To think schools could do dental checks?

[cheminotte]

Just reading that poor dental health is linked to poverty and how many families struggle to find an NHS dentist.
Also read an article earlier this year about a boy in America who died of teeth decay as the infection spread. And recently heard that tooth decay is linked to heart disease.
Could schools do a dental check in reception like they do an eyesight and hearing test?

I don't understand why there is a shortage of NHS dentists but happy to have it explained.
If there was guaranteed work then maybe that would make a difference?

the problem is the children of the cba parents shouldn't suffer, but as a culture, having children without giving it an iota of thought is hugely encouraged and that is a massive problem

Far better to provide more money to SS so that more children are picked up for intervention from poor parenting rather than have schools turned into medical facilities. There should be harsh penalties for poor parenting.

Not read the whole thread but I'm a dentist who used to do these 'checks'.
More accurately it's screening and doesn't replace a check up at a dental surgery with decent positioning, lighting, the ability to dry teeth and do additional investigations like X-rays and other tests.
The idea was to catch those poor kids with obvious dire need who were not accessing care.
However, all we could do was book them in to the clinic and inform their parents, through school, that they required dental treatment and include the appointment. Our failure rate to those appointments was phenomenal.
In addition, the government changed the requirements for consent for such examinations so that parents had to opt in rather than out of them. Obviously, the demographic we were targeting were poor engagers and we would get few returns.
More helpful than screening in schools are initiatives to provide preventive programmes: such as Child Smile. Nursery and school brushing and fluoride programmes. The evidence is good for these making a real difference. Consent and opting in is still difficult, but now there are programmes which require you to consent or decline at school entry as part of the registration process with school which get better results.
Fluoridated water supplies also make a massive difference to a populations oral health and don't require active opting in of the families most in need.

I see your point but on the other hand preventing tooth decay is not rocket science, why should there have to be checks in school to screen for a (largely) completely preventable condition? (Before I get picked on for that comment, there was a prog on tv a while back re tooth decay in kids and the dentist on that said it was the only disease that’s completely preventable)

And what happens when the letter goes home to say the child has tooth decay and the parents either can’t be arsed or still can’t find an nhs dentist?

"The service is free for children. There really isn't an excuse. It's so very basic" really? What if the nearest nhs dentist is 60+ miles away and has no space on their list? That's the situation in some parts of England.

Not saying there aren't feckless parents but it's not the whole story.

Re not enough dentists I am NOT an expert but I think it's something to do with new contracts brought in by Blair meant that the new nhs contracts didn't pay enough to dentists to even cover their costs so a lot of dentists went private. Think there were other issues too about them not getting payments from govt for treatments given in a timely manner leaving them out of pocket.

I think here in Scotland and possibly in Wales that didn't apply.

They do it here is Switzerland

Thanks TigerBread - that's really interesting.
Can you explain why there's a shortage of NHS dentists?

In addition, the government changed the requirements for consent for such examinations so that parents had to opt in rather than out of them. Obviously, the demographic we were targeting were poor engagers and we would get few returns.

When I very first started teaching, I remember we had a dentist come in and check the children's teeth-I can't remember if it was just Reception or the whole school as it only happened once (late 90s?) but the parents were informed it was happening and nearly all of the children whose teeth were a concern, were kept off school that day by their parents. I guess they thought they'd be told off?!

Yes it is early intervention and screening the dentist isn't doing a scale and polish in schools. I actually think schools having a community approach it is a part of it takes a village to raise a child thing which is no bad thing imo

Because the contract system under which they work is unfit for purpose and when it was imposed many left the NHS.
I have not worked as a general dentist under the new contract and don't speak for myself but many well respected friends who are great believers in the NHS left because they felt they were unable to offer patients the care they deserved under the constraints imposed in the new contract. If you google your question, there are quite a few newspaper articles which explain it well, look at the guardian rather than DM 😁

tigerbread

It’s interesting you say the take-up of follow-up appointments was poor. I’ve seen threads on here where people are indignant that school nurses use schools to do height and weight checks. The ones who opt out are inevitably the ones whose children are over or underweight.

So I’m guessing the same would happen with dental checks. The best the school can do is employ someone to support parents - as I do - and ensure that support includes constant nagging about looking after their children teeth.

There are still checks which take place in schools. These Epidemiology Surveys which are data collection exercise to build up a picture of the oral health of children nationally and how it changed over time.
It's called the National Dental Epidemiology Programme (surprised?) 🙂
Those are the figures which often make the news : 5 year olds in the North West have the worst dental health in England (etc)
It's theoretically so that prevention programmes can be targeted to areas most in need.
Again, opt in consent required...
We don't write home about every child with decay that we see (and parents are told that), we only write if we spot something urgent eg infection.
It is an exercise in data collection for the benefit of the policy makers (and it's good and robust data) but it is not intended to be for the benefit of individual children.
A random sample of children are selected, unless it's a small class or a 'census survey'

The NHS weren’t paying dentists enough to cover their costs and make a profit (ie enough money to pay their mortgages and look after their families) so most of them realised that as they owned their own businesses and premises, offering a service that people want and need, that they could do that privately which would allow it to be a viable way to make a living. So they did. I don’t blame them.

