Enabling Environments

Tackling tooth decay in early years

  • Tackling tooth decay in early years

Early years settings can do much to safeguard the oral health of young children, says Celia Freeth…

Every 10 years, a survey into the dental health of children assesses the changes in each generation and the impact it has on their health and wellbeing.

The latest report (published in 2015) found that nearly 26,000 children aged five to nine, were admitted to hospital in England in 2013–14, up 14% from 2011, with tooth decay.

In the same report, nearly one-third of five-year-olds and nearly half of eight-year-olds had obvious decay in their milk teeth.

These statistics are apparent in older children too, with a fifth of 12- and 15-year-olds (22% and 19% respectively) reporting that they experience difficulty eating and are embarrassed to smile or laugh due to the condition of their teeth (35% and 28%).

Tooth extractions are the biggest reason children are admitted to hospital for general anaesthetics in the UK and yet, roughly 40% of children still don’t visit the dentist each year.

It’s clear that more needs to be done from a younger age, in order to not only address the oral health of children, but also recognise the impact it has on wellbeing.

As a teacher of 16 years teaching across Key Stage 1, Key Stage 2 and early years, I’ve always understood the implications of a poor diet and the impact this can have on learning and wellbeing.

While academic achievements are important, so too is the ability for children to express how they’re feeling and understand the importance of their nutrition.

After all, it’s well known that you learn better when you’re healthy and happy. This focus led me to become an early years consultant for HES, working with early years settings across Havering to support young children and their families in improving health outcomes.

Let’s talk about teeth

As part of this, we worked alongside early years organisation Sue Overton Applied Practice and launched the ‘Let’s Talk About Teeth’ programme, which we’ve been running in Havering.

The course delivers two programmes, each focusing on a different stage of a child’s development including the first trip to the dentist, the sugar content of popular drinks and foods, nutritional balance and portion sizes, through to supervised toothbrushing and the consequences of neglecting teeth. Practitioners are then given handouts, resources and ideas for practical activities and play opportunities to use with children.

Due to the positive work we were already doing with our preschools and childcare providers, in 2017, we were selected to take part in the pilot project for Healthy Early Years London (HEYL) along with five other boroughs.

HEYL is an awards scheme introduced by the mayor of London that supports and recognises achievements in child health, wellbeing and development in early years settings.

The idea is to help reduce health inequalities by better supporting a healthy lifestyle, including healthy eating, oral and physical health and early cognitive development.

Havering Early Years advisors were able to support a range of childcare providers with submitting strong case studies and evidence of improved outcomes related to improving the health of our youngest children.

Once submitted to HEYL, the entries were moderated, and settings were awarded with Bronze, Silver or Gold awards. Since the pilot, our settings have continued to register with the programme and work towards achieving each of the awards.

With 14 Bronze, eight Silver and one Gold Award being presented to a selection of early years providers, Havering remains one of the leading London local authorities.

Supporting settings

HES’ early years team funds the projects for each setting involved in the scheme.

This not only includes training for practitioners, but also role play kits, toothbrushes, toothpaste and storage facilities approved by the Oral Health Foundation so that every child has access to equipment and resources that will allow them to learn more about the importance of oral health and hygiene, and get used to scenarios such as visiting the dentist, and what they can expect.

Everything we do at Havering Early Years as part of the project is fully funded to allow our preschools and early years settings to focus on providing effective provision, support and guidance to young children and their families.

As part of this, settings run parental workshops in order to promote oral health, and nutrition. With the best intentions, parents will often give their children food they believe to be healthy, or snacks as a treat.

These workshops are designed to help them learn about healthy food choices, portion sizes, and how much sugar is in children’s snacks – including those that claim to be nutritionally balanced!

These have been particularly effective, with parents voicing surprise at the amount of hidden sugars there are in food and snacks aimed at children.

Parents are also signposted dentists in their local area; quite often dentists will tell you that very young children are too young; however, as soon as their teeth come through, it’s important to take them and register at the dentist.

The younger we start this process, the more effective we can be at combating the early stages of tooth decay.

Changing behaviours

We’ve had some really positive feedback from the settings we’re working with, including children reporting that because of the work being done, they are no longer worried or frightened to visit the dentist.

This is in addition to our practitioners commenting that they now feel better equipped to talk about oral hygiene and changing behaviours related to brushing teeth, both with young children and their parents.

We currently have about 30 settings undertaking the programme in Havering, with more joining steadily each time we launch a new wave.

HES’ Early Years team will continue to fund the scheme as we recognise how important it is to reduce the number of children having teeth removed for tooth decay – a large percentage of which is easily preventable, with the right advice, training and support.

We are continuing to work alongside our settings to ensure we reach Gold status at every possible opportunity!

Links to learning

Health and wellbeing are threaded all the way through the Education Inspection Framework, to ensure children are equipped to make healthy choices, and schemes such as HEYL support the principles of the EYFS through a focus on role playing, making healthy choices, learning to cooperate and finding out about the world.

This approach helps children become more self-confident and develop a positive self-image as well as refining motor skills, and developing mathematical skills including a sense of time, counting, problem solving and sequencing.

Share the message

Three ways to promote oral hygiene, nutrition and wellbeing…

  • Consider hosting parental workshops to improve awareness and ensure the work you do is reinforced at home.
  • Research free or funded training opportunities and provision in your local area or online to bolster your activities.
  • Make learning as interactive as possible; encourage children to get hands-on, as it will help them get to grips with good practice which they will take with them later in life.

Celia Freeth is early years quality assurance manager at HES. To find out more about HES, visit hes.org.uk