Smiling mother and son brushing teeth in bathroom.

Peninsula Dental School is partnering with Livewell South West in this early phase study. The study examines whether by accessing first time parents and their infants through the Family Nurse Partnership model, an intervention can be delivered to improve the oral health of children in populations at high risk of poor oral health. 

Dental disease is one of the commonest health problems for children and is the most common reason for children to be admitted to hospital. There are 25,000 operations under general anaesthetic for the extraction of teeth every year. Dental extraction before a child is six years of age is not only highly traumatic but is also associated with poor oral health in the child’s future. The problem is markedly worse in the most deprived sectors of the population with a clear link between deprivation and oral ill-health.

To prevent future oral health problems, the National Institute for Health and Care Excellence guidelines recommend that local authorities focus their oral health promotion efforts on children's early years, particularly in areas of high social deprivation. The key behaviours that will deliver improved oral health are known (tooth brushing with fluoride toothpaste, not using sugared drinks in bottle, not putting to bed with a bottle, early progression from bottle to cup and positive attitudes to oral health and dental visiting) but the best ways to support parents to carry out these behaviours with their young children are unknown, particularly in the most deprived communities. While the actions that can be taken to help prevent tooth decay in children are known, the best ways to support parents to carry out these actions are unknown. This exploratory study is seeking to address this. 

The research team is working with the Family Nurse Partnership (FNP) in Plymouth. The FNP works with first-time young mothers offering intensive, structured home visits by specially-trained nurses, from early pregnancy until the child is two. The study has three phases. In phase one interviews were held with 10 first time young mothers participating in the FNP programme exploring what does and doesn't help them in carrying out the key behaviours to care for baby’s teeth (see above) and what they would be willing to accept help with. In Phase 2, using an approach informed by Phase 1, an oral health worker is offering up to 20 young mothers support, encouragement and the necessary materials to protect their child’s newly-emerging teeth. Phase 3 will evaluate Phase 2 and explore next steps.

The outcomes of the study will inform the development of a practical, acceptable and theoretically sound intervention which has the potential to change behaviour relating to the care of babies’ teeth. Addressing the issue of oral ill-health in infancy could improve health and quality of life, save NHS costs and lessen the gross inequalities that exist between deprived and affluent children.

The research is funded by the Medical Research Council and Wrigleys and also supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenARC).