Evidence
These policies and guidelines form the evidence base for Childsmile.
The SIGN 83 Guideline, Prevention and Management of Dental Decay in the Pre-school Child, (2005), outlines the need for a wide range of health and dental professionals to be involved in the prevention of dental decay and this is the foundation for the Childsmile Programme.
SIGN 47, Preventing Dental Caries in Children at High Caries Risk. Section 3: Primary Prevention of Dental Caries (2000) also recommends a supervised toothbrushing programme, twice yearly fluoride varnish application, provision of fissure sealants, community-based oral health promotion and regular visits to the dental team.
The Childsmile Programme embodies all of these recommendations, incorporating oral health promotion and clinical prevention and utilising the support of professionally trained dental health support workers working in their local communities.
Prevention and Management of Dental Caries in Children, Dental Clinical Guidance (Scottish Dental Clinical Effectiveness Programme, 2010) presents clear and consistent advice to support dental professionals to deliver preventive care and where necessary manage caries.
Public Policy Context
HEAT target 9: Child oral health
From April 2010 a new oral health HEAT (Health Improvement, Efficiency, Access, Treatment) target has been developed focusing on reaching the most disadvantaged children.
This requires at least 60% of three- and four-year-old children in each SIMD (Scottish Index of Multiple Deprivation) quintile to receive at least two applications of fluoride varnish per year by 2014.
The Childsmile programme is based on a robust evidence base. The important documents are detailed below.
Action Plan also outlined the Scottish Government’s target for NHS Health Boards, stating that 60% of five-year-old children should be decay free by 2010.
Promoted a shift in balance of care towards prevention rather than treatment by targeting the early years age group.
Better Health, Better Care (Scottish Government, 2007).
Better Health, Better Care announced that Childsmile will be ‘rolled out as a new schools based prevention dental service’ incorporating fluoride varnish applications to children’s teeth and fissure sealants applied as appropriate.
Equally Well: Report of the Ministerial Task Force (Scottish Government, 2008)
Equally Well reiterates its commitment to children’s dental health during the early years.
Getting it Right for Every Child (Scottish Government, 2008)
GIRFEC places children’s and young people’s needs first. It ensures that they are listened to and understand decisions which affect them and they get more co-ordinated help where required for their well-being, health and development.
It requires that all services for children and young people – social work, health, education, police, housing and voluntary organisations – improve how they work together to support children and young people.
The integration of Childsmile within mainstream national child health programmes will ensure child dental health to becomes part of core business in the future.
Early Years Framework (Scottish Government, 2008)
Seeks to shift the focus of service provision to early identification and early intervention, these philosophies are congruent with Childsmile.