Systematic review of settings-based oral health promotion in the UK

Background: The World Health Organisation (WHO) has highlighted the unique advantage schools have in promoting oral health.

Objective: To summarise current school-based oral-health promotion strategies in the UK and help outline future steps that can be taken to improve oral health promotion.

Methods: Systematic review of published papers and government publications, official government websites and policy reports.

Results:

1. The National-Healthy-Schools. This is a government initiative to create school environments for children to be physically and mentally healthy. It has four themes: Personal, Social & Healthy Education; Healthy Eating; Physical Acitivity and Emotional Health & Wellbeing. Oral health promotion is not mandatory curriculum in schools neither is explicitly mentioned in the Government White Paper, “Saving Lives: Our Healthier Nation”. However, some schools have included oral health promotion in their projects.

2. The Sure-Start. It was introduced in 1999 in a cross-government initiative providing support to families with under-five children. Sure Start offers education on the importance of tooth-brushing, regular dental assessments and healthy eating. Also helps families to find the local NHS dentist. Sure-Start appears very promising, currently targets economically disadvantaged areas, but it can only impact the families that use their services, hindering the benefit for many children.

3. Brushing-for-Life. This government initiative, aimed at reducing the inequalities in children's oral health, provides free toothbrush/toothpaste. It targeted initially 21 high-caries health authorities and later extended to a further 9 areas. It is now offered nationally to Sure-Start schemes in areas lacking water fluoridation.

4. A few other local initiatives. The National Childminding Association and the National Day Nurseries Association include oral health in their quality assurance system. Two Primary Care Trusts are devising their own free fluoride toothpaste/toothbrush programme and assessing the need for fluoridated water.

Conclusion:

The WHO principles (Oral health promotion: An Essential Element of a Health-promoting School, 2003) need to be embedded across all schools to achieve a true national oral health promotion programme for the UK. The Healthy Schools Programme is the perfect platform.