Puja Kalawadia explains how she went back to the classroom and ultimately how you encourage schoolchildren to prevent dental decay, and adopt a healthy and habitual routine.
As we all know, teeth aren’t only there to showcase a lovely smile, they also allow us to eat and speak with comfort and confidence for a lifetime. Healthcare behaviours are constantly influencing the younger generations. I therefore wanted to make an impact by drawing on how important it is to adopt a healthy and habitual routine to prevent dental decay. The consequences of dental decay do not only affect the quality of life of the children but also extends to the community and National Health Service. I was lucky enough to personally deliver this message to the year one and year two children of St Robert Southwell Primary School, based in north west London.
In preparation for my first school visit, I acquainted myself with my local Colgate representative, who was kind enough to provide me with enough toothpaste samples and ‘decay busters’ colouring sheets to entertain a classroom full of five- to seven-year-olds. I also collaborated with a local dental practice, Watford Road Dental Care in north west London. The practice principal, Dr Sana Mohavedi, was very supportive and keen to be involved, and allowed dental nurse Shalu to help and assist me on the day. Having the help of another colleague who is aware of the routine dental information we give to our patients was a great benefit, since she was also able to answer the questions that the children had.
My main aims for the day were to keep the children entertained and engaged, yet convey an informative message about the significance of a good diet and oral hygiene regime at home. Although I am not a mother, my experience of working in a general dental practice has illustrated how short the attention span of a child can be! A study carried out by Galesic and Garcia-Retamero (2013) concluded that visual aids seem particularly beneficial for patients who have low knowledge about medical facts. Therefore, I felt that using an interactive-based approach with props, to allow the participation of the children, would be my best bet. So, I collated pictures of different food and drink items (deemed both ‘good’ and ‘bad’) along with pictures of children with decayed teeth to help the children’s understanding of the difference between what is healthy and unhealthy for their teeth. I also decided to take a plastic mouth model and toothbrush to the school, which I found to be an excellent aid to demonstrate efficient and effective tooth brushing techniques.
As I was addressing 30 children at a time, it was crucial to embed the important facts before moving onto interactive games. We spoke about visiting the dentist twice a year, brushing their teeth twice a day with a fluoridated toothpaste (especially before bed) and reducing their consumption of sugary food and drinks. Advising them to spit and not rinse, along with recommending the use of the only a pea-sized amount of toothpaste were only two of many pieces of advice (quoted in the Delivering Better Oral Health Toolkit) passed onto the children that day.
I then focused on gauging the children’s oral hygiene regime in the comforts of their own homes. A quick show of hands indicated that the majority of the children were brushing twice a day under supervision of a parent or older sibling. However, when a few showed their brushing technique on the mouth model, it was clear that much improvement was needed. Demonstrating the modified bass technique while talking through the motions to carry out on their teeth was a helpful visual aid and assisted their knowledge. Encouraging the children to then display the correct technique to the whole class worked very well and showed that they had taken the method on board.
A four-letter word
One four-letter word that is crucial to incorporate when giving advice about the prevention of dental decay is diet. Although the percentage of caries has fallen, research carried out by Public Health England in 2013 revealed more than a quarter of five-year-olds are suffering from dental decay. Sugar and dental caries have a direct link, and making both the children and parents aware of this association is paramount. Schoolchildren are usually subject to healthy school dinners, however, the majority are allowed to bring snacks from home to enjoy at break time.
Parents with an understanding of the aetiology and pathogenesis of dental decay are more likely to give fruit and vegetables to their child compared to those who do not. I was lucky enough to take a sneak peek into some break time nibbles and although the majority of the children did have apples and oranges peering through their lunchboxes, a handful had chocolate-coated raisins and fruit flakes as part of their snack. Fruit Shoot and diluted Ribena drinks seemed to be the popular beverages. With the assistance of pictures illustrating decayed deciduous teeth, we discussed the harmful and detrimental consequences that sugary food and drinks can have. This allowed the children to interact with one another and compare several healthy and unhealthy options and appeared beneficial to their understanding.
At the end of the session, the children were asked to write a few sentences about what they had learnt in the 20-minute session. It was rewarding to see that the main preventive messages, about good oral hygiene and reduction of sugary snacks, had been clearly understood.
Take home advice
The children were all sent home with a small tube of fluoridated toothpaste and a leaflet with information about Watford Road Dental Practice. The children were also given questionnaires to take home for their parents to complete and return to school the following week. In three months’ time, I plan to re-do the questionnaires to see whether the children and their parents have taken the information on board and made a change towards bettering the oral health of the children.
Every day’s a school day
Dental decay continues to be one of the most common juvenile diseases, even though it is entirely preventable. Untreated dental caries can affect the way a child eats and speaks, which can, in turn, change their behaviour altogether. Using fluoridated toothpaste along with controlling sugary snacks in a child’s diet may seem like a small intervention, however, as studies show, the impact can be life-changing not only on a child’s teeth but also their general health. In addition, presenting this information in a learning environment, like a primary school, can be greatly advantageous as the children will pass it onto their parents.
Galesic M, Garcia-Retamero R (2013). Using analogies to communicate information about medical treatments and screenings. Applied Cognitive Psychology 27(1): 33-42
Public Health England (2013) Tooth decay hits quarter of five-year-olds, survey suggests. Available: http://www. bbc.co.uk/news/health-24162248 [accessed 3 October 2016]
Public Health England (2014) Delivering better oral health – an evidence-based toolkit for prevention
*This was originally published in Oral Health magazine.
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