SolentNHS Trust

An Oral Health Improvement Programme for Early Years settings

Saving Smiles

SolentNHS Trust

Contents

Section 1: Introduction Evidence-based practices The Saving Smiles Programme Process for achieving the Award

Review of Award Further help

Section 2 – Collecting Supporting Evidence

Guidance on Supporting Evidence

Supporting Evidence - Healthy Eating Supporting Evidence - Regular Tooth Brushing with Fluoride Toothpaste

Supporting Evidence - Visiting a Dentist Regularly

Welcome to the Saving Smiles programme! The programme is designed to help Early Years settings promote oral health habits to their children, and families. Good oral health is important to help everyone enjoy a variety of foods, talk, smile and feel confident. This is especially important in children who are learning to talk and socialise.

Young children are learning all the time, from what they see as well as from what they are taught. Activities that improve their health, including oral health establish good habits from an early age. This includes eating lots of fruit and vegetables, drinking water rather than sweet drinks and brushing their teeth twice a day every day.

Your role is very important, as many children spend significant amounts of time in an Early Years setting. You can help children develop good health habits and offer support to parents and carers to help them make healthier food choices and help with their child’s tooth brushing at home.

Many of the factors associated with poor oral health are common to other conditions. For example, a poor diet can lead to dental decay and as well as obesity. Obesity itself can lead to various health problems including heart disease in adult life. So, there are lots of reasons for children to keep their mouths healthy and disease-free as they grow up.

The recommendations in Saving Smiles are based on the best available evidence for development of good oral health. We look forward to working with you to complete the programme, achieving the Saving Smiles award and maintaining the good practice.

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Introduction to the programme

The 3 evidence-based practices for good oral health

1. Healthy Eating and Drinking

• Reduce the frequency and amount of foods and drinks containing sugar by keeping all foods containing sugar to mealtimes

• Snack on fruit and/or vegetables between meals

• Drink only milk and water as much as possible. Sweetened drinks, including fruit juice, should only be given occasionally and only with a main meal.

2. Daily Tooth Brushing with fluoride toothpaste

• Brush twice a day, at night and at one other time

• For 0-3 year-olds: smear of toothpaste with no less than 1000ppm of fluoride

• For 3-6 year-olds: pea-sized amount of toothpaste with 1000 - 1450ppm of fluoride

• For older children and adults: toothpaste with 1350-1450ppm of fluoride

• Parents should supervise tooth brushing until at least 7 years of age to ensure proper cleaning

• Spit out excess toothpaste after tooth brushing and do not rinse so the toothpaste stays in contact with teeth for longer.

3. Visiting a Dentist Regularly for advice and treatment

• Children should be seen at regular intervals of between 3 and 12 months.

• Young people and adults should be seen at regular intervals as determined by their dentist.

The Saving Smiles Programme

Saving Smiles supports co-ordinated activities with the aim of improving oral health in children and contributing to the foundations for good health throughout life. The programme has been developed by the local oral health improvement team.

The programme will enable practitioners in Early Years settings to demonstrate and be recognised for ensuring that:

• their environments promote good oral and general health

• self-care behaviours are adopted which will promote good oral health and prevent dental decay

• families are signposted to accessible NHS dental services

• the views, ideas and expressed needs of everyone at the setting are taken into account in delivering the programme

• parents/carers are involved in the planning and delivery of activities

• a member of staff is selected to be the setting’s oral health champion.

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Achieving the award - Flowchart below

The Solent Oral Health Promotion team will work with the oral health champion and setting to implement the programme and collect evidence to support progress.

On successful completion of the programme, Solent NHS Trust will award the Savings Smiles Certificate that can be used to demonstrate the setting’s commitment to providing an environment that supports both oral and general health for the families in their care.

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Saving Smiles Training Event facilitated by OHP team for staff at setting.

Record evidence for current activity in the setting.

Identify gaps in activity and produce an Action Plan.

Work on Action Plan and collect and record supporting evidence.

Work with the OHP Team to monitor progress.

Awarding Saving Smiles Certificate. Sharing of good practice via press.

Annual review and reaccreditation of the Saving Smiles Award.

Meetings to discuss the programme and Award and to select an Oral Health Champion.

The programme will involve settings collecting and recording evidence of activities and interventions.

The programme can be undertaken in any order. You can choose what area you want to concentrate on first.

Settings will elect an Oral Health Champion who will then receive appropriate training from the Oral Health Promotion Team and will:

• collect current oral health improvement activity evidence

• identify any gaps in current oral health improvement activity

• develop an Action Plan to address any gaps found

• report progress of the Action Plan to the Oral Health Promotion Team

• implement and promote a Saving Smiles environment

Review of Award – 12 months after previous award On successful completion of the Savings Smiles Award, settings will need to demonstrate continued or enhanced activities.

Settings will be contacted every six months by the Oral Health Promotion Team to review progress and offer further support.

Settings can contact the Oral Health Promotion Team if they require support before a review.

