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The Carevan Sun Smiles Program

Tooth decay has a profound impact on a child’s quality of life.

Over half of 6 year old Australian children have tooth decay (AIHW 2015).

Children experience dental pain and infection which impacts on their physical growth and cognitive

development and lowers their self-esteem. Research shows that poor oral health and toothache can

put children at a serious disadvantage in school. Oral health problems are a significant factor in school

absences. Toothache restricts a child’s participation at school and impacts on their academic

performance, leading to lower school grades.

Many children require hospital admission for dental treatment under general anaesthesia caused by

tooth decay. General anaesthesia carries a small but significant risk of mortality and places a large

financial burden on the Australian hospital system.

Access to preventive dental care is a major issue.

Children from low socio-economic families, with rural and CALD backgrounds, are at greater risk of

poor dental health behaviours and limited access to preventive oral healthcare. This places them at a

higher risk of developing tooth decay and other oral health problems.

Sun Smiles dental screening at Wodonga West and Glenroy Primary Schools

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Introduction

The Carevan Sun Smiles program was launched in June 2012, out of a growing concern for

the oral health of primary school children in the Hume region of Australia. The Sun Smiles

program is delivered free to all public primary schools and community groups who participate.

In 2012 Sun Smiles oral health promotion sessions were delivered to 270 Wodonga West

primary school students and 60 Albury Midnight Basketball participants. 224 students

received a dental screening and fluoride varnish treatment.

In 2013 Sun Smiles oral health promotion sessions were delivered to 689 primary school

students at Wodonga West and Glenroy Primary Schools and 60 Albury Midnight Basketball

participants. 597 students received a dental screening and fluoride varnish treatment.

In 2014 over 700 students participated in the Sun Smiles program at Wodonga West,

Wangaratta and Kennington Primary Schools in Victoria and Glenroy and Lavington Public

Schools and Albury Midnight Basketball in NSW.

In 2015 the program was launched at Homebush West Public School, in Western Sydney.

Inaugural Carevan Sun Smiles Team 2012

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Aim

Sun Smiles aims to improve oral health literacy, oral hygiene skills and

access to preventive dental care for primary school children in the

Albury, Wodonga, Bendigo, Wangaratta and Western Sydney regions

to enable future improvements in their oral health.

Objectives

1) Strengthen local community and oral health professional’s

capacity to provide oral health promotion and preventive dental care.

2) Develop oral health promotion resources utilising a creative

approach called DATA (Dental Awareness through Art) focuses on the

Carevan’s youth artwork and oral health puppetry.

3) Build partnerships with Australian Universities to support and

develop Dentistry and Oral Health Therapy student’s rural clinical

placement and outreach experiences.

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Sun Smiles Program

The Carevan Sun Smiles Program is a free multi-strategy, oral health promotion

and decay prevention program. The Sun Smiles program incorporates strategies

from the Department of Health’s ‘Action plan for oral health promotion 2013-

2017’.

The program includes 4 key components which are integrated within the World

Health Organisation’s Health Promoting Schools Framework:

1) Oral Health Promotion: Engaging children through oral health puppetry. Oral

health education and skills development, focused on twice daily toothbrushing

with Colgate fluoride toothpaste.

2) Nutrition: Engaging children in healthy eating choices and encouraging

children to drink fluoridated tap water.

3) Fluoride Varnish: Professionally applied bi-annual Colgate Duraphat 5%

sodium fluoride varnish within the school setting.

4) Dental Referral Pathway: Dental screening and establishment of dental

referral pathways to local Health District Dental Clinics, University Dental Clinics,

Aboriginal Health Services and private dental practices.

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Oral Health Promotion

Oral health education is a key component of the Sun Smiles program. A suite of powerpoint presentations have been developed, which are presented on the school’s interactive white boards. The presentations cover age specific oral health issues including:

Tooth decay.

Dental erosion.

Nutrition, including soft drink

consumption

The benefits of using fluoride

toothpaste and fluoride varnish to

prevent tooth decay

.

Innovative hands-on workshops have been developed to engage children in actively learning

about oral health.

Fluorescent disclosing gels and UV torches are used by the children to teach about the

association of dental plaque with tooth decay and gum disease.

Science experiments are used to demonstrate the effect of sugar and bacteria.

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Children receive a Sun Smiles take home showbag which includes:

Colgate fluoride toothpaste and Colgate children’s toothbrush, accessed from the South

Pacific Child Oral Health Taskforce. This is endorsed by International guidelines for

community based provision and use of fluoride toothpaste.

Colgate Bright Smiles Bright Futures brochures.

Plastic dental mirror (from dental screening)

Fluoride varnish homecare brochures.

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Nutrition

The 2011-12 Australian Health Survey (AHS) is the largest and most comprehensive health

survey ever conducted in Australia. The AHS food and nutrients data (ABS 2014) provides the

first comprehensive analysis of what Australians are eating in almost 20 years. Early findings

show that only 30.8% of children aged 8-11 years met the recommended intake of at least 3

serves of vegetables.

The 2007 Australian Children’s Nutrition and Physical Activity Survey, led by a team of CSIRO and University of South Australia researchers, showed that only 1 in 5 children aged 4-11 years consumed the recommended amount of dairy foods each day.

The 2007 survey showed that many children are not eating enough nutritious food, which means they don’t get the vitamins and minerals needed during their growth years, especially calcium for strong bones and teeth. The survey showed that fruit, vegetables and dairy foods are being replaced by foods high in kilojoules, salt and saturated fat – the very dietary patterns linked to the development of type 2 diabetes, high blood pressure and heart disease in adults.

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Vegetables

Fresh fruit

Milk drinks

Cheese

Since food behaviours formed in childhood shape lifelong dietary habits, an opportunity exists for the Carevan Sun Smiles program to engage students in healthy eating choices. Sun Smiles healthy eating messages are aligned with the ‘oral health messages for the Australian public’ national consensus workshop findings (ARCPOH 2011). Sun Smiles is also guided by the Eat for Health: Australian Dietary Guidelines (NHMRC 2013) including encouraging children to drink fluoridated tap water at school and home.

Nutritious fruit and vegetable platters, milk drinks,

yoghurt and cheese are served from the Carevan,

by volunteers, to all school children in the program, to

raise awareness of the consumption of ‘calcium rich’ dairy

foods and fresh fruits and vegetables for good oral health

and overall general health.

