Frequently asked questions
What is the absolute minimum staffing requirements for Childsmile dental teams applying fluoride varnish in educational establishments?
During the demonstration phase most NHS Boards have started the programme with teams of two EDDNs (Extended Duty Dental Nurses) supported by one DHSW (Dental Health Support Worker). NHS Boards have raised this question in relation to difficulties in maintaining this is some circumstances. Following further investigation it has been established there is no clinical or regulatory reason for this.
The Childsmile Executive therefore supports the use of one trained EDDN chaperoned by one other person to deliver Childsmile Nursery and Childsmile School on the day of application. Deployment of staff is, however, a local NHS Board decision and may vary according to local circumstance.
What do I do in the situation where mum signed the consent previously but the child is now with Gran and will be for the foreseeable future? Gran has signed it this time. The school have advised that it is a complicated family situation and there doesn't seem to be the option of mum being approached.
Only the legal guardian or parent can sign the consent forms. The person signing has responsibility for any statement they make. There are two consent forms: for toothbrushing only; and for toothbrushing and fluoride varnishing. Childsmile does not have a responsibility to check statements made.
What details should be recorded on the Childsmile @ HIC system for a child who is looked after by a local authority?
Information provided on the consent form, including the full address and postcode of the address where the child is residing, should be recorded. All correspondence should go to this address. All data held on the system should be handled in accordance with confidentiality policies and not shared by Childsmile staff with other parties.
Can consent continue from nursery to school?
Yes, consent for toothbrushing is for the duration of a child’s time at nursery and primary school. One consent form should be completed when the child is offered the opportunity to take part in the Toothbrushing Programme and this consent will be valid for any establishment, participating in toothbrushing, that the child goes on to attend.
For fluoride varnish application, medical histories must be updated every time the varnish is applied and consent for the application is sought at the same time. There is a combined toothbrushing and fluoride varnish consent form.
What is the length of time for which a prescription for fluoride varnish application is valid?
The HIC system for Childsmile Nursery and Childsmile School flags children with the colour green when they have been consented for fluoride varnish application and validated by the prescribing dentist.
This is valid for a six-month period thereafter. If they were absent at the time of the fluoride varnish visit, the consent will remain green unless a re-consent letter is returned replying no to fluoride varnish. If a further appointment is made to visit the nursery or school within a six-month period the consent and prescription remains valid and fluoride varnish can be applied, even if a re-consent has not been returned.
Is there any potential risk to the child in receipt of two fluoride varnish applications in dental practice and a further two fluoride varnish applications as part of the targeted Childsmile Nursery or Childsmile School programme?
No. Childsmile aims to apply fluoride varnish four times a year to children at increased risk of developing dental caries. This dose is well within the safe limits for acute toxicity levels (even if two applications were on the same day) or chronic ingestion resulting in fluorosis.
Furthermore, most of the teeth and certainly the six anterior teeth, will have calcified by the age of 3.5 years.
The optimum benefit would be four doses equally spaced throughout the year.
Does fluoride varnish work?
Yes. Fluoride varnish, applied at least twice a year and in addition to brushing with a fluoride toothpaste, has been shown to reduce caries in children.
The SDCEP guidance on the Prevention and Management of Dental Caries in Children (external link) recommends six monthly fluoride varnish application to all children from two years via primary care dental services.
Childsmile provides two applications per year within participating dental practices and offers a further two applications in participating nurseries and schools.
Can you explain the legality around Childsmile promotional banners being sited on, for example, school railings?
There is no requirement to seek permission from your local council (Roads Authority is not usually involved “unless banners are of a commercial nature”).
Permission from the head teacher is required.
Banners should not:
- be erected adjacent to a pedestrian crossing or busy junction.
- interfere with vision of drivers, cyclists, pedestrians, etc.
- block any road traffic signs.