Dental practice staff

Childsmile has been integrated into Statement of Dental Remuneration (SDR) and all practices delivering NHS care to children are expected to deliver Childsmile interventions. Access the Childsmile dental renumeration booklet.

A Childsmile Practice is required to provide preventative dental care and caries management tailored to the individual needs of the child.

Interventions must incorporate:

• dietary advice
• toothbrushing demonstration for parents and carers
• fluoride advice
• clinical prevention, as appropriate.

This may involve an initial appointment with the Extended Duties Dental Nurse (EDDN) to assist your practice in determining the level of support required.

In some practices the EDDN will continue to see the children and parents on a long-term basis. Sometimes this is in conjunction with visits to the dentist, depending on the needs of the family.

Childsmile additional support

Practices are expected to deliver a more intensive programme of care for children and families requiring additional support (anticipated to be the majority of children residing in the most deprived quintiles SIMD 1-3).

Interventions for families requiring additional support must cover the above bulleted list in more depth, either over a longer appointment or more regular visits to the dental practice. This will often be delivered by an EDDN working alongside other members of the dental team.

Fluoride varnish application

Childsmile practices are expected to provide fluoride varnish applications to the teeth of all children at six-monthly intervals from the age of two years (provided an appropriate medical history is available and deemed satisfactory); this is recommended by the Scottish Dental Clinical Effectiveness Programme (SDCEP) Prevention and Management of Dental Caries in Children (external link) guidance.

• The appropriately trained EDDN must have the consent of the legal parent or guardian to proceed with the fluoride varnish application.
• The EDDN must have an appropriate medical history form signed by the dentist on each occasion that fluoride varnish is to be applied by an EDDN.
• The dentist must write the treatment required i.e. ‘fluoride varnish application (Rx F- varnish application)', sign, date and print their name. The Paediatric Medical History Form has been updated to include a section on this.

A medical history must be completed at each visit to primary care dental services. This may be the Childsmile medical history or the service’s own version.

GP17s: recording Childsmile activity

GP17s are required to be completed by Salaried, Community and General Dental Practices for payment and monitoring purposes.

GP17 Guidance has been developed by Practitioner Services Division (PSD) to ensure that the GP17 forms can be processed appropriately for Childsmile monitoring and payment purposes.

The role of the Dental Health Support Worker in dental practices

A family may be referred to a Dental Health Support Worker (DHSW) via their health visitor or public health nurse who will visit the family in their home to support and facilitate their attendance at dental practice.

The DHSW will often call the practice from the patient’s home to make their first dental appointment.

Practices are required to set up an appointment system to allow DHSW and families to make appointments (ideally this would be incorporated into their existing appointment system).

The DHSW may accompany the family to the practice to offer support.

The DHSW will liaise with your practice and ensure it is able to order resources. The DHSW will also liaise between the practice and Childsmile Coordinator.

If the patient fails to attend the appointment, they are asked to make one more appointment with the patient; if they then fail to attend this we would ask the practice to highlight patients to the DHSW patients who have failed to attend on two occasions and any concerns requiring further follow up.

The role of the Childsmile Co-ordinator in dental practices

The role of the Childsmile Coordinator is to:

• visit the practice and explain what is involved and what is expected in relation to Childsmile
• work with practices, sharing examples of good practice
• work with practices to try and resolve any difficulties they are having in delivering Childsmile
• regularly contact practices to offer support, including ongoing dialogue regarding onward referral to other dental services, and provide resources (for example toothbrushing packs and leaflets).