphasis on raising awareness of oral diseases to the public at community clinics, hospitals, local mosques, and care homes. The promotions often tied in with national and international health campaigns, such as Sugar Awareness Week, World Oral Health Day, and Mouth Cancer Action Month.

Our work has been significantly disrupted by COVID-19. Government recommendations on social distancing has put a halt on the interactive nature of oral health promotion. On the other hand, an increased consumption of unhealthy commodities have been fuelled during the pandemic. The Oral Health Foundation pointed out that 70% of families with children under five reported more snacking in the household; 3 the Obesity Health Alliance also reported 39% of adults were consuming more sweets and confectionery. 4 Provision of dental services has been reduced and so have patients' incentive to seek dental care due to fear of contracting COVID-19. These have all contributed to an inevitable increase in dental pain and infections which were not treated in a timely manner. 5 To adapt to the current pandemic, we have produced some online materials which will help disseminate key messages of protecting oral health.

For the first time this summer, the Wandsworth Food Partnership launched a SUGAR SMART campaign in collaboration with Public Health Wandsworth. We were asked to join in this campaign to address the overconsumption of sugar in the local area.

Normally, we would go into local children's settings like libraries, schools and educational community centres to interact with and educate children on the ways they could make healthier choices in relation to sugar. This would be through games, posters and quizzes. However, due to the limitations on social interaction, we came up with something new and put together a series of informative videos aimed at teaching children the health risks associated with sugar on oral and general health. These are especially needed during this time when access to health education from medical staff and in school settings is reduced.

After much research on the video software currently available, we decided to acquire a new software to make two animated videos. The first video gives tips on how to brush and how the lack of brushing leads to plaque accumulation and thus tooth decay. The second video demonstrates how to be smart about sugar consumption and the effect it has on both oral and general health. All advice and recommendations in both videos were sourced from Public Health England's Delivering better oral health toolkit -but it was tailored to younger children by using cartoons, animations and layman's terms.

Through this, we hope that we can cause some behavioural changes within the young people living in Wandsworth by giving  Chi Wing Natalie Liu Favour Onudiwe them information and encouragement to change unhealthy behaviours to healthier ones. We are hoping for this project to lower levels of sugar consumption and consequently tooth decay within young people in Wandsworth.

Due to the positive reception and feedback from our collaborating organisation and public engagement, we are expanding the project by making more videos and online resources like these for our local GP surgeries, libraries and community centres. Our vision is to spread awareness of dental health through simple but consistent messages, and reach people who would normally not visit the dentist due to language or financial barriers.

The uncertainty of the future caused by COVID-19 is ever-growing. It has been hard for us to reach out to different organisations and local authorities about their plans for health promotion. It is a crucial time to give out prevention advice when dental access is limited. While overcoming technical and communications difficulties, your participation in public health campaigns will truly make a difference in the oral health and overall wellbeing of the community.

The British Society of Paediatric Dentistry (BSPD) wants all children to understand from an early age the importance of caring for their teeth -and this is now set to become a reality thanks to an addition to the school curriculum, driven by Public Health England's Jenny Godson and aided by BSPD member, Professor Zoe Marshman (pictured).

As of September, oral health is now included in the 'Relationships Education, Relationships and Sex Education (RSE) and Health Education' curriculum for both primary and secondary schools in England.

Professor Marshman, Professor of Dental Public Health, who is based at the School of Clinical Dentistry, Sheffield and whose interest is child-centred dental research, worked with the Department of Education to develop the teachers training module underpinning the curriculum changes.

Professor Marshman said: 'This development turns oral health into a mainstream topic in schools in England and will help children understand that teeth are integral to their health and how best to look after them' .

The British Society of Paediatric Dentistry's (BSPD's) Outstanding Innovation Award (OIA), which celebrates inspiring and innovative schemes to improve the oral health of children, is about to enter its fifth year. Entries are invited for 2021 from anyone with an initiative or scheme which has a demonstrable impact on children's oral health. The deadline is 31 December 2020.

By creating positive publicity around innovative schemes, BSPD's aim is to encourage, promote and disseminate good practice. The winner in 2020 was Linzi Maybin (pictured, centre) for her Happy Teeth Outreach initiative.

Linzi said of the OIA: 'It was a huge and important stepping stone with raising awareness of Happy Teeth Outreach. To have dentists from BSPD believing in the project was incredible. The OIA and BSPD's support has fuelled my passion and drive to continue to reach young people with disabilities to improve their oral health. '

Other winners of the award are: 2019, Helen Rogers for Connect Trainees; 2018, Ben Underwood for Brush DJ; and 2017, Ingrid Perry for Teeth Team.

The key criterion for the OIA is evidence of the benefits of the scheme which must meet BSPD's mission to improve the oral health of children. A BSPD member must have initiated or manage it and submit the entry. The prize is the opportunity to speak about the winning scheme at the BSPD annual conference, to which you gain free access for the day. If there are several outstanding entries, there may be the opportunity for 'Highly Commended' awards.

For more information visit: https:// www.bspd.co.uk/Professionals/Awardsand-Prizes/The-Outstanding-Innovation-Award. Applications will be considered at the February meeting of the BSPD Executive. The deadline for entry is 31 December and submissions should be emailed to the administrator, Neil Sutcliffe: administrator@bspd.co.uk.

Public Health Profiles

JSNA Factsheet -Oral Health of Adults

Oral Health Foundation. Lockdown leading to increased snacking culture

Briefing: How are COVID-19 measures affecting the food environment?

FDI World Dental Federation. Oral health and access to care under siege during COVID-19 pandemic