Learning from good practice: a review of current oral health promotion materials for parents of young children

Objectives To examine the quality of UK-based oral health promotion materials (OHPM) for parents of young children aged 0-5 years old. Data sources OHPM were obtained via email request to dental public health consultants and oral health promotion teams in the UK, structured web-based searches or collected from oral health events. Data selection Materials were included if: they were freely available; they were in English; they were parent facing and included oral health advice aimed at children aged 0-5-years-old. Data extraction Quality assessment was based on: whether the oral health messages were consistent with Public Health England’s Delivering better oral health guidance, and what barriers to good oral health were addressed by the OHPM using the Theoretical Domains Framework (TDF). Data synthesis A wide range of printed and digital OHPM were identified (n = 111). However, only one piece of material covered all 16 guidance points identified in Public Health England’s Delivering better oral health (mean 6, SD 4), and one other material addressed all 12 domains of the TDF (mean 6, SD 2). Conclusions Although there were examples of high quality, further development is required to ensure OHPM are clear, consistent and address a wider range of barriers to good oral health behaviours

Dental caries and school readiness in 5‐year‐olds: a birth cohort data linkage study

Objective To describe the association between dental caries and school readiness in 5-year-old children taking part in the Born in Bradford (BiB) birth cohort, UK. Methods The Early Years Foundation Stage Profile (EYFSP) assesses the school readiness of young children and is strongly predictive of future academic attainment. Children are recorded as ‘emerging’ (below expected), ‘expected’, or ‘exceeding’ in five key learning areas. The Oral Health Survey of 5-year-olds (OHS5) is undertaken biennially in England, assessing caries experience at a dentine threshold (d3mft). EYFSP and OHS5 were available for a proportion of children participating in BiB. Odds ratios and confidence intervals for caries experience were established, and odds ratios adjusted for significant sociodemographic variables. Results EYFSP and OHS5 data were available for 2.5% (n = 346) BiB participants. Nearly half (45.2%) had caries. A measure of socio-economic status, receiving free school meals, was the only demographic variable strongly related to caries experience (OR: 2.8, 95% CI: 1.6–4.9). After adjustment, children ‘emerging’ in EYFSP learning areas had 1.6- to 2.2-fold (95% CI: 1.0–3.8) higher odds of experiencing caries. Children ‘exceeding’ EYFSP learning areas had 2.3- to 4-fold (95% CI: 0.1–0.9) lower odds of caries experience. Conclusion This is the first study to explore the association between caries experience and school readiness using a holistic assessment tool. The association was found across different learning areas and was comparable to and independent of socio-economic status. The findings indicate oral health-related absenteeism is not a causative factor. EYFSP shows potential to enhance the targeting of preventive interventions at a child, class or school level

Using process drama to explore the causes of dental anxiety in primary‑school children

Background Drama and role play can be unlisted as methods to allow children to view problems from a range of different perspectives that may differ from their own experience. Application of drama technique to assess the cause of dental fear and anxiety in a school setting is novel. Aim The aim of this study was to engage primary school children in the core investigation via participatory arts methodologies, namely, process drama to gain understanding of the causes of dental anxiety. Design Sixty-three children, aged 7–10 years from three primary schools participated in this study. A 90-min drama workshop was carried in each school. The children were encouraged to identify the causes of dental anxiety using key concepts from process drama. The sessions were audio-recorded and transcribed. Results Four key concepts emerged: (1) fear of the unknown; (2) unpleasant sensory experience; (3) society’s perception and portrayal of the dentist; and (4) learnt negative associations with the dentist. Within each four key concepts, two sub-themes were identified. Conclusions Role-playing and use of drama are a novel application and can reveal a considerable amount of information from the child’s perspective on the cause of dental fear and anxiety

Personality differences in dental professionals: A cross-sectional survey.