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Further help Information and resources can obtained through the Oral Health Promotion team.

A Handbook to support Daily Supervised Tooth Brushing at the setting is also available.

For support and advice, please contact the Solent NHS Trust Oral Health Promotion Team:

West Hants team:

Oral Health Promotion Office

Level A Mary Seacole Wing

Brinton’s Terrace

Southampton

SO140YG

Tel: 023 8071 6557

East Hants Team:

Special Care Dental Service - Oral

Health Promotion

Gosport War Memorial Hospital

Bury Road

PO12 3PW

Tel: 023 9279 4712

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Supporting evidence:

Healthy eating and drinkingReducing the frequency and amount of foods and drinks containing sugar by:

• Keeping all foods containing sugar to mealtimes

• Snacking on fruit and/or vegetables between meals

• Drinking only milk and water on site

How does your setting ensure that:• All foods containing sugar are restricted to mealtimes only

• Fresh fruit and/or vegetables are offered as snacks between meals

• Milk and water are the only drinks available on site

Suggested evidence:

• Your setting has a healthy eating policy.

• Parents have been given the opportunity to contribute to the planning of the policy.

• The healthy eating policy is promoted to parents/carers for example within an induction pack, parent evenings, on the setting’s website and social media pages etc.

• Staff communicates healthy eating messages to parents/carers to encourage healthy eating at home.

• Snack/meal menus are displayed and are up to date.

• Healthy eating and drinking is a regular agenda item at staff meetings

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Collecting supporting evidence

Guidance on supporting evidenceThis section provides guidance on how to identify activities which are currently taking place in the setting and develop new activities which could be used as evidence for the three evidence-based practices:

1. Healthy Eating and Drinking

2. Daily Tooth Brushing with fluoride toothpaste

3. Visiting a Dentist Regularly

The aim of the Programme is to embed as much of the activities into the regular operations of your setting as possible. This will help make the activities more sustainable.

The Oral Health Promotion Team will guide you on what they will consider sufficient evidence. One piece of evidence may support one or more of the four evidence-based practices.

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Signed by Oral Health Champion:

Signed by Oral Health Promotion Team:

Date:

Evidence

Daily tooth brushing with fluoride toothpaste

Key messages:• Brush twice a day, at night and at one other time

• Using fluoride toothpaste with the correct level of fluoride

• Supervising tooth brushing until the child is at least 7 years of age

• Spitting out and not rinsing after brushing

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Supporting evidence for daily tooth brushing with fluoride toothpaste

How does your setting promote daily tooth brushing with fluoride toothpaste and ensure that the key messages are available to staff, parents and carers. Suggested evidence:

• Key messages are given during induction sessions, parent forums, on the setting’s website and social media pages etc. and are displayed in the setting via notice boards, displays, newsletters etc.

• Staff ask parents and carers about current brushing behaviour and encourage daily brushing using key messages

• Resources are available that support and encourage daily tooth brushing at home for example songs and stories about brushing, Brushing Charts, Brushing Certificates

• Where appropriate the setting has a daily brushing scheme

• Toothpaste containing the correct amount of fluoride to use at home is available at the setting or information on appropriate toothpastes is available.

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Signed by Oral Health Champion:

Signed by Oral Health Promotion Team:

Date:

Evidence

If a daily supervised tooth brushing scheme is in place it is implemented and monitored according to the Solent NHS Trust Supervised Tooth Brushing Handbook.

Suggested evidence:

• Staff have a Certificate to show they have received appropriate training on implementing and monitoring the scheme

• Date of termly review by Oral Health Promotion team

• Daily tooth brushing is a regular agenda item at staff meetings which can be evidenced by minutes, reports etc.

Evidence

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Signed by Oral Health Champion:

Signed by Oral Health Promotion Team:

Date:

Visiting a dentist regularly

• Children should be seen at regular intervals of between 3 and 12 months

• Young people and adults should be seen at regular intervals as determined by their dentist

• Setting promotes the Hampshire Dental Helpline website www.hampshiredentalhelpline.nhs.uk and 111 telephone number for people who need to find a dentist for regular or emergency care

• Setting is aware of when and how to access the Solent NHS Trust Special Care Dental Service

How does your setting ensure that families attend a dentist regularly.

Suggested evidence:

• Staff ask families if they have dentist

• Staff provides Information about how to access local NHS dental services through the Hampshire Dental Helpline by telephoning 111 or by visiting the website www.hampshiredentalhelpline.nhs.uk via notice boards, in newsletters, on the setting’s website and social media pages, included in induction etc.

• Staff know when and how to signpost to the Special Care Dental Service when necessary

• Information about NHS dental charges and exemptions is displayed

• Children are given the opportunity to role play visiting a dentist and parents are involved in activities

• Stories, songs and other resources are used about visiting the dentist.

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Evidence

Signed by Oral Health Champion:

Signed by Oral Health Promotion Team:

Date: