Summary

Research on the oral health of children in care conducted by Dr. Muirhead at Barts and the London School of Medicine and Dentistry showed that children in care had high levels of tooth decay and gum diseases in spite of their required annual dental check-up. Some children had no tooth brushing habits and unhealthy diets consisting of high sugar snacks, fizzy drinks and sweets. Based on this research the team went on to develop the “Ten key questions for foster carers” booklet in 2015 which is now distributed to all new approved foster carers in the borough.

The science: understanding the oral hygiene habits of children in care

The “Let’s Talk about Teeth” research study, led by Dr. Muirhead at Barts and the London School of Medicine and Dentistry, was conducted in children in care in Tower Hamlets in 2014-15. Children in care are a recognisable vulnerable group, often excluded from research because of complicated parental responsibility and consent issues. Although they are more frequently affected by physical, mental and sexual health problems than other children are, few studies have explored whether they also suffer from poor oral health. Most children in care live in foster homes, with very little known about foster carers’ experiences of managing and supporting the oral health of children in their care.

This study consisted of an oral health survey and a qualitative study of foster carers. The oral health survey included the most vulnerable children: five to 15-year olds placed under a care order where the court gives local authorities corporate parental responsibility held jointly with parents for the child’s protection. The survey found that children in care had high levels of tooth decay, gum diseases and unmet dental treatment needs despite having their statutory annual dental check-up. The unmet needs identified in they suggest that the process of social workers just recording whether a child has had their annual dental check-up does not guarantee that the child receives appropriate prevention and comprehensive dental treatment. The qualitative study of foster carers explored their dental health attitudes, knowledge, and experiences of overseeing the oral health care management of children in care. Foster carers described the poor oral health of children in care particularly when they first entered the care system. Some children had no tooth brushing habits; unhealthy diets consisting of high sugar snacks, fizzy drinks and sweets were quite common. Foster carers had concerns about what key preventive dental health messages to give to children having had inconsistent messages from dentists.

Putting research into action: impact on the oral health of children in care

A recommendation made in the “Let’s Talk about Teeth” study was to develop a tailored oral health resource for foster carers providing evidence-based oral health messages. The “Ten key questions for foster carers” booklet was developed in 2015. The booklet was initially distributed to the 130 foster carers in Tower Hamlets caring for more than three hundred children in case. It is now distributed to all new foster carers who are approved as carers in the borough.

The “Let’s Talk about Teeth” project was included as a case study in the Local Government Association (LGA) publication, “Healthy futures: Supporting and promoting the health needs of looked after children” in December 2016. Cllr Linda Thomas, Vice-Chair of the LGA’s Community Wellbeing Board said: “This report adds further weight to the need for urgent investment in oral health education so that parents and children understand the impact of sugar on teeth and the importance of good oral hygiene. As LGA analysis revealed earlier this year, there are 170 operations a day taking place in hospitals to remove teeth in children and teenagers.” Untreated dental care remains one of the most prevalent diseases affecting children and young people’s ability to speak, eat, play and socialise. This study underlines how regular check-ups at a dentist can help prevent tooth decay and the need for hospital treatment.