Introduction : Despite its influence on occupational performance and team dynamics, there has been little research into the personality of dental professionals. Existing research does not typically use the prevailing five-factor model of personality. We aimed to measure the personality of dental professionals in the United Kingdom and investigate differences among groups. Methods: The sample (n 5 906) comprised dental nurses (n 5 475), general dental practitioners (GDPs) (n 5 182), orthodontists (n 5 201), and oral and maxillofacial surgeons (OMFSs) (n 5 48). Recruitment was via email and social media. The questionnaire collected data on demographic variables and contained the Big Five Inventory, a validated self-report personality test. Participants scored on extraversion, conscientiousness, agreeableness neuroticism, and openness. A one-way analysis of variance and post-hoc tests with Bonferroni correction were used to identify significant differences in personality between occupations. Hierarchical multiple regression determined the influence of occupation over and above demographic variables. Results: On a 5-point scale, orthodontists had a mean conscientiousness score 0.23 points higher than GDPs (95% confidence interval [CI], 0.10-0.36). Dental nurses had a mean conscientiousness score 0.28 points higher than GDPs (95% CI, 0.17-0.39). Dental nurses had a mean agreeableness score 0.16 points higher than orthodontists (95% CI, 0.05-0.27) and 0.30 points higher than OMFSs (95% CI, 0.10-0.50). For neuroticism, orthodontists had a mean score 0.21 points lower than dental nurses (95% CI, 0.06-0.36), and OMFSs had a mean score 0.43 points lower than dental nurses (95% CI, 0.16-0.70). GDPs had a mean neuroticism score 0.43 points higher than OMFSs (95% CI, 0.14-0.71; P 5 0.001). Differences were small to moderate in size (d 5 0.35-0.45) and occupation was associated with personality after accounting for demographic variables. Conclusions: The personalities of dental nurses, GDPs, orthodontists, and OMFSs differed. Occupation was associated with differences in personality after accounting for demographic characteristics. (Am J Orthod Dentofacial Orthop 202

A systematic review and meta-analysis of the executive function-health behaviour relationship

Objective: This study provides the first comprehensive meta-analysis of the relationship between executive function (EF) and performance of health behaviours in healthy populations. Method: Electronic databases (MEDLINE, Embase, PsycINFO, Web of Science) were searched, and forward and backward citation tracking was undertaken to identify articles investigating the relationship between EF and health behaviour. Studies were eligible if they examined the direct correlational relationship between EF and health behaviour in healthy populations, were available in English and published in peer-reviewed journals in any year. Results: Sixty-one articles covering 65 tests were included in a random effects meta-analysis. Several moderators were assessed, including: the type, and addictiveness of the health behaviour; the type of EF measure; study design, and sample characteristics. Overall EF had a significant, but small correlation with health behaviour; EF was significantly positively associated with health-protective behaviours and significantly negatively associated with health-damaging behaviours. There was considerable heterogeneity in the observed effect sizes, but this was not explained by the examined moderators. Conclusions: Although the meta-analysis indicates a significant effect for EF on health behaviour, effect size is small. Due to the complex nature of EF, more research is required to further elucidate the relationship between EF and health behaviour in its entire conceptualization

Recommendations for delivering oral health advice: a qualitative supplementary analysis of dental teams, parents’ and children’s experiences

Background: Tooth decay has a significant impact on children, their families and wider society. The dental consultation provides an opportunity to prevent tooth decay by engaging in an effective oral health conversation with parents and children. However, there is limited literature which explores how these oral health conversations are delivered, received, and understood. Aim: To explore the common facilitators of delivering oral health advice from dental teams, parents' and children's experiences, to identify and inform practical recommendations for clinical practice. Method: The current paper used a qualitative supplementary analysis to reanalyse data of existing published studies by applying a different research question. Qualitative focus groups were undertaken following a semi-structured interview guide with 27 dental team members (dentists, dental nurses, practice managers and receptionists), 37 parents and 120 children (aged 7–10 years old) in the northern region of England. Thematic analysis informed the identification of themes and aggregation of findings. Results: Three overarching themes were developed: (1) An engaging and personalised dental visit for parents and children; (2) Dental teams, parents and children working collaboratively to improve oral health habits; and (3) Recommending appropriate oral health products. Many parents and children had little recollection of any preventive oral health conversations when visiting the dentist. Practical solutions were identified by different stakeholders to facilitate three-way, personalised, non-judgemental and supportive oral health conversations. Adopting these innovative approaches will help to enable parents and their children to adopt and maintain appropriate oral health behaviours. Conclusion: Understanding the context and triangulating the experiences of stakeholders involved in preventive oral health conversations for young children is an essential step in co-designing a complex oral health intervention. This study has provided recommendations for dental practices and wider paediatric health care services. Furthermore, the findings have informed the design of a complex oral health intervention called "Strong Teeth"

