1. Better Start Oral Health Improvement Strategy Donna Taylor CECD Development Officer

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

4. 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

5. Where are we now? Indicator Timeframe Blackpool England
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

6. 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

7. 5 year old children with caries in Better Start and other areas 2015

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

9. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. Tooth brushing Campaign

17. Tooth brushing Campaign

18. 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.

19. Supervised Tooth Brushing in EY Childcare settings

20. 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

21. 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

22. “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

23. 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

24. Thank You and Any Questions?