Unfortunately people don’t realise what they’ve got til it’s gone.

I'm the one with the terrible teeth. I remember I was taken once to the dentist as a young child, I then had 6 (or 8) milk teeth removed on that visit. I also remember the absolute agony of toothache as a child. I returned a couple of times later when still a child to have teeth filled. Every one of my back teeth is filled and this was all done in childhood.

What can we do to make parents look after their children's teeth? I know somebody is going to come on and say it's due to lack of education but I think that's rubbish. Everybody knows teeth should be brushed twice a day and that sugar and sugary drinks cause decay. I would also dispute it's down to lack of money, you can get tooth paste for 30p. Why don't parents look after their children's teeth? I don't know why mine weren't looked after, it just wasn't something my family did, the adults didn't brush their teeth either.

I have three children, I make sure their teeth are looked after, it's not hard.

Unfortunately people don’t realise what they’ve got til it’s gone.

I don't know why the NHS doesn't just employ more dentist directly. The NHS owns the surgery and the dentists are just paid a salary. This would free the dentists from running a business and also remove any incentive for dentists to do unnecessary work for extra payment.

We have Childsmile here in Scotland, DS actually just had his done on Wednesday. I agree it should be a nation wide thing, not every parent is vigilant with their children’s dental health.

Wow. Lots of hostility!

Here (Scotland) you have your first visit to the dentist at age 6 months. Generally, we see the nurse every 3-6 months, and the Dentist every 6 months.

On top of this, dental nurses visit the nursery/preschool at least once every term. Also, the kids have their own toothbrush in the nursery and they brush after snack. Once at school they brush their teeth after lunch for the first two years.

In addition to all this, the dentist and team visit the school annually for a health check (and inform parents if any work is required and to please book an appointment). You can opt out of this check if you wish, but you have to do so in writing to the dental team.

It costs the school nothing. It’s paid for through the Childsmile initiative and is classed as health promotion. Scotland is trying hard to shake off the unenviable title of being the sick man of Europe, and it’s apparently working. Hopefully this will lead to a healthier nation, and lessen the dependency on the nhs brought about by preventable conditions.

I don't know why the NHS doesn't just employ more dentist directly.

Presumably you've seen in the news what's happening to the NHS-it's crumbling around ours ears due to lack of funding and quite possibly won't even exist in ten years.

Presumably you've seen in the news what's happening to the NHS-it's crumbling around ours ears due to lack of funding and quite possibly won't even exist in ten years.

Yes well it's our own fault then for electing a Tory government. Why do we just shrug our shoulders about this as if there's nothing we can do about it.

Can I just say as well that treatment isn't only necessary due to decay/poor hygiene I wouldn't want people who 'look after our teeth' to think they can be complacent.

Dd has not one filling but has had lots of treatment due to overcrowding and overbite, mine were good until I had a car accident and nutted the steering wheel resulting in broken and chipped teeth which still aren't quite right several years later.

There's also numerous illnesses, disabilities and Meds that can negatively affect teeth, and as this is mn - pregnancy too of course.

I'm sure the pp that's a dentist can back this up.

Yes I've been very impressed since moving back to Scotland that seeing the hygienist is as normal as 6 monthly check - I even got a well done last time (mine are a bit wonky now too so can be hard to clean)

My teeth are awful. HG did not help at all :(

I’m assuming all of those posters expressing outrage at the “ridiculous “ suggestion that dental and other checks should be carried out in schools are too young to remember that back in the 70s/80s this actually took place and was completely accepted.

To all those frothing about “lack of parental responsibility” some parents struggle to take time off work for appointments, some have no NHS dentist anywhere near them and can’t afford to pay for private treatment.

And yes some parents can’t be bothered. But why should their poor kids suffer the consequences as we shrug our shoulders and turn our backs?

Routine health checks in schools are a cost effective way of reaching those kids. Intervention and prevention at this stage is much cheaper than trying to repair the awful damage later.

God, I weep for this country. When did we become so uncaring?

I started school in 1978 and had no dental checks at school.

My children were in the childsmile programme and had their teeth looked at once in p1 so not sure where all these amazing dental health programmes are taking place in Scottish schools.

It's not about being incaring.

The more responsible schools and the state become the more the number of parents who don't bother will grow.

It's far better to target the crap parents then all aspects of a child's lives will be better not just one.

Having to work or not wanting to pay for a dentist is no excuse. Its twice a year for five minutes if just routine.

Yes they should. There are kids who lack a responsible carer to book them appointments and supervise teeth brushing These are the kids who suffer teeth decay and getting seen by a dentist at school might be the only chance they get.