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Oral Health Puppetry

Puppets are a powerful tool in health education, particularly for children with low

literacy. Puppets provide visual and kinetic (touch) learning experiences.

Research shows that oral health education involving puppets provides better

learning outcomes. Oral health puppets are used for role play and to teach

toothbrushing techniques.

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Sun Smiles Mascots

Carevan Cookie Bear and Colgate BSBF Dr Brushwell

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Wangaratta Primary School

Carevan Hot Soup Day June 2014

Wangaratta Primary School Student Representative Council combined fundraising with healthy eating

to host a Carevan hot soup day in June 2014. This whole school event, supported by the Parents &

Friends Club, served nutritious, home made soups from the Wangaratta Carevan. Raising awareness

of healthy eating and the role of the Carevan within the local community. The school students raised

over $500.00 to support the work of the Carevan.

Colgate Oral Care Brigade Recycling Program 2015

Every year in Australia over 30 million toothbrushes and 80 million toothpaste tubes are thrown away.

What a waste! Wangaratta Primary School is participating in the Colgate Oral Care Brigade, a unique

recycling solution by Terracycle. Students are collecting used oral care waste, including old

toothbrushes, toothpaste tubes, floss containers and their outer packaging so it can be recycled. Each

item recycled helps raise funds for the Carevan Sun Smiles Program.

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Kennington Primary School, Bendigo

Sun Smiles visit by La Trobe University students October 2014

Bendigo Oral Health and Dentistry Student (BOHDS) members carried out Sun Smiles oral

health promotion sessions with 93 Grade 4 students at Kennington Primary, with the help of Dr

Rabbit and Colgate Bright Smiles Bright Futures (BSBF) resources.

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Albury Midnight Basketball: Sun Smiles workshops.

Midnight Basketball is a national social inclusion

program to help 'at risk' youth identify and embrace

positive opportunities. Midnight Basketball is open

to youth aged 12 to 18 years.

A hot, nutritious dinner supplied by the Carevan,

compulsory life skills workshops and tournament

basketball games are run at the Police Citizens

Youth Club in East Albury on Friday or Saturday

nights from 7.30pm till midnight. This program

keeps disengaged youth off the streets by providing

a safe environment.

Each year sixty Midnight Basketball players from less advantaged, Indigenous and culturally

and linguistically diverse (CALD) backgrounds, including Sudanese and Bhutanese teenagers,

participate in a Sun Smiles workshops. The program includes a twenty minute ‘Shooting

goals for oral health’ powerpoint presentation on oral health for teenagers, followed by a

hands-on oral health life-skills workshop.

The workshop involves teenagers applying fluorescent disclosing solution on their own teeth

and learning effective toothbrushing and flossing skills. Each participant receives a Sun

Smiles take home kit, which contains a Colgate toothbrush, toothpaste, floss, Wrigley’s Extra

sugar free chewing gum sachets and oral health brochures.

Surveys undertaken by the Midnight Basketball players show many have not been able to

access regular dental visits or receive preventive dental care. The majority of teenagers

expressed a desire to access these services through the Sun Smiles program.

Survey results showed all the dental volunteers felt their involvement in the Sun Smiles

program increased their capacity to carry out oral health promotion activities and they would

volunteer for future Sun Smiles events.

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Fluoride Varnish: evidence based care.

The Health Education Authority Review found programs aimed at decay reduction were

only effective when fluoride agents were used. The efficacy and safety of fluoride varnish has

been supported by an Australian systematic review undertaken by the National Health and

Medical Research Council in 2007. This review corroborates with international systematic

reviews; including a Canadian review (Azarpazhooh & Main 2008) and the recent Cochrane

Collaboration review (Marinho, Worthington, Walsh, Clarkson 2013) showing decay rates

can be reduced by up to 37% in the primary dentition and up to 43 % in the permanent

dentition, with fluoride varnish programs.

Fluoride varnish treatments also align with contemporary Australian clinical protocols, including

the Caries Management System, developed at the University of Sydney (Evans & Dennison

2009). Together with international evidence based guidelines for the use of topical

fluorides from Ireland (OHSRC 2008) and Scotland (SDCEP 2010).

Colgate Duraphat 5% fluoride varnish applied during the mixed dentition phase of a

child’s oral development, provides an opportunity to access newly erupting premolars

and ‘high risk’ tooth surfaces, including the mesial surface of the 1st permanent molars.

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Australian and International community fluoride varnish

programs:

The Ottawa Charter for Health Promotion (World Health Organisation 1986) promotes a re-orientation of the health system, to focus on prevention and early intervention of disease and health promotion. This stance is reflected in oral health plans which incorporate community fluoride varnish programs to prevent or minimise dental caries in children.

In Australia, fluoride varnish programs which use a school or community setting rather than a

dental setting to provide bi-annual 5 per cent sodium fluoride varnish treatments, are emerging

as an effective intervention to reduce decay rates, particularly in disadvantaged ‘at risk’ rural

children (Slade, Bailie, Robert-Thomson, Leach, Raye, Endean, Simmons and Morris 2010).

A dental surgery with specialised dental equipment is not required to carry out dental

screening and fluoride varnish treatments. This preventive dental care can be easily adapted

and carried out in school or community buildings, using plastic, disposable equipment and

universal infection control procedures. The school setting provides an additional oral health

access point for disadvantaged children who may not be able to access other dental health

services (DOH 2010).

Colgate Duraphat 5% fluoride varnish being applied to ‘high risk areas’ on children’s

teeth: including decalcified incisors and hypomineralised molars.

International community fluoride varnish programs have been established since 2002.

American, Canadian and Scottish studies contain the largest body of evidence pertaining to

school & community fluoride varnish programs.

Common traits exist between all the international school & community fluoride varnish

programs. The programs focused on children from low socio-economic, rural communities,

providing a minimum twice yearly application of fluoride varnish over a two year period.

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Dental screening and dental referral pathway

School based dental screening has been endorsed by the World Health Organisation (2003).

Dental screening enables early detection and timely intervention of dental diseases, leading to

substantial cost savings for families and communities. Dental screening plays an important role in

understanding the oral health status of children participating in the Sun Smiles program. Screening

enables a thorough oral health needs assessment to be carried out within each participating school,

which assists in program development.

