Healthy Teeth, Happy Smiles! Leicester City Council
Healthy Teeth, Happy Smiles! is an early intervention programme from birth to improve the oral health of preschool children.
Summary
Leicester’s Healthy Teeth, Happy Smiles! is an early intervention programme from birth that is part of the city’s first Oral Health Promotion Strategy for preschool children (2014 to 2017). The strategy adopts a population and targeted approach to improving oral health and ensures a mixture of evidence-based dental public health interventions.
Leicester also established the Oral Health Promotion Service which is based in neighbourhoods. The service has developed multi-agency oral health training packages aimed at all frontline health, care and education staff.
What was involved
Although oral health in England has improved significantly over the last 30 years, many challenges remain, particularly for those living in Leicester with children in the city experiencing very high levels of dental decay. Leicester City Council prioritised the improvement of oral health for preschool children and developed its first Oral Health Promotion Strategy for preschool children (2014 to 2017), with the ambition to achieve a 10% increase in the proportion of 5 year olds in Leicester with no signs of dental disease by 2019.
Leicester’s Healthy Teeth, Happy Smiles! programme is an early intervention programme from birth (modelled on Scotland’s Childsmile programme) and is progressively being developed, with all resources being met by partnership funding.
Antenatal, and a range of age specific oral health leaflets have been developed and distributed.
A supervised tooth brushing programme has been established with over 60% of nurseries and 20% of primary schools now delivering daily supervised tooth brushing.
The local Personal Child Health Record (Red Book) has been amended to include Healthy Teeth, Happy Smiles! oral health pages.
Oral health pathways have also been agreed with health visitors and school nurses. Health visitors are now distributing free toothbrushes and toothpaste universally to all children at specific points in their lives. Additional packs are also distributed to more vulnerable children and their families.
A pilot dental practice accreditation scheme was launched and 10 dental practices were selected to participate with 4 practices achieving accreditation to date. 5 practices are still working towards gaining accreditation by providing evidence and demonstrating their commitment to improving oral health and championing dental prevention. One practice has opted out of the scheme.
A pilot early years accreditation was launched in March 2017 and 8 city nurseries are working towards accreditation standards by demonstrating the work they do to encourage healthy eating, regular tooth brushing and visiting the dentist.
A number of short visual and audio infomercials have been developed for the programme and are being shown in all GP practices. They were also being broadcast on local radio during peak times and in local cinemas before the screening of every film from May 2016 for 12 months.
Prolonged bottle feeding, often with sugared drinks, is of particular concern in Leicester. This issue was tackled when revising the infant feeding strategy with all parents now being encouraged by health visitors to discard feeding bottles at the appropriate developmental stage.
All Children, Young People and Families Centres across Leicester also participate by swapping baby bottles for free-flow drinking cups. Approximately 4,000 free-flow cups have been distributed to the centres for the scheme.
Leicester City Council also established the Oral Health Promotion Service which is based in neighbourhoods. The service has developed multi-agency oral health training packages aimed at all frontline health, care and education staff.
The service:
- has ensured oral health input into early years training programmes, antenatal classes and parenting classes in the city
- participates in national oral health campaigns and engages the communities with oral health messages
- distributes free oral health resources to homeless hostels and food banks across the city during campaign months
- encourages all libraries in the city to participate during campaign months by holding oral health themed story telling sessions and distributing Healthy Teeth, Happy Smiles! oral health booklets
- promotes oral health messages using social media
What works well
Approximately 30,000 children in the city are benefiting from free toothbrush and toothpaste packs every year, with appropriate advice and information on oral hygiene, diet and early dental attendance by all health visitors.
As of April 2017, approximately 780 members of staff have been trained to deliver supervised tooth brushing with 6,300 children benefiting from daily supervised brushing.
Approximately 400 frontline health and care staff have received the multi-agency oral health training. Feedback received on the Oral Health Promotion Service has been excellent with all delegates agreeing that that training had helped improve their knowledge and given them confidence to deliver evidence-based oral health messages.
Some specific social media postings have reached approximately 7,000 people in Leicester. A particular campaign attracted interest from 80,000 people with 6,600 people clicking through for further information on oral health.
The programme in Leicester received an RSPH Health and Wellbeing Award in 2015. The award was conferred to the Council for its planned and comprehensive programme of oral health improvement for children.
Next steps
A contract was awarded to University College London (consulting) to undertake formal evaluation of the Oral Health Promotion Strategy. The evaluation will test the effectiveness of the strategy in achieving its stated objectives.
Work is continuing to increase uptake of the supervised tooth brushing programme in preschool settings, and focus on increasing the uptake in primary schools from September 2017.
The current pilot dental practice accreditation scheme is being reviewed and will move towards a sustainable scheme which can be rolled out across the city.
Further information
Contact Tiffany Burch, Leicester City Council, Tiffany.Burch@leicester.gov.uk or Jo Atkinson, Consultant lead for oral health in Leicester, Jo.Atkinson@leicester.gov.uk.