Frequently asked questions

3.10_Girl brushing teeth

What is the absolute minimum staffing requirement for Childsmile dental teams applying fluoride varnish in schools?

During the demonstration phase most NHS Boards have started the programme with teams of two Extended Duty Dental Nurses (EDDNs) supported by a Dental Health Support Worker (DHSW). NHS Boards have raised this question in relation to difficulties maintaining the staffing requirement in some circumstances. Following further investigation it was established there was no clinical or regulatory reason for this.

Therefore, the Childsmile Executive supports the use of one trained EDDN who is supervised by one other person to deliver Childsmile Nursery and Childsmile School on the day of application. However, the deployment of staff is a local NHS Board decision and may vary according to local circumstances.

What do I do in a situation where the mum previously signed the consent form but the child now lives with a grandparent for the foreseeable future? The grandparent has signed the form this time and approaching the mum doesn't seem to be an option. The school have advised that it is a complicated family situation.

Only the legal guardian or parent can sign the consent form. The person signing has responsibility for any statement they make. Childsmile does not have a responsibility to check the statements made.

What details should be recorded on the Childsmile @ Health Informatics Centre (HIC) system for a child looked after by a local authority?

Information provided on the consent form, including the full address and postcode of where the child is residing, should be recorded. All correspondence should be sent to this address. All data held on the system should be handled in accordance with confidentiality policies and not be shared by Childsmile staff with other parties.

Can consent continue from nursery to school?

Yes, consent is for the duration of a child’s time at nursery and primary school. One consent form should be completed when a child is offered the opportunity to take part in the fluoride varnish programme. This consent will be valid for any participating establishment the child attends.

A fluoride varnish update letter is then sent out every six months and offers the opportunity to update their medical history and other personal details.

Is there a potential risk to a child who has received two fluoride varnish applications at a dental practice followed by a further two applications as part of the targeted Childsmile Nursery and 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 or chronic ingestion resulting in fluorosis, even if two applications were on the same day.

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 in addition to brushing with a fluoride toothpaste, has been shown to reduce caries in children.

The Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance on the Prevention and Management of Dental Caries in Children (external link) recommends six-monthly fluoride varnish applications to all children aged from two years through primary care dental services.

Childsmile provides two applications per year at participating dental practices and offers a further two at participating nurseries and schools.

Can you explain the legality of Childsmile promotional banners being used on, for example, school railings?

There is no requirement to seek permission from your local council but permission is required from the headteacher. The Roads Authority is not usually involved unless banners are of a commercial nature.

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.