Dental screening, through the Sun Smiles program, also provides many children with their first

encounter with a dental professional. Providing a positive dental experience in a safe, familiar setting,

alleviates anxiety and fosters better rapport with the children. Screening also provides the opportunity

for children to receive individualised oral hygiene advice.

Children who have parental consent are provided with a dental screening prior to their fluoride varnish

application. The dental screening prioritises children who need further dental care, due to tooth decay,

gum disease, orthodontic needs or developmental dental defects (ie: molar incisor hypomineralisation).

Dental referral letters are printed and posted by the primary school to parents, asking them to follow-up dental care for their child through their local community or university dental clinic or private dental practice. The new Australian Government Child Dental Benefits Schedule will allow many families

who receive certain Government benefits – such as Family Tax Benefit Part A - to access up to $1,000 in dental care, capped over two years.

Dental screening session at Glenroy Public School, NSW

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Sun Smiles Team

The Sun Smiles Team is an inclusive dental team, incorporating dentists,

orthodontists, dental assistants, hygienists, therapists and oral health therapists.

Sydney University and Charles Sturt University Bachelor of Oral Health and

Dentistry students and their clinical supervisors are integral members of the

team.

Cathryn Carboon, dental hygienist, is the Sun Smiles program manager.

Dr John Brabant, orthodontist and Founder of the Carevan, is a clinical

team leader.

Dr Robert Smith, orthodontist, is a clinical team leader.

Bec Assigal, oral health therapist, is a Sun Smiles member.

School community support is also needed, with leadership from the school

principal, teachers and administration staff. All parents and carers give informed

consent for their children to take part in the Sun Smiles program. Sun Smiles

school ambassadors are chosen from each school’s Grade 6 leadership group to

assist with program.

Sun Smiles school ambassadors from Grade 6 assist the dental team.

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Sun Smiles: child centred research & program

evaluation

Sun Smiles is committed to undertaking child centred research and

program evaluation which will inform future program planning.

Research areas include: oral health status, access to preventive

dental care and acceptance of fluoride varnish from a child’s

perspective.

Qualitative and Quantitative data is collated to measure the Sun

Smiles program reach and impact. Participant and volunteer surveys

have been developed and trialled which have a mix of structured and

open ended questions.

Written testimonials, which incorporate reflective practice, are

collected from key stakeholders, including University students, primary

school children and the Sun Smiles volunteers.

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Sun Smiles advocacy for access to preventive dental care for children

Part of Sun Smiles mission is to advocate on behalf of school communities for better access to

oral health promotion and preventive dental care for primary school children. The Sun Smiles

program was invited to participate in the ‘Healthy Together Wodonga’ initiative on 16th

August 2013, to showcase the successful healthy eating and dental programs run at Wodonga

West Primary School. The event was attended by the Hon. David Davis MLC, Victorian

Minister for Health, Bill Tilley MP, Member for Benambra and Wodonga Mayor Mark Byatt.

(Pictured below with Wodonga West students and principals)

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Volunteering: part of the Carevan ethos

The success of the Carevan was acknowledged when the Carevan Foundation was awarded the 2012 NSW State Volunteer Team of the Year, by the NSW Minister for Citizenship and Communities, Victor Dominello MP. The success of the Carevan Sun Smiles program was also acknowledged by the Minister at the May 2014 launch of National Volunteer Week in Sydney.

‘The personal benefits of volunteering are well established and considerable: longer lives, better health and wellbeing, greater trust and better connections within communities. Volunteering empowers individuals, helps form new relationships, builds networks (social and professional) and makes real contributions in areas of need.

Following a known pathway which is flexible and responds to local needs is a powerful way to develop and support employee volunteering to create positive opportunities and outcomes for local communities. A good example is Carevan Sun Smiles, currently operating in Albury Wodonga and expanding into Sydney and Brisbane. Sun Smiles is a dental prevention program, teaching primary school children to improve nutrition and oral health. The Carevan’s dental puppets visit schools to make education engaging, supported by local businesses including dentists, dental supply companies, Rotary, the Commonwealth Bank and Charles Sturt University. Organisations contribute their labour, expertise and supplies.

What is so good about this project is that it responds to local needs, works collaboratively with local communities and makes a direct positive difference in the health of children now and in the future. And it’s made possible by contributions from businesses of all size, local and national. This is an example of a model project that can be developed, reproduced and improved in other communities, letting businesses see the tangible benefits volunteering can deliver for them company, their employees and their communities.’

Simon Watts, Senior Manager for NSW Volunteering

Office of Communities, Department of Education and Communities

Excerpt from ‘Volunteering is good for business’ The Sydney Morning Herald May 12th

2014

NSW Minister for Citizenship and Communities Victor Dominello MP (left)

at the 2014 Launch of National Volunteer Week.

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Homebush West Public School Launch 10th March 2015

Sun Smiles program launched by Craig Laundy, Federal Member for Reid.

In partnership with The University of Sydney, Faculty of Dentistry.

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Good dental hygiene is paramount to an adult’s

overall wellbeing. Sun Smiles, through early

intervention and education provides children with the

opportunity to better understand oral health and

gives them a chance to change their lives for the

better. I am proud to be a part of what is truly an

exciting and innovative project.

Congratulations to Dr John Brabant and Cathryn

Carboon for their amazing work in establishing Sun

Smiles. I commend their determination to bring it to

parts of my electorate where such a service is truly

needed. Thank you to all those who have selflessly

volunteered their time to make Sun Smiles in Sydney

a reality, the Sydney University Oral Health staff for

their tireless work behind the scenes and the Oral

Health Therapy students themselves who will be our

next generation of leaders.

Aside from the immediate oral health benefits of Sun Smiles I also see the program as a

testament to the community’s commitment to social justice and social change. The impact of

Sun Smiles will be felt far beyond the classroom bounds. The program does not just provide

an education, but a real opportunity for lifelong social development.

I see it as my role to serve the community and to help provide sustainable solutions to the

problems faced by my area and beyond. Programs such as Sun Smiles, that harness existing

infrastructure, promote partnerships, corporate philanthropy and volunteering are perfect

examples of this.

I know that the success of Sun Smiles will continue to grow and the lives of thousands of

young people will be better for it.