A national survey of supervised toothbrushing programmes in England

Introduction Supervised toothbrushing programmes (STPs) are a cost-effective public health intervention, reducing tooth decay and health inequalities in children. However, the uptake of STPs in England is unknown. This study aimed to establish the current provision of STPs across England and summarise the barriers and facilitators to their implementation. Methods An online survey was sent to dental public health consultants, local authority (LA) oral health leads, and public health practitioners across England. Quantitative data were analysed using descriptive statistics. Barriers and facilitators were analysed using the Consolidated Framework for Implementation Research. Results Information was received for 141 LAs across England. Approximately half implemented an STP (n = 68/141). Most STPs were commissioned by LAs (n = 44/68) and adopted a targeted approach (n = 54/68). Barriers to implementation were: 1) acquiring funding; 2) poor communication and engagement between LAs, oral health providers and settings; 3) oral health not a priority; 4) logistically challenging to implement; and 5) lack of capacity. Facilitators were: 1) an integrated and mandated public health approach; 2) collaboration and ongoing support between LAs, oral health providers, and settings; 3) clarity of guidance; 4) flexible approach to delivery; 5) adequate available resources; and 6) ownership and empowerment of setting staff. Conclusion The current provision of STPs is varied, and although there are challenges to their implementation, there are also areas of good practice where these challenges have been overcome

HABIT-an early phase study to explore an oral health intervention delivered by health visitors to parents with young children aged 9-12 months: study protocol.

Background: Parental supervised brushing (PSB) when initiated in infancy can lead to long-term protective home-based oral health habits thereby reducing the risk of dental caries. However, PSB is a complex behaviour with many barriers reported by parents hindering its effective implementation. Within the UK, oral health advice is delivered universally to parents by health visitors and their wider teams when children are aged between 9 and 12 months. Nevertheless, there is no standardised intervention or training upon which health visitors can base this advice, and they often lack the specialised knowledge needed to help parents overcome barriers to performing PSB and limiting sugary foods and drinks.Working with health visitors and parents of children aged 9-24 months, we have co-designed oral health training and resources (Health Visitors delivering Advice in Britain on Infant Toothbrushing (HABIT) intervention) to be used by health visitors and their wider teams when providing parents of children aged 9-12 months with oral health advice.The aim of the study is to explore the acceptability of the HABIT intervention to parents and health visitors, to examine the mechanism of action and develop suitable objective measures of PSB. Methods/design: Six health visitors working in a deprived city in the UK will be provided with training on how to use the HABIT intervention. Health visitors will then each deliver the intervention to five parents of children aged 9-12 months. The research team will collect measures of PSB and dietary behaviours before and at 2 weeks and 3 months after the HABIT intervention. Acceptability of the HABIT intervention to health visitors will be explored through semi-structured diaries completed after each visit and a focus group discussion after delivery to all parents. Acceptability of the HABIT intervention and mechanism of action will be explored briefly during each home visit with parents and in greater details in 20-25 qualitative interviews after the completion of data collection. The utility of three objective measures of PSB will be compared with each other and with parental-self reports. Discussion: This study will provide essential information to inform the design of a definitive cluster randomised controlled trial. Trial registration: There is no database for early phase studies such as ours