Quality statement 2: Early years settings and schools

Quality statement

Local authorities provide oral health improvement programmes in early years services and schools in areas where children and young people are at high risk of poor oral health.

Rationale

The risk of dental caries and periodontal disease is reduced by good oral health behaviour, such as reducing sugar consumption and brushing teeth with fluoride toothpaste twice a day. Giving clear advice about good oral health and providing services such as supervised tooth brushing schemes and fluoride varnish programmes encourages this behaviour and reduces the risk of dental decay.

To help support this statement, local authorities should also ensure that healthy food and drink options are displayed prominently in local authority and NHS venues, including early years services and schools (see quality statement 3 in the quality standard on obesity in children and young people: prevention and lifestyle weight management programmes).

Quality measures

Structure

Evidence of local arrangements to ensure that oral health improvement programmes are provided in early years services and schools in areas where children and young people are at high risk of poor oral health.

Data source: Local data collection.

Process

a) Proportion of early years services in areas where children are at high risk of poor oral health where oral health improvement programmes are provided.

Numerator – number in the denominator where oral health improvement programmes are provided.

Denominator – number of early years services in areas where children are at high risk of poor oral health.

Data source: Local data collection.

b) Proportion of schools in areas where children and young people are at high risk of poor oral health where oral health improvement programmes are provided.

Numerator – number in the denominator where oral health improvement programmes are provided.

Denominator – number of schools in areas where children and young people are at high risk of poor oral health.

Data source: Local data collection.

Outcome

a) Plaque on teeth of children.

Data source: Data on the presence or absence of plaque on the teeth of 5‑year‑old children is recorded as part of the oral health survey of five-year-old children.

b) Tooth decay in children and young people.

Data source: Data on the prevalence and severity of dental decay in 5‑year‑old children is recorded as part of the oral health survey of five-year-old children.

c) Tooth extractions in secondary care for children and young people.

Data source: Data on tooth extractions for children aged 10 and under admitted to hospital is included in the NHS Outcomes Framework 2016–17.

What the quality statement means for service providers, healthcare, education and social care practitioners, and commissioners

Service providers (such as school nursing services) ensure that oral health improvement programmes are provided in early years settings and schools in areas where children and young people are at high risk of poor oral health.

Healthcare, education and social care practitioners (such as school nurses, health visitors, social workers and family link workers) ensure that they provide oral health improvement programmes in early years settings and schools in areas where children and young people are at high risk of poor oral health.

Commissioners (local authorities and health and wellbeing commissioning partners) ensure that they commission oral health improvement programmes in early years settings and schools in areas where children and young people are at high risk of poor oral health.

What the quality statement means for children and young people

Children and young people in areas at high risk of poor oral health are told about the importance of looking after their teeth and are helped to do this. For example, they take part in a programme at school or nursery where teachers, teaching assistants or school nurses supervise them brushing their teeth or they are encouraged to reduce the amount of sugar they eat.

Source guidance

Oral health: local authorities and partners (2014) NICE guideline PH55, recommendations 14, 15, 16, 18 and 21

Definitions of terms used in this quality statement

Oral health improvement programmes

These include providing supervised tooth brushing schemes, fluoride varnish programmes or programmes providing advice to encourage brushing with fluoride toothpaste and reducing the amount and frequency of sugar consumption. Advice should be based on the information provided in Public Health England's Delivering better oral health.

[Adapted from NICE's guideline on oral health: local authorities and partners, recommendations 14, 15, 16, 18, 19, 20 and 21]

Areas where children and young people are at high risk of poor oral health

Schools and early years settings in areas where children and young people are at high risk of poor oral health can be identified using information from the oral health needs assessment.

Children and young people living in areas that are described as socially and economically disadvantaged are often at high risk of poor oral health. Local authorities (and other agencies) define disadvantaged areas in a variety of ways. An example is the government's Index of Multiple Deprivation. This combines economic, social and housing indicators to produce a single deprivation score.

Based on the oral health needs assessment, local authorities may prioritise other population groups at high risk of poor oral health, such as looked-after children, some ethnic groups, and children and young people with physical, mental or medical disabilities.

[Adapted from NICE's guideline on oral health: local authorities and partners, glossary, recommendations 3 and 4 and expert opinion]