Kind Regards,

Craig Laundy MP

Federal Member for Reid

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Endorsements and Testimonials

‘It is a pleasure to lend my support to the Sun Smiles program. Sadly, many

children in our region are not getting access to high quality dental care.

Prevention is the best solution to dental care, but too many kids miss out

when they don’t visit a dentist regularly. Preventing dental problems early can

stop a lifetime of expensive and invasive remedial care.

That’s where Sun Smiles comes in. Sun Smiles visits local primary schools

working with the school teachers, students and parents in a proactive way to

improve oral health outcomes for all the children involved. With their referral

pathway to dentists and fluoride varnish programs, Sun Smiles are providing

primary dental care to many children who are otherwise getting no care.

Importantly, Sun Smiles also educates children and parents about better

dental hygiene and nutrition. They also follow up with kids to make sure their

teeth are still doing ok six months down the line.

Although Sun Smiles is in its early days, it is already showing positive results

in our community. I wish them all the best for 2014 and hope they’ll keep our

region smiling for many years to come.’

Cathy McGowan AO MP

Federal Member for Indi

16th December 2013

Cathy McGowan with Wangaratta Primary School students

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Sun Smiles, smiles indeed!

Not only are their smiles from the student and

staff volunteers, but also more importantly,

smiles from the children, teachers and parents.

As part of collaboration between the Carevan

Sun Smiles Program, Craig Laundry (MP for

Reid), and the Faculty of Dentistry at the

University of Sydney, Bachelor of Oral Health

students will have continuing involvement in this

thoroughly well organised, fantastic oral health

program available to us for the first time in

Sydney.

The University of Sydney students and staffs together with the wonderful team at Carevan have the

privilege to work alongside the educational team at Homebush West Primary School (established in

1912). The University of Sydney and The Homebush West Primary School both celebrate and embrace

cultural diversity and with a current and expanding population of approximately 500 children, 97% of

whom are from a non-English speaking background, there is no greater time to begin this partnership.

Homebush West Primary School have opened their arms (and mouths) to this program, and students

delivered healthy oral health messages with puppets, and performed oral health screening, nutritional

information, and fluoride varnish application to a record number of 213 children. The Homebush West

Primary School students are polite, enthusiastic, and asked some of the best questions, I personally

have ever experienced. The opportunity to promote oral health messages to children, some of whom

had never attended a dental clinic or had access to dental services, emphasises the need for oral

health care right here in Sydney’s Western suburbs. As one student emailed that night “It was really fun

and I'm so glad we got to see another side of oral health promotion. It makes me even more driven to

do what we do :) Thanks again!” (R. Robosa).

The students from the University of Sydney found the experiences thus far to be invaluable in terms of

their growth and learning and are lined up to volunteer for the next Carevan Sun Smiles day. The

Carevan Sun Smiles Program is an incredible asset to socially disadvantaged Australian school

students and through its provision of services, is providing substantial support to assist Australia’s

National Oral Health Care Plan 2015-2024 (draft). I look forward to the continual involvement of myself

and from the students at The University of Sydney to support this worthy and most imaginary school

dental screening program currently available.

KAREN LANSDOWN BOH MEd (pictured on right)

Associate Lecturer, Bachelor of Oral Health, Faculty of Dentistry THE UNIVERSITY OF SYDNEY 10 March 2015

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Since the successful initiative of the Carevan Sun Smiles program was

instigated, CSU students studying in the Bachelor of Oral Health and Bachelor

of Dental Science degree courses, have had an ongoing opportunity to

participate and learn about health promotion in school and community settings.

The dental courses started when Charles Sturt University commenced

investigations into the feasibility of establishing a dental program in 2004 in

response to concerns expressed by local dental practitioners and members of

the community about the shortage of dentists and oral health workers in inland

NSW. Government reports provided clear evidence that rural and regional

communities in NSW did not enjoy the same level of good oral health as other

Australian communities (Australian Institute of Health & Welfare Dental

Statistics and Research Unit, 2003; Australian Research Centre for Population

Oral Health, 2005). In May 2007, the Federal Government granted CSU a total

of $65.1 million to complete the program for a 2009 commencement.

The University has now established a cross-campus School of Dentistry and

Health Sciences with pre-clinical and clinical facilities in Orange and Wagga

Wagga and clinical education facilities in Albury, Bathurst and Dubbo. Charles Sturt University offers a 3 year

degree in oral health therapy (Bachelor of Oral Health in therapy/hygiene) from the Wagga Wagga campus and

from 2013 pre-clinical facilities were established in Holmesglen, Victoria.

The 5 year program in dental science (Bachelor of Dental Science) is based from the Orange campus. Clinical

facilities and teaching is offered from facilities with state of the art resources for dental education, with a range of

laboratories, lecture theatres, teaching facilities and clinical spaces. Students from both cohorts of the degrees,

rotate on clinical placements across the CSU clinical facilities. A depth of clinical experience is provided from the

wealth of established practitioners in these areas.

A focus on educating proficiency in up-to-date dental degrees must include knowledge about prevention and

promoting improved oral health outcome (Dyer & Robinson, 2006). The geographical placing of CSU facilities

provide opportunity to learn in rural and regional settings. While students are on placement in Thurgoona, the

opportunity for participation in Carevan activities in school and community health promotion initiatives provides

extremely valuable learning for students to gain competency in health promotion and disease prevention.

Helen Tãne (pictured)

Head of Discipline, Bachelor of Oral Health

School Of Dentistry and Health Sciences

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Charles Sturt University Student Dental Association

(CSUSDA) and students

‘The Carevan Foundation and the CSUSDA have set up

a partnership in giving university students the opportunity

to volunteer their time in this community project. In 2013

we were honoured to receive the Wrigley Australian

Dental Association Foundation Community Service Grant

for our commitment in promoting oral health to primary

school children in regional and rural areas of New South

Wales and Victoria. This grant is designed to further

assist and support dentistry and oral health students to

participate in future primary school visits.

The CSUSDA was founded in 2010 and represents over

200 dental students studying dentistry at Charles Sturt

University. The SDA is a strong supporter of the

universities motto “For the Public Good”. Our vision and

goal is to bridge the gap in oral health education and

services for regional and rural communities in Australia.

As an association we advocate and strongly believe that

healthy mouths, make healthy lives.

