Better Start Oral Health Improvement Strategy Donna Taylor CECD Development Officer

A Developmental Approach 3 Better start outcomes and 2 local developmental milestones

Why are we doing this? Children's dental health in Blackpool is poor High levels of hospital admission for teeth extraction under General Anaesthetic Approx. 60% of 2, and 5 year olds have not seen a dentist in the previous 12 months www.blackpoolbetterstart.org.uk

Where are we now? Indicator Timeframe Blackpool England 4.02 - Proportion of five year old children free from dental decay  2014/15 57.5 75.2 dmft (decayed, missing or filled teeth) in five year olds 1.83 0.84 Incisor caries prevalence in three year olds 2012/13 8.1 3.9 Proportion of three year olds free from dental decay 83.1 88.4 dmft in three year olds 0.63 0.36 Proportion of twelve year olds free from dental decay 2008/09 57.4 66.4 DMFT in twelve year olds 1.06 0.74

Caries prevalence in Better Start and other areas Ward grouping Number of children examined Percentage with caries experience 95% CI of prevalence Mean dmft 95% CI of mean dmft Sum of Incisor caries Percentage with incisor caries Better Start 64 50 12.25 2.4 0.784 11 17 Not Better Start 115 36.5 8.80 1.3 0.443 8 7 Blackpool total 179 40.1 14.6 1.8 0.87 28 16

5 year old children with caries in Better Start and other areas 2015

Average number of decayed, extracted or filled teeth among 5 year olds in Better Start and other areas

Better Start Oral Health Strategy Our approach is… Multi-level, multi-component intervention with: Strand 1: Community mobilisation including high levels of stakeholder engagement, capacity building and community organising Strand 2: Media advocacy to support local policy/service changes Strand 3: Suite of effective/cost-effective interventions www.blackpoolbetterstart.org.uk

www.blackpoolbetterstart.org.uk

Strand 1: Community and Workforce Mobilisation Aim to increase access to preventative oral health care Develop opportunities for collaborative projects with General Dental Practitioners Develop and support capacity of community members to advocate and champion oral health Increase the integration of primary care practitioners with the community and other health and social care professionals Encouraging dental activities within community/ early years settings www.blackpoolbetterstart.org.uk

NHS England- Starting Well Oral Health Improvement Initiative This is NHS England ( NHSE) scheme aim is to support: The reduction of oral health inequalities and improvement in oral health in children under 5 years of age through creative commissioning expenditure In UK 13 priority areas: North West its Blackpool and Blackpool with Darwen CECD is working collaboratively with NHSE to increase children under 5 accessing dentistry

Starting Well- Blackpool Examples of Starting well initiatives Practices designate Oral Health Champions Network with community connector –oral health Better Start Community Connector Oral Health- key to integration with the Starting Well initiative Increase access to fluoride varnish applications Reach out to community adopt a setting work with Children’s Centres

Community Connector- Oral Health Better Start Community Connectors- work with families to promote healthier lifestyles encouraging healthy eating and physical exercise, adopting lifestyle changes, engagement in services Work with Dental Practice Champions to engage with the community and encourage families to attend dental appointments -coordinating facilitated access to dental appointments, and fluoride varnish clinics

Strand 2- Media Advocacy Development and distribution of oral health messages Consulted with the community to find out what OH messages are known/ not known by community Community experience mixed OH messages from practitioners Some health messages absent ‘spit don’t rinse’ Develop messages and resources appropriate for and acceptable to early years families www.blackpoolbetterstart.org.uk

Tooth brushing Campaign

Tooth brushing Campaign

Strand 3 -Evidence informed interventions Oral health improvement programmes should be based upon the evidence base and the needs of the population. Commissioning Better Oral Health, Approaches for Local Authorities and their Partners to Improve the Oral Health of their Communities, Delivering Better Oral Health and Smoke Free and Smiling provide the evidence base for oral health improvement interventions.

Supervised Tooth Brushing in EY Childcare settings

Strand 3- Effective Interventions Its is an oral health improvement programme to get children and families brushing their teeth (aimed at PVI childcare settings) Aim to increase access to fluoride through daily brushing with fluoride toothpaste We hope that children who take part in the scheme will encourage behavioural changes within the family We have enrolled nurseries and childminders into the Blackpool Better Start Supervised Brushing Scheme Provided all resources for one year free and asked settings to commit to continue daily tooth brushing after the initial 12 months www.blackpoolbetterstart.org.uk

Results and Feedback Launch of scheme in June 2017 Training sessions undertaken throughout July Delivery of resources to nurseries and larger childminders Results to date >1000 children undertaking supervised brushing each day 35 childminders trained (61% of registered childminders) 8 out of 11 childminders in Better Start wards are trained 26 nurseries trained (52% of eligible settings) 11 out of the 14 nurseries (78%) in Better Start wards are trained 0 parents have opted-out of the programme Very positive feedback from settings – kids loving the programme

“my children are enjoying the programme” “everyone has taken it on board and it actually improved dentist visits as at least 7 of our children have been to the dentist since we started All our children still involved, no opt outs and 2 more dentist visits” “my children are enjoying the programme” “my children are enjoying the programme” “I have 5 children enjoying brushing their teeth and 3 mums now use home timers

So how will we know it’s been a success? Reduction in dental decay, ECC and extractions at 5 years Numbers recorded through Supervised Tooth brushing scheme Increased access to dental care through general practices Reduction in age at first dental visit Evidence of raised awareness of importance of issue Evidence of consistent oral health messages reaching community

Thank You and Any Questions?