What is the impact of the UK soft drinks industry levy on childhood tooth decay?

DESIGN: Interrupted time series analysis. DATA ANALYSIS: An interrupted time series (ITS) analysis was conducted to determine if there was an association between the announcement and implementation of the soft drinks industry levy (SDIL) and rates of hospital admission for tooth extractions due to dental caries in children. Hospital Episode Statistics (HES) were used on hospital admissions for tooth extraction of one or more primary or permanent tooth due to a primary diagnosis of dental caries in children aged 0-18 years attending a National Health Service (NHS) hospital in England from January 2012 (pre-SDIL) to February 2020 (post-SDIL implementation). HES data were grouped and summarised by Index of Multiple Deprivation (IMD) and age group. RESULTS: There was an absolute reduction of 3.7% (95% CI 5.3% to 2.2%) per 100,000 population/month and a relative reduction of 12.1% (95% CI 17.0% to 7.2%) in hospital admissions for carious tooth extractions in all children (0-18 years) compared if there had been no announcement of the SDIL (counterfactual scenario). Reductions were observed in children living in most areas regardless of the level of deprivation and most notably in the youngest children (<10 years). CONCLUSIONS: An ITS analysis of administrative data on hospital admissions found the announcement of the UK SDIL was associated with improvements (reduction) in the incidence of hospital admissions for tooth extractions due to dental caries. This study provides evidence of benefits of the UK SDIL to children's oral health.

Health visiting teams and children's oral health: a scoping review.

BACKGROUND: Recent policies have recommended early-life interventions to prevent caries. The four nations of the UK each have a national universal children's health programme, through which health visitors and their wider team (HVTs) promote health in the early years. HVT visits offer an opportunity to support parents to improve their child's oral health. A scoping review was conducted to provide a descriptive synthesis of the current literature related to the role of HVTs in improving the oral health of children 0-5 years old and to identify significant gaps for future research. This review informed the feasibility study of the First Dental Steps Intervention, a targeted health visitor-led infant oral health intervention in England. METHODS: Electronic database searches for peer-reviewed literature were performed using Medline via Ovid and Web of Science (1946-2021). The quality of included intervention studies was assessed using the Effective Public Health Practice Project tool. Additionally, a grey literature search was conducted (key organisations, bibliographic and thesis databases, forwards and backwards citation, Google). RESULTS: Thirty-nine publications, published between 1980 and 2021, were included. The majority of included papers were from the UK. The quality of intervention studies (n = 7) ranged from weak to strong. Thematic analysis identified the following themes: (1) professional knowledge, education, and training; (2) involvement of HVs in the delivery of oral health interventions; (3) effectiveness of interventions; (4) perspectives of HVs providing oral health advice and acceptability; and (5) barriers and facilitators to promoting oral health. The grey literature search identified 125 sources. HVT involvement was reported in a variety of source types: reports, guidance documents, evaluations, reviews, and training resources. HVTs were involved in oral health by providing oral health packs, brushing and oral health advice, registration and attendance, oral health training, risk assessment, and referral to dental services. CONCLUSION: The current literature suggests that HVTs are well placed to improve children's oral health. Facilitators and barriers are encountered by HVTs in promoting oral health which should be considered by commissioners. There is a need for future high-quality studies that address the inadequacies found and provide further evidence of the effectiveness of HVT's oral health interventions.

Can motivational interviewing help prevent dental caries in secondary school children?

Design This study was a randomised controlled trial (RCT) designed to evaluate the effectiveness of three school-based interventions to improve the oral health behaviours of adolescents and prevent dental caries. Participants were assigned to one of three groups: Group I - oral health education (which was considered as usual care); Group II - motivational interviewing (MI); and Group III - MI aided by the interactive patient communication tool, the Cariogram. Cluster randomisation was applied and schools were stratified by district. The interventions were delivered at school by trained hygienists. The main outcome measures were psychological (self-efficacy) and behavioural measures about snacking and toothbrushing with clinical measures of plaque and caries.Case selection Participants were selected from 15 secondary schools located in three main districts in Hong Kong in 2015-16. Inclusion criteria were: full-time students enrolled in participating schools; 12 or 13 years old; and having unfavourable oral health behaviour, defined as 'toothbrushing less often than twice a day' and/or 'snacking three times or more a day'. Eligible participants were identified through a screening questionnaire.Results In total, 512 participants were recruited (161, 162 and 188 in Groups I-III, respectively) and of those, 460 (89.9%) were followed-up 24 months post intervention. When compared with Group I, restriction of frequent snacking was more likely in Group II (odds ratio [OR] [95% confidence interval (CI)]: 3.91 [1.48-10.33]) and Group III (OR [95% CI]: 6.33 [2.46-16.27]). Participants in Group III had a higher likelihood to start performing adequate toothbrushing (OR [95% CI]: 4.80 [1.79-12.85]). No significant reduction in plaque score reduction was found among the three groups (p >0.05). Groups II and III developed fewer teeth with caries into dentine (ß [95% CI]: -0.19 [-0.37, -0.01] and -0.20 [-0.38, -0.02], respectively), whereas the increment of total carious lesions (enamel and dentine) was lower in Group III (ß [95% CI]: -0.63 [-1.24, -0.02]).Conclusions The findings of this RCT suggest school-based MI interventions were more effective than traditional oral health education in improving adolescents' oral health self-efficacy, behaviours and preventing dental caries. The authors suggest the benefits of this intervention may potentially extend beyond caries prevention to other oral and systemic diseases.

Does poor oral health impact on young children's development? A rapid review.

Background The extent to which poor oral health in young children impacts developmental milestones is unclear.Aim To review the evidence of association between poor oral health and development of young children (0-5 years).Method A rapid review was conducted. Medline was searched for articles in English published from 2000 onwards. The outcomes considered were the impact of poor oral health on speech and language development, oral health-related quality of life (OHRQoL), school performance and attendance.Results In total, 15 studies were included: four systematic reviews, a critical review and 10 primary studies. All data were from observational or cross-sectional studies. Premature extraction of primary maxillary incisors was associated with change in speech sounds and articulation. Two primary studies found associations between early childhood caries and physical and psychomotor deficiencies, while acknowledging a web of causation with other factors, including socioeconomic status. Children with dental caries reported lower OHRQoL. Studies found caries experience was associated with preschool absenteeism.Conclusion Poor oral health in young children appears to be associated with speech and language development, OHRQoL, and school attendance and performance. However, there are significant limitations in the existing evidence, with further high-quality, observational, longitudinal research required to fully understand the impact of poor oral health on the development of young children. Strategies to improve oral health by health and education professionals are needed to ensure young children reach their potential.

Are teenagers 'drowning' in sports and energy drinks? The need for upstream and downstream interventions.

Sports and energy drinks are consumed regularly by adults, children and young people (CYP). The dental and wider health implications of their frequent consumption pose a challenge to dental and other health professionals alike, in particular the increasing consumption in CYP, with up to one-third drinking caffeinated energy drinks regularly. The recent popularity of products such as Prime has highlighted the role of social media and marketing on the purchasing and consumption of these drinks, particularly for CYP. This paper describes current consumption of sports and energy drinks nationally and the potential impact on general and dental health. It discusses their popularity in CYP, including purchasing habits and motivations for this age group, and the role of social media in promoting consumption. It then highlights the importance of introducing public health measures to address these factors. Finally, a key role for dental teams is proposed, with an emphasis on the importance of further research to determine the effectiveness of dietary interventions delivered by dental professionals.