1. Demonstration of oral hygiene resources
Dr Sally Weston-Price
Clinical Lecturer Adult Oral Health and Dental Public Health
Bart's and the London School of Medicine and Dentistry

2. Overview of this session
Development of the resource
Module demonstration
Initial feedback and evaluation
The next phase

3. Development of the resource
Developed for Key Stage 2 (7-11 years)
Activity based lesson plan
National curriculum links
Draws on social learning theories
The two themes that are expanded on are diet and oral hygiene

4. Development of the resource
The first draft of the module was presented to focus groups of teachers who work with the specific key stages within and outside of London.
The teacher response was very positive with all expressing they would want to incorporate the lesson into their teaching.
Several themes emerged from the focus group:
Lesson duration
Nutrition content
Lesson feasibility
All the teacher feedback was collated and utilised to modify and compile the final module.

5. Our department was commissioned to develop an Oral health education module for the European website e-Bug.
The oral health module was developed to complement the style, graphics and knowledge based model of existing e-Bug materials. It is aimed at key stage 2 pupils which in the UK is a coverage of 7-11 year olds.
The content follows evidence based prevention advice from the department of health’s toolkit “delivering better oral health” and focuses on two main learning outcomes; understanding the importance of reducing the amount and frequency of sugar consumption and increasing and improving tooth brushing with fluoride toothpaste.
e-Bug commissioned the current module “Oral Hygiene, Prevention of infection” to be developed by the Dental Public Health Department at Bart’s and the London School of Medicine and Dentistry. The lesson plan is evidence based and follows cognitive and social theories of learning and aims to impart oral health related knowledge over two themes, reducing the amount and frequency of sugar intake and to increase and improve tooth brushing.

6. Pre-task:
Diet diary: Write down the day and record everything you have to eat or drink (however small) and note the time. Do this for 2 weekdays and one weekend day.
Brushing diary: Write the day of the week in the diary and tick each time you have brushed your teeth in the box for that day.
Students are provided with diet and brushing diaries to complete at home one week prior to lesson

7. The lesson:
This begins with a PowerPoint presentation designed to introduce children to the concept that tooth decay is a preventable disease.
Teachers are provided with background information to prepare for this and are encouraged to ask the questions within the presentation to promote discussion and gather what knowledge the pupils already have.

8. Activity 1: Diet
Individuals highlight sugar attacks in their diet diaries and class totals are plotted to visualise group sugar consumption.
Each time we eat or drink foods with free sugars this is classified a sugar attack. Free sugars are those added by the cook, consumer or manufacturer including those sugars naturally present in honey, syrups and fruit juices, but excludes whole fruits and unrefined carbohydrates such as brown rice and whole wheat pasta. Sugar attacks should be kept to a minimum and limited to mealtimes to reduce the risk of tooth decay.

9. Activity 1: Diet

10. Activity 1: Diet This activity is for groups of 2-3 students.
Provide each group with a different empty drink bottle from a popular brand (include flavoured and plain water and a range of soft and fizzy drinks), a teaspoon, a bag of sugar and a clear plastic bag (such as a sandwich bag).
Before they begin, each pupil should be asked to look at the nutritional information label and identify how much sugar is contained within each bottle. Teachers can help pupils locate the sugar content on the label, and check the amounts.
Pupils should be asked to fill each bag with the equivalent amount of sugar contained within each drink (1 teaspoon is approximately 4 grams).
Once the activity is completed, each group can present their findings (drink name, amount of sugar in grams and number of teaspoons of sugar) to the rest of the class.
Ask the pupils to present and discuss their findings.
Pupils can collate the project and produce a 3D poster board for display within the classroom; containing drink bottles and sugar bags attached to the paper.

11. Activity 2: Hygiene
Hygiene is tackled by a class exercise using brushing diet diaries to visualise group brushing frequency and the class is shown a video of effective tooth brushing technique.

12. Activity 2: Hygiene

15. Follow-up lesson:
Students are provided with new diet and brushing diaries to complete at home for one week post lesson. The class exercises involving these diaries are repeated at the follow up lesson.

16. Initial feedback and evaluation
A pilot study to assess knowledge acquisition following the eBug lesson was conducted last July involving 140 children from the London boroughs of Havering and Tower Hamlets
A short questionnaire was administered to the children before and immediately after the children received the lesson.
Correct and incorrect responses were analysed showing a statistically significant increase in knowledge across several of the learning outcomes

19. Of the eight knowledge based questions asked students showed a significant increase in knowledge gain across six.
Suggesting they learnt that:
Teeth can be protected from decay
Tooth decay can cause pain
Sugar in food and drink causes tooth decay
Brushing last thing at night is most important
Fluoride tooth paste is better for your teeth
After brushing you should spit out the tooth paste but not rinse

20. Public Engagement

21. Initial feedback and evaluation
Since going live in March the webpage has attracted traffic across the UK, Europe and beyond - 1,417 page views, with 777 downloads of the English lesson plan
eBug feedback data indicates 159 UK schools have already used the module with 154 of these rating the materials as good or excellent.

22. The next phase for this module
A large scale assessment of knowledge acquisition and retention across 7-11 year olds exposed to this lesson is under development including an assessment of diet and brushing behaviour change
A qualitative study to explore the oral health knowledge, attitudes, behaviours and views about school-based oral health education of year old secondary school children was undertaken last summer to gain an insight into the Key stage 3 age group and their needs regarding a module

23. Thank you for listening