Community Insights and Inspiring Change: Fighting Oral Health Inequalities in the UK
Scene setting
Poor oral health is a fact of life for many people, especially those who experience inequality and disadvantage. It is truly shocking that in 2018-19, more than 44,000 dental extractions were performed on children and young people under 18 years of age, costing the NHS in excess of £40m. However, the impact is more than purely economic as it affects educational attendance, increased medication, delayed speech development, ability to enjoy a range of foods, confidence, self-esteem and much more. Poor oral health is one of the reasons many children fail to thrive. For people with a learning disability the picture is also bleak as those who experience tooth decay are more likely to have a tooth extracted rather than restored. Whilst high quality treatment, care and services are available, accessibility is an issue for many, and therefore prevention becomes even more important.
There is a need for preventative oral health education programmes which are impactful, creative, engaging and relevant. Considering who are best placed to deliver such interventions is a useful starting point when developing new approaches.
Dental teams clearly play a central role in delivering evidenced based initiatives which are rooted within the clinical practice as well as engaging directly within their local communities. This is also an opportunity to consider how other professionals and community-based colleagues can share key prevention messages more broadly.
There are many organisations and stakeholder groups who can broker contacts and engage directly with communities, they are already embedded, trusted and valued by local people and are well placed to share messages and signpost to services. Their staff have amazing communication and interpersonal skills, have a real understanding of local need and would be delighted to support oral health improvement initiatives. Examples include children’s centres, resident groups, hostels, community centres, faith groups, probation services, and charities such as Well Connected.
Being Well Connected
As the Strategic Lead for Community Engagement at Well Connected, a Plymouth based wellbeing charity, which has specialised in the delivery of oral health projects for a number of years, I take an active role engaging directly with a variety of such organisations. I am passionate about partnerships and have established collaborations which have resulted in the co-creation of meaningful and award-winning programmes. I believe that this is the most effective way to truly engage and puts people into the heart of everything we do.
I am privileged to work alongside local people, groups and organisations as well as colleagues from the business, education and health sectors. Collectively this provides amazing opportunities to be bold and ambitious about the future.
I would encourage you to connect with your communities, find out what is happening, especially in those settings that help vulnerable and disadvantaged people. Often walking through the door or making the phone call is the hardest thing to do; once the conversation has been started, you will be able to identify many ways you can support. Examples of how you can help in a practical way could include:
- providing toothbrushes and toothpaste for the local food bank
- putting a call out for warm clothing for people who are homeless
- genuine offers to help by simply just being there
- listening and informing others, especially for people who feel excluded
- demystify the world of dentistry by sharing simple, easy to understand prevention messages
- undertake a voyage of discovery within your neighbourhood to connect and reach out to others
Staying Well Connected
Central to all engagement is creating authentic and genuine connections, it is not paying lip service to outreach. It is being honest and open, recognising that there are opportunities to share knowledge and skills which have cross cutting and interprofessional benefits. It will also encourage you to think outside of the traditional oral health education box, to be creative, use art, craft, music, cookery, and games to deliver the messages you want to share. Using the skills, knowledge and attributes of your teams will really help you to uncover the hidden talents you have access to.
I would also urge you to be kind; a very wise and experienced community colleague once said to me “kindness is a strength…..” and his words resonate with me, now more than ever. A kind approach will ensure you build respect from those around you, help you to use your skills effectively and enable you to deliver projects with understanding and empathy.
I truly believe that by supporting, motivating and encouraging others, real change can take place. These are challenging times for everyone, and the natural response is to stop looking outwards and focus internally, however, I would suggest it is the perfect time for innovation and collaboration.
Connected Projects
Working with dental professionals, special needs providers, dietitians and early years venues has enabled us to deliver evidenced based oral health improvement projects in the South West region. The key ingredient is our community engagement model, which encompasses codesign, true community consultation and effective communication. For example:
- The award-winning Dental Ambassador programme: cited as good practice in government guidance enables people with learning disabilities to learn more about their own oral health and share key prevention messages with others. Simple in its approach, but with outstanding impacts going far beyond improved oral hygiene; for example, participants have experienced improvements to medical conditions such as diabetes and obesity leading to reductions in their medication; it has helped to increase independent living skills, confidence and self-esteem. These are massive achievements for people who can often be excluded and overlooked from programmes and services. It is always a joy to deliver programmes with these groups, they embody positive attitudes, demonstrate resilience and have a wonderful sense of humour.
www.gov.uk/government/publications/oral-care-and-people-with-learning-disabilities
- We have also created links with the Guiding and Scouting Associations who have warmly welcomed us into their weekly sessions. Working within these settings requires different approaches, it is not the same as delivering a classroom-based session, although structure and planning are needed, they are based on exploration and discovery, enabling children and young people to have fun whilst developing skills for life. We have embraced this approach by creating a lively and energetic workshop that informs, inspires and encourages behaviour change, combining healthy eating choices with key oral health messages. Games, experiments and creativity form the basis of these workshops, which sees everyone going home enthused and wanting to share a couple of key prevention messages with their families. The oral health gift bag goes down a treat too!
- Enabling and encouraging community groups to share key oral health messages as part of their existing themes and activities led us to create our Teeth on Tour initiative. A box of colourful, interactive and fun resources which includes jigsaw puzzles, giant models of teeth, puppets, story books, posters, and dressing up kits; help early years settings to include oral health in everyday activities. We also offer training workshops to colleagues which increases understanding and helps them to feel more confident when talking about the importance of happy and healthy smiles with parents, carers and children.
Connected Communities
The challenges to improve oral health, especially for those who are vulnerable and marginalised, are far reaching and require long term commitment and investment. I suggest that a joined-up approach for national and local programmes is a positive way forward which can make a real difference to the life chances and experiences for so many children, young people and their families.
Engagement and community outreach is part of the solution, genuine partnership approaches will really help to create interest, new opportunities and ways of working. The future will be different but hugely rewarding; lets embrace it and enjoy together.
Want to do more but not sure where to start? Like to help us to continue and expand our work?
Please contact us and we would be delighted to help, support and advise.
Wendy Smith MBE