The SDA is a strong supporter of the Sun Smiles program. The reason for this is because there is still a

huge gap in oral health education. Statistics show that by the age of 6, 50% of children will have tooth

decay. It is evident that the importance of oral health is undervalued and not even realized in today’s

society by a large majority, and hence urgently needs to be addressed.’

Jessica Zachar (pictured on the right)

President

CSU Student Dental Association

13th November 2013

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‘Sometimes as part of our employment within the dental sector we

get to do things that are extremely rewarding and that make us

proud to be part of all that is good in the world of dentistry and oral

health promotion. One such occasion was that of our recent trips

over two consecutive weeks to the Wodonga West Primary School

as part of the Carevan Sun Smiles Team. I had the pleasure of

joining the 3rd year students from Charles Sturt University Bachelor

of Oral Health program, along with other border region dental

professionals including our esteemed (and highly organised) team

leader Ms Cathryn Carboon, to participate in delivery of the core

messages and primary oral health interventions that form the basis

of this important and worthwhile health promotion and social

engagement project.

The concept of joining the children in their classrooms for

oral health education delivered by the CSU students gave the

children a chance to interact and ask questions. This proved a

winning strategy in terms of sparking interest in their oral health and

also for what may come later in this day of dental adventures. The accompanying power point

presentation engaged all age groups from prep to grades 5 & 6, as did the puppets with their “toothy”

smiles, the giant toothbrushes and mouth mirrors which allowed the school students to display some of

their own oral hygiene skills with the puppets as their “patients” Important information about the

relationship between diet, oral hygiene and the development of tooth decay were all painlessly

imparted to the children as they watched an informative power point of what might happen when all is

not well with their own tooth brushing habits. Then, the hero fluoride and its armour forming protection

was introduced to the children and they were told of how it would be applied to their teeth later that very

day so that they may all have the benefits of this tooth toughening cream for their teeth.

The practical session where the children attended for a basic dental screening and fluoride

application was another victory for the program. A previously unthinkable 100% compliance and

acceptance for fluoride application amongst those children whom had written parental/guardian consent

was achieved!! The screening, including a form indicating any treatment needs to be followed up was

also completed to be sent home for the parents’ information and action. All this was achieved in a

timely and organised manner, and with adherence and observance of OHS & infection control

standards. Sadly, a pre-screening questionnaire revealed that there are still children that have had little

if indeed any exposure at all to the dental environment. Therefore the benefits of such an intervention

cannot be overestimated. So too, the excitement and enthusiasm of the children when they received

their own package of oral hygiene products for their home use; some children commenting that they did

not have a tooth brush at home.

As health promotion interventions go this is one that can tick many boxes for the purists wishing to

evaluate outcomes this program is SMART. That it is Specific, Measurable, Achievable, Relevant and

Timescale (a second visit is planned in 6 months), delivered to a group with high needs; and tools and

templates for evaluation have been developed is a testament to some very dedicated and caring

professionals with improved health outcomes as their primary goal.

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My final words of praise for this program, its core principles and its method of delivery and engagement

must go to Ms Carboon. Since my days as a student at La Trobe University I have long admired Ms

Carboon as a dedicated, accomplished and inclusive professional willing to give of her time and

knowledge. My experience of this program was no exception with Cathryn as the mastermind. The

seamless flow of the daily schedule form prepared power point presentations and puppet show to

neatly packaged take home bags for the children had a Cathryn Carboon handprint all over them. For

those of you whom have previously experienced that particular handprint on an intervention you know

that program success will most definitely ensue.’

Alanna Glenn

BOHSc La Trobe University

2012 Clinical tutor Charles Sturt University (pictured with school students)

‘During my 15years in the dental industry, I have never been involved in a community volunteer

program that is so very rewarding and well organised. I would of course be talking about the Carevan Sun Smiles dental program, run by the hard working and community focused Mrs Cathryn Carboon. In my role as a Clinical Tutor with Charles Sturt University Oral Health program, I feel it is a wonderful opportunity for our 3rd year Bachelor of Oral Health students to work alongside dental professionals such as Mrs Carboon and Carevan founder Dr John Brabant. Their drive and passion for oral health prevention provide excellent role models for the BOH students, as are the wonderful children we get to spend the day with, who inspire and motivate us all to see the Sun Smiles program be the success it deserves to be! I have had the pleasure of working in both a Victorian and New South Wales school, where the Sun Smiles program has been initiated. The effort that Mrs Carboon has poured into this oral health program is paying off in the high consent rate and positive feedback being received from parents, students, and staff. I look forward to being involved in many more Sun Smile days, and thank Mrs Carboon and Dr Brabant for being such fantastic role models in community

oral health promotion.’

Keri Calvert Dip. Dental Hygiene (Otago) NZ

2013 – 2014 Clinical Tutor Charles Sturt University

(pictured)

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‘As part of our 5th year clinical placement

studying the Bachelor of Dental Science at

Charles Sturt University, a group of students

were afforded the opportunity to assist in the

Carevan Foundation’s Sun Smiles Program.

Our brief was to head out to Wodonga-West

Primary School to promote oral health, provide

a dental screening service and topical fluoride

application to kids from prep to grade 6.

As I walked through the halls of Wodonga

West Primary School, I felt like a giant, (having

forgotten that obviously everything needs to be

proportionately smaller) and excited to get

these children thinking about and ultimately

motivated to improve and maintain their own oral health.

Aided with a well thought out and eye catching powerpoint presentation, the kids were fully engaged from the

start, as we began talking about the very basics of oral health, such as what plaque is, why it causes tooth decay,

recognizing tooth decay and why tooth decay is a real problem! It was clear that the best way to bolster their

enthusiasm and reinforce their knowledge was to ask them questions, and nearly every boy or girl in the room

had their hand up to answer a question at some point. Using a fluorescent plaque disclosing agent, the kids were

given the opportunity to see how well they’d brushed that morning, which was a fun, social and interactive way of

introducing the fundamental principles of oral health.

Following the presentations, a healthy morning tea courtesy of the Carevan was provided and those who had

parental permission slips were able to attend the screening. Set up with disposable mirrors, headlights and

fluoride, the dental students set to work seeing each child for up to 5 minutes. During the 5 minutes, we were able

to assess the general overall condition of the child’s oral health, determine whether they required urgent dental

treatment or dental treatment within the year, and assess the growth and development of their facial skeleton and

dentition to determine any necessity for an orthodontic referral.

