Aims To provide an overview of steps taken to improve oral health in one UK city and to review factors relevant to maximising the contribution that paediatricians (and potentially other health professionals) can make to improving oral health.
Methods The article provides information on the strategic approach taken in Leicester, one of the most ethnically diverse cities in England, and also one of the most deprived. Over a third of children aged 3 years, and half of those aged 5 years, have experience of obvious dental decay. The collaborative strategic approach taken includes implementing a comprehensive evidence-based early intervention programme from birth (Healthy Teeth, Happy Smiles!) and a focus on professional education and engagement. In order to ensure sustainability and further improvement, wider engagement with paediatricians and other primary care providers is essential and is increasingly recognised by professional bodies.
Literature relevant to the factors which inhibit engagement with paediatricians and others is reviewed and highlights issues of knowledge and competency, policies and guidelines, time and capacity and referral and access.
Conclusion Children's oral health in England has improved over the last 30 years, but inequalities persist, with those living in areas of higher deprivation experiencing a substantially higher burden of dental disease. The article highlights several potential barriers which can be reduced. Collaboration is encouraged between medical and dental professionals as well as commissioners and providers at both the national and local level in order for oral health to be fully integrated within general health. Such collaboration requires appropriate leadership in order to develop policies that support curriculum changes, drive the implementation of associated guidelines, design integrated healthcare service provision and develop the partnership relationships to support this work.
- Paediatric Practice
- Comm Child Health
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Contributors Both authors drafted the manuscript, undertook the review, identified themes and actively participated in the writing and in approving the final version submitted for publication. Both authors are accountable for all aspects of the manuscript and in ensuring that questions relating to the accuracy or integrity of any part of the manuscript are appropriately investigated and resolved.
Funding The Healthy Teeth, Happy Smiles! early intervention programme in Leicester was established through partnership funding from NHS England and Leicester City Council.
Competing interests JM was the lead Consultant at Leicester City Council who was responsible for the conception, establishment and implementation of Healthy Teeth, Happy Smiles! the early intervention dental public health programme in Leicester. RM was Divisional Director of Public Health in Leicester City Council with accountability for the programme.
Provenance and peer review Commissioned; externally peer reviewed.