Sugarless Green:
An education intervention programme for oral care in young children

Each year, about 60,000 school days are missed because children need to have tooth extractions (Public Health England, 2019). In London boroughs alone, the NHS spends approximately £7m for acute dental care for children, including these emergency extractions (British Dental Association, 2019). This has led to the British Dental Association (BDA) declaring the prevalence of tooth decay in young children as a crisis and calling for more political action geared to prevention (BDA, 2019). Tooth decay is not an isolated physical health issue; it also affects mental wellbeing. In the UK, 12% of children have nightmares about their teeth and 18% are stressed about the general appearance of their teeth and smiles (Oral Health Foundation 2020). Covid-19 has exacerbated these issues due to heightened restrictions, causing a back log of dental appointments and increased anxieties for families visiting dentists (Westgarth, 2020). This bid aims to support health and wellbeing in young children by reinforcing correct oral hygiene techniques, and also educating them on healthier food choices, as alternatives to sugar.

 

What is this project about?

The proposal is for a new project, ‘Sugarless Green’, which builds on The Cathedral Group’s knowledge exchange project, ‘Communiversity Values in Action’ (2020). The latter is a collaborative bid shared across four UK universities, and Roehampton’s contribution examines university students’ engagement with the local community, via the Growhampton Student Union. ‘Sugarless Green’ will also support the sustainability initiatives of Growhampton, through targeted engagement with children at Key Stage 2 (ages 7-11), across 1 or 2 primary schools (depending on participation rates) in the Alton Estate (total approximately 120 pupils), in the London borough of Wandsworth. The BDA has noted that Wandsworth is among the top 5 boroughs which has seen worsening incidences of child tooth decay since 2015 (BDA, 2019), particularly due to the socioeconomic inequalities in the area.

The project will involve a series of one-hour sessions, facilitated by the University of Roehampton (UoR), School of Education students, with each class of pupils at the university campus garden-plots. The facilitators will be trained using information packs approved by local dentists. The pupils will be participating in a range of engaging activities demonstrating oral hygiene, using the garden vegetables as props. Some examples include brushing the soil off a carrot top to bottom, and flossing debris out of potato-carved teeth. The sessions will also educate the children about the importance of the vegetables in their diets while explaining how difficult it can be to remove sugar from their teeth, showing for example, the challenge of brushing sticky caramel off beets.

 

What’s the impact on children?

It is expected that the practical, outdoors setting of the event will spur the interests of the children and motivate them to rehearse out the learned techniques of oral hygiene at home by associating them with fun activities. It is also expected that the sustainable, ‘green’, context for educating the children about the vegetables, combined with the contrasting presentation of sugar, as being artificial and foreign to the environment, will inspire and empower the children to make healthier food choices for their teeth.

 

Dental disease can impact children’s abilities to eat, sleep, speak, play and socialise with other children. It is interesting to consider that in the UK 1 in 8 children (12%) have nightmares about their teeth and 1 in 5 children (18%) are unhappy about their smile and stressed about the appearance of their teeth (Oral Health Foundation, 2020). Often it causes children to miss school (tooth aches, or dental extractions) and parents to lose income due to time off work.

Supporting research-led policy making

In a 2019 global survey of 13 high-GDP countries by FDI World Dental Federation, the UK ranked last in promoting good oral health for children (BDA, 2019). Although Public Health England (2017) has published an evidence-based toolkit for dental teams, which includes guidance on changing patients’ attitudes to oral care and principles of toothbrushing, these are generalised and do not address the commitment of children beyond the clinical setting. The proposed project can support in this latter regard. Furthermore, higher-level consultations by the UK government which stress preventative measures for dental care are resource-driven, seeking to decrease availability of sugary products (2018) and increase fluoride uptake and supervised brushing (2019). These recommendations have also been taken up at the local level in Mayor Khan’s Healthy Schools London and Healthy Early Years London schemes.

 

However, as recognised by the London Assembly of the Greater London Authority (2019), such schemes work best only from the earlier ages and where there is absolute buy-in and resource allocation for teachers and schools. ‘Sugarless Green’ avoids the centralised targeting of such resources by educating and empowering children to take individual responsibility for maintaining their teeth, and also focuses on the intermediate 7 to 11-year group of children who may be more resistant to transitioning out of poor oral health habits. In these respects, ‘Sugarless Green’ can complement local borough schemes and combine with other London-centred initiatives to scale up joint oral health interventions at the national level. Our students at Roehampton will be working with the young children and facilitating the programme activities, which are free for the children in the local community and schools. One session is expected to be approximately 45-minutes and will take place on the University campus. Under the umbrella of Growhampton initiatives this project is also environmentally sustainable as it informs children how to upcycle their used toothbrushes by transforming it into a gardening tool.

What does participation involve?

Our students at Roehampton will be working with the young children and facilitating the programme activities, which are free for the children in the local community and schools. One session is expected to be approximately 45-minutes and will take place on the University campus. Under the umbrella of Growhampton initiatives this project is also environmentally sustainable as it informs children how to upcycle their used toothbrushes by transforming it into a gardening tool. Each child will be provided with a sustainable bamboo toothbrush as a keepsake for participating and a means to raise awareness about more environmentally kinder options as alternatives to plastic toothbrushes.

Interested in participating please get in touch for the programme details, or to participate or arrange attendance for sessions.

 

© Melissa R. Jogie, January 2021