From a dental student’s perspective, it was fantastic to gain experience in assessing children in the mixed

dentition stage, taking into consideration their potential need for orthodontic treatment. More importantly however,

this program reinforced the importance of oral hygiene for those children who had adequate oral health, and

provided a mode of intervention and referral for those children suffering from decay.

For many of these children, this was their first interaction with oral health professionals. Thanks to the familiar

environment, non-invasive and friendly nature of the visit, I believe the experience for both the dental students

and primary school students was an overwhelmingly positive one. As I near the end of 5 years of study in

dentistry, I find it somewhat comforting to be reassured by this experience that the career path I have chosen is

the correct one. Spending time working with the Carevan Sun Smiles program was a joy, and I feel privileged to

have been given the opportunity to obtain the knowledge and skills necessary to provide this valued service to

children who will undoubtedly benefit in both the short and long term. Cathryn and the Sun Smiles team have

assuredly reinforced the altruistic nature that I believe should first and foremost surround all health professions.

The Sun Smiles program is a credit to all involved.’

Alastair Norris, Charles Sturt University Bachelor of Dental Science 5th Year Student

(Pictured applying fluoride varnish to a school student)

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‘As part of my 4th year clinical placement for the Bachelor of Dental

Science, I recently had the pleasure of being involved with the Carevan Sun

Smiles program, through the support of a Wrigley ADAF community grant.

This was well organised, interactive and fun. I spent my morning in the

classroom educating and promoting oral health to primary school children.

The afternoon involved completing dental screenings with the application of

a fluoride varnish. It was great to work with all age groups of primary school

children assessing their need for dental treatment and orthodontics. This

was a great experience and complimented my paediatric studies undertaken

as part of my course work.

This is a great initiative and program to reduce dental caries. It was

personally rewarding to be part of this prevention strategy teaching children

about home care, diet and generally healthy habits. I enjoyed my time with

the Carevan Sun Smiles program and encourage my fellow dental

colleagues to volunteer some of their time to this worthy cause.’

Yvette Rainbow (pictured applying fluoride varnish to a Wodonga West school student)

Charles Sturt University Bachelor of Dental Science 4th Year Student

‘As part of the Bachelor of Oral Health Program I was privileged to

assist in the Sun Smiles Carevan program. This was the first

experience for me personally to visit a primary school and be part of a

community initiative; to educate children about the importance of oral

health and conduct dental screenings of children from kindergarten to

Year 6.

Walking into a primary school brought back memories to when I was

at school and how the role had changed from once being a young

child to now an educator. The use of a short video from Colgate about

oral health provided a good platform to have a discussion about oral

health and questions to ferment the key points of oral health. Using

puppets and also involving the children in tooth brushing

demonstrations allowed them to have input into their own learning.

The children were excited, willing to learn, some eager to share their knowledge about oral health. It was certainly evident of

the diversity of children displaying different characters and level of knowledge.

During the dental screening and fluoride application sessions, it was evident to me that many children had not been to a dental

clinic and were quite anxious about being touched inside their mouth. It was important to me to establish a trusting rapport

within the first couple of minutes and make the experience as pleasant as possible. This experience reinforced how important

it is to reach out into the community and educate children. The role and impact dental professionals have upon their future oral

health is enormous. Ensuring the key points of tooth brushing, use of fluoride and diet are instilled, will assist in decreasing

the risk factor for dental caries. It was a rewarding experience to share knowledge with the school children, with some

particularly grateful in receiving their own oral health bag.

I hope that this program can be implemented nationally, particularly in rural and remote areas where the intervention of

fluoride application can have a great impact on dental caries rates amongst children. This program has already made a

difference in the Wodonga community and is credit to Cathryn Carboon and the Sun Smiles team.’

Nicole Mueller (Pictured applying fluoride varnish to a Wodonga West school student)

Charles Sturt University Bachelor Oral Health 3rd Year Student

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‘I first started working with the Carevan Foundation

nearly 2 years ago when they introduced the Sun Smiles

program at Wodonga West Primary School. The

program is run bi-annually usually at 6 monthly intervals.

The Sun Smiles team usually consists of students from

Charles Sturt University dental and oral health clinic,

program manager, admin support, and helpers to make

the day flow.

The program involves, a presentation – usually delivered

with a power point, verbally reinforced, with question

time following. The students are informed on correct oral

hygiene techniques, health eating habits and a briefing

on the afternoon’s fluoride application session. This is

set informally, within the classroom, with the audio

visual, and puppets and tooth models provide ‘tools’ to

engage the students. It has always been an extremely

positive program and the students thrive when the ‘Sun

Smiles team’ are in their school. Especially when Dr

Rabbit visits!

The Carevan is set up to provide a milk drink and fruit

/cheese snack to the children before the afternoon

session. The students from Wodonga West Primary

School receive a preliminary screening, a ‘goody bag’,

fluoride application and for some, their first and only

exposure to dental personnel.

The students from CSU Dental and Oral Health Clinic are provided with this great opportunity to provide a service

within this unique setting.

I have personally been moved by the unique nature of how this provides both teaching and learning knowledge to

the CSU dental and oral health students and equally the positive reinforcements and messages that the young

primary students are left with.

I have been fortunate enough to volunteer with the Carevan Sun Smiles on their Midnight Basketball evening.

The Carevan program picks up the youth, from various locations within Albury/Wodonga. They are fed ‘home

cooked’ meals…which otherwise they might not eat. They are encouraged to attend the ‘clinics’ before

embarking on a round robin style basketball evening. They are dropped back home by the Carevan at the end of

the evening. This evening provided me with the opportunity to deliver oral hygiene messages including oral

hygiene instructions, health eating advice and general discussions within a team environment to inform the most

vulnerable youth of our society.

I have been currently studying a Certificate in Oral Health Promotion, and this program has reinforced to me how

really important the impact of preventive oral health is.’

Jill Kohne (pictured with Wodonga West primary school student)

Dental Assistant

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“Wodonga West Primary School has been

fortunate to be the first school in the

nation to partner with the Carevan to

deliver the innovative ‘Sun Smiles’

Program, thanks to funding provided by

community grants and the services of Oral

Health Therapy students from Charles

Sturt University, Albury. We are aiming to

put healthy smiles on the faces of all our

students and to help prevent poor oral

health that potentially leads to

absenteeism, lack of self-esteem and

chronic health issues later in life.

