1. NICE Shared Learning Awards 2015
Improving oral health
of children in a deprived
London borough
Camden and Islington Public Health aim to improve
oral health and reduce oral health inequalities. In
line with NICE guidelines, and as part of a wider oral
health promotion programme, they commissioned
a targeted community-based fluoride varnish
programme for children.
Programme
commissioned
following successful
pilot
The Director of Public Health took on the role
of ‘oral health champion’ to influence the local
commissioning agenda and to drive the strategy
forward. The local community dental service
(Whittington Health NHS) was commissioned
to deliver a pilot programme for 10 months
in selected children’s centres, nurseries and
primary schools. A number of other stakeholders
worked in partnership to deliver the programme
including local dentists and local authority
services.
The pilot was successful and a tender process
commenced for a 3-year contract. This
programme aimed to improve oral health of
residents by:
Providing 2 fluoride varnish (FV) applications
per year to children aged 3-10 years that were
likely to be at highest risk of dental decay
Working with parents and carers to obtain high
levels of consent for FV
Increasing the number of children and their
families accessing local NHS dental services
Targeted settings
receive two visits
each year
Between July 2011 and November 2014, the
programme achieved:
43,035 FV applications
An average consent rate of 74%
93% of consents resulting in FV applications
There was little variation in uptake across
settings, suggesting children in the most deprived
areas had equal access to the intervention. In
addition, a high proportion of children referred by
the programme to NHS dental services, received
treatment.
Key learning points:
Identify a champion in each setting and build
relationships to ensure good communication
Visits should be scheduled well in advance
Encourage settings with smaller populations to
attend FV application days at larger settings
Information leaflets should address specific
cultural concerns and be translated into the
main local languages
Work collaboratively and ensure the programme
integrates with other health promotion initiatives
Approaching and speaking to parents informally
at school gates was more effective than the
more formal parent information sessions
Provider contact: Sanoj Majeed
FV Programme Coordinator
Whittington Health NHS
Email: sanoj.majeed@nhs.net
Telephone: 0203 317 2341
Contact: Mandy Murdoch
Independent Health Strategist
Murdoch Health Consulting Limited
Email: mandye.murdoch@gmail.com
Telephone: 07792 483 436
“We found fluoride varnish programmes, as
recommended by NICE, to be an effective way
of tackling tooth decay in deprived areas.”
Mandy Murdoch, Independent Health Strategist
(formerly Senior Public Health Strategist, Camden and Islington
Public Health)
Tooth decay common
yet entirely preventable
Islington is a densely populated and highly
deprived London borough. Dental decay is a
significant problem, despite the fact it is entirely
preventable. Disease levels are higher than
both regional and national levels. It is also more
prevalent among socially deprived or excluded
groups, who are more likely to experience ill
health and poor access to dental care.
Islington Public Health, together with
commissioners and providers of dental
services, ran a detailed oral health needs
assessment, which found higher levels of tooth
decay among 5-year olds compared to other
London boroughs. Much of this disease was
untreated.
To tackle this, a local oral health commissioning
strategy – which is aligned with NICE guidance
– was developed. This included:
A “Brushing for Life” programme distributing
fluoride toothpaste and oral health advice to
parents of young children
A community-based fluoride varnish
programme to further address oral health
inequalities
www.nice.org.uk
Whittington Health