The program is designed to teach students good tooth brushing skills, utilising highly engaging puppets

and to inform students about dental care and hygiene. In addition, around three quarters of our school

students participated in having a free fluoride varnish treatment applied to their teeth, a treatment that

will be repeated every 6 months. We are confident that these regular fluoride treatments will

significantly reduce the incidence of tooth decay by up to 36 %.

The ‘Carevan Sun Smiles’ program generously provided a tooth healthy snack and drink to our

students, as well as a toothbrushes, toothpaste and the fluoride varnish, donated by Colgate. This was

a real team effort and all parties involved in this partnership reported that the potential for this program

to be rolled out nationwide is an exciting opportunity for our communities.

Our students were very positive about the entire program and commented on how fantastic it was to

have this treatment happen within their school environment, rather than on a trip to the dentist. This

also gave the Bachelor of Oral Health students from Uni the chance to give each student an oral health

check. In return, the University students gained experience in working with a diverse range of students

in an engaging and positive way – a win/win for all concerned. We have indeed been fortunate to host

the launch of this exciting program at our school and welcome the opportunity to expand this further

into the future and put a ‘Sun Smile’ on every face.

Wodonga West Primary School would highly recommend this program as an authentic experience to

educate the community and promote healthy smiles leading to healthier communities.”

Jocelyn Owen. Wodonga West Primary School Principal

(Pictured with school students)

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“Glenroy Public School proudly hosted the

‘Carevan Sun Smiles’ team recently as they

provided nearly all of our students from

Kindergarten to Year 6 with an impressive

oral health care program in the most

engaging and thoughtful manner. Our

students listened in awe to Charles Sturt

University Bachelor of Oral Health students

deliver the important messages of good oral

health in an interesting and clever way. This

was followed by the Carevan offering

fabulous tasting fruit and cheese snacks to all our students along with a milk drink, while meeting and

interacting with the cute and cuddly life size Carevan ‘Bear’ (an instant hit). Having then created such a

good rapport, in the afternoon the CSU students strategically and methodically checked all students

oral health, in a safe and calm manner, without any trepidation or tears noted!

The program is excellent on several levels. Firstly, it immediately engages the students and teaches

them about good oral health. Secondly, it demystifies the once feared ‘dentist visit’ and thirdly, it offers

a free and much needed preventive dental service to all of our school families.

On this day we were fortunate to also enjoy the ‘Bright Eyes’ program, also funded by community

grants and Carevan. 100% of our Year One students received an eye check from Kelly Gibbons, a

volunteer optometrist and her optical dispensing assistant Lauren. Written reports were provided to

families as to whether their child’s eyes may require further testing, of which 20% in fact did. What a

difference that information could make to a child’s learning capabilities! Again, this was a free service

for all our families.

Not to be ignored is the indirect effect that this voluntary service has on our students as they are

working towards becoming purposeful, kind and caring young citizens and leaders of the future. They

can clearly see that helping one another in our community is a worthwhile and positive experience.

They may indeed choose to one day join the Carevan team to support others in their community.

As Principal of Glenroy Public School I fully endorse and recommend the Carevan Sun Smiles Program

and the wonderful and positive impact it has had on our school community.”

John Dent

Glenroy Public School Principal (pictured with school student)

May 2014

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Endorsement from the school teachers and

primary school students

‘The Carevan’s provision of fruit, cheese and milk

is wonderful for children to experience ‘good

food’ rather than mass produced packet food that

most of them now eat!!!

The dental team members are all happy and

helpful and have the ability to actively

communicate with Year 1 /2 students. The age

appropriate DVD was a great way to impress the

message to children regarding dental hygiene

and Dr Rabbit added a ‘cute’ value to the

session.’

Grade 1/2 Primary School Teacher

Wodonga West Primary School Sun Smiles Program 13th August 2013

“The Sun Smiles Carevan program was a very memorable one for me. I learnt how to brush my teeth

the proper way and the importance of it.

I think the quality of the program was very good and I liked how the professionals and trainees were

there to clean our teeth. I also liked how they provided us with a gift bag for healthy teeth, a hot milo, a

cheese platter and a fruit platter which was very nice of them.

I think that the value of the Sun Smiles Carevan program is very important to our community because it

helps promote healthy teeth and the importance of caring for your teeth.”

By Kira Brigham.

Wodonga West Grade 6 Primary School Student

“When the dentists came I was a little nervous because I didn’t

know any of them, but as I got to know them I found that they were

very nice.

I enjoyed using the puppets to entertain the kids before they had

their teeth done. My favourite puppet was a big clown fish. When

the kids came in we would pick someone to call out their favourite

song and if we knew it we would sing it. We made up a story about

Elmo lost all his teeth. It was because he never brushed them.

I learnt that fluoride is something that is in toothpaste and even

water. It stops decay from forming on your teeth. Sometimes if you

don’t brush your teeth your gums will rise and that is called gum

disease.”

By Leah Hasler. (pictured)

Wodonga West Grade 6 Primary School Student

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Endorsements from Albury Wodonga parents

“Great program and teaching tool for kids. Parents can’t always

get the message of oral care across to children and with this

program they can learn first-hand from professionals.”

Parent at Wodonga West Primary School, VIC

“Kids loved the take home showbag and puppets. Great

program and would love it to continue.”

Parent at Wodonga West Primary School, VIC

‘Tobee totally enjoyed his experience. He couldn’t shut up about

his own toothbrush and toothpaste, it was quite funny. Thanks

for putting a smile on his face.’

Parent at Glenroy Public School, NSW

Glenroy Public School Sun Smiles Program October 2013

‘An extremely worthwhile program that my child enjoyed

participating in. It led to a pleasing discussion about oral health care.’



‘My daughter had a wonderful day and is very inspired to have clean healthy teeth. I think this program

is a fantastic idea.’



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Endorsements from Homebush West parents

10th March 2015

‘My child enjoyed the whole experience. She

would like to see the Sun Smiles staff come back

again and visit her. She particularly liked the little

mirror from the gift bag. Thank-you!’

‘My son came home talking about how much he

learned today. Even though I’ve told him what he

needs to do before he went to you today. He’s

very keen to listen to what you say. So thank-you.’

‘My son was very happy with the showbag and

started to brush properly as shown on the day.

Very effective program, thanks.’

‘She has learnt that rinsing after you brush your teeth is not the right way and she has learned

about more strategies for brushing her teeth, so I think the Sun Smiles program helped a lot.

We both are glad that we learnt the right way to brush teeth because of Sun Smiles.’

‘Fantastic program, please continue at

Homebush West Public School.’

‘He enjoyed the experience and it

motivated him to take better care of his

teeth.’

‘My son is very happy about your program

at his school. He was brushing his teeth

very good.’

‘She was so excited. She got a drink, fruit

and vegetables, cheese etc. She loved it.’

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Congratulations to all volunteers of the Sun Smiles program including Charles Sturt University (CSU) dentistry and BOH students, the CSU academic faculty, clinical supervisors and CSU staff including dental assistants. Not only has this valuable initiative already helped over 400 primary school children from both Wodonga West and Glenroy Primary Schools it has recently been highlighted as best practice by the National SARRAH (Services for Australian Rural and Remote Allied Health) Summit, held at Parliament House in November 2013. Wrigley Company Foundation is extremely proud to have supported the program in 2013 by awarding a USD$6,000 Community Service Grant to the volunteers, including oral health therapy and dental

students at Charles Sturt University (CSU) who help roll-out the Sun Smiles program, in partnership with The Carevan Foundation. This vital community initiative aims to improve access to preventative dental care for disadvantaged primary school children in rural regions by providing school fluoride varnish programs, dental screening and oral health education. Not only is the program beneficial to local primary school children, feedback shows 100 per cent of CSU students found the Sun Smiles program increased their ability to carry out oral health promotion activities. This feedback is a strong testimonial to how the program enriches students’ clinical placement experience and introduces them to the value of social responsibility within dental care. We are passionate about playing a role in inspiring the next generation of dental professionals around preventive dental programs in rural Australia. As part of Mars Incorporated, which also includes the Mars Petcare and Food segments, we have a rich history of giving back to communities. And so while, Wrigley Pacific is located in Sydney, we are particularly proud to support a community oral care program close to our Petcare headquarters in Wodonga. Our segment philanthropic arm, the Wrigley Company Foundation, was established in 1987 and this year together with the Australian Dental Association Foundation (ADAF) we have awarded a total 13 grants across Australia to valuable volunteer dental programs. The grants provide much needed funding to volunteer dentists, dentistry students and teams of dental professionals, helping improve the oral health of some of Australia’s most deprived communities. Effective partnerships continue to drive the success of the Community Service Grant program from the alliance between the Wrigley Company Foundation and the ADAF to our collaboration with the hard working dentists and dental student grantees such as those involved in the Sun Smiles program from Charles Sturt University. We’re proud of all their achievements and the positive impact their programs continue to have on disadvantaged communities. Congratulations again to all volunteers. We hope the Sun Smiles program continues to grow from strength to strength. Sophie Hughes (pictured) Senior Corporate Affairs Manager, Wrigley Pacific 2013

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Colgate-Palmolive is a company that has supported the

dental and oral health profession in the improvement of

oral health in Australian communities for decades.

Colgate is committed to the provision of oral health

education in pre-schools and schools through the Bright

Smiles Bright Futures program which was established in

Australia in 1997. This program has reached 6 million

children and their parents in the region to date and is

freely available to Pre-K and Year 2-4 classes. Materials

from the “Bright Smiles, Bright Futures” program have

been utilised through the Sun Smiles program, with

guest appearances from the mascot of this program, Dr

Rabbit (pictured).

Over the last 6 years Colgate has also supplied 100,000

brushes and paste per year to community oral health

promotion projects in high need areas through the South

Pacific Child Oral Health Taskforce. Some of the

programs that these products support include tooth-

brushing in remote area schools and oral hygiene

instruction with refugee and new immigrant populations.

It is through the Taskforce, that Colgate has been able

to provide ongoing support for the Carevan Sun Smiles

program.

The use of bi-annual fluoride varnish applications has been clinically proven to reduce dental caries in

children. The combination of fluoride varnish application together with oral health promotion, dental

screening and referral is a positive implementation strategy which we applaud.

Colgate has been very happy to provide assistance to the Carevan team and sees this initiative as a

great way to provide a service to children who would otherwise not receive this excellent preventive

care. The Carevan team are to be congratulated on their hard work, dedication and great results so far.

We look forward to an on-going productive partnership in the area of oral health promotion.

Our thanks and good wishes go to Dr Brabant, Cathryn Carboon and all of those involved in the project.

Dr Sue Cartwright

Scientific Affairs Manager, Colgate Oral Care

Ms Lenore Tuckerman

Public Health Consultant, Colgate Oral Care

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2014-2015 Media Releases

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Professional, Community and Corporate Support & Sponsorship 2012 - 2016:

Australian Dental Association Foundation

Australian Dental Association (NSW Branch & Riverina Branch)

Wrigley Company Foundation

Royal Australasian College of Dental Surgeons

Dental Hygienists’ Association of Australia

South Pacific Global Child Dental Health Taskforce

Border Dental Study Group

The Rotary Club of Albury Foundation (pictured below with Cathryn Carboon)

Westpac Bank

Commonwealth Bank

Peter Donnelley

Craig Laundy MP, Federal Member for Reid

Invisalign Australia

Colgate Oral Care

TrollDental

Dentalife

Horseley Dental Supplies

Adam Dental Supplies

AB Orthodontics

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Sun Smiles Program Manager:

Cathryn Carboon Assoc Dip Dental Hygiene; Grad Cert Health Promotion (pictured above)

Email: [email protected] Phone: 03 57214451 or 0458 580713

Carevan Founder and Sun Smiles clinical team leader:

Dr John Brabant Bachelor of Dental Surgery (Honours), Master of Dental Science (Orthodontics),

MRACDS (pictured above)

Email: [email protected] Phone: 0417 240114

Sun Smiles clinical team leader:

Dr Robert Smith Bachelor of Dental Surgery (Honours), Master of Dental Science (Orthodontics),

MRACDS

Website: www.carevan.com.au

mailto:[email protected]

mailto:[email protected]

http://www.carevan.com.au/

Documents

Tooth decay has a profound impact on - Carevan · Tooth decay has a profound impact on a child’s ... goals for oral health’ powerpoint presentation on ... Fluoride varnish treatments