Agenda item

The Chairman invited Dr Djuretic to speak on the item.

Dr Djuretic presented the report on Children’s Oral Health. She noted that Barnet has had a stubborn rate of tooth decay in children under five years of age which had not changed over many years, despite efforts to improve this. A needs assessment would be undertaken to review the current offer and to find out where additional interventions would need to be introduced, including a review of best practice in other local authorities.

Dr Djuretic reported that details of the Young Brushers’ Project were provided in the report. Barnet had successfully bid for funding from the North Central London Integrated Care Partnership Inequalities Fund for the project, which is targeting 40 Early Years settings, involving up to 3200 children, and has so far agreed a commitment with 11 Early Years settings, reaching 317 children. Dr Djuretic noted that the provider had received a good response so far and was chasing the remaining settings. She added that this was also providing an opportunity to train people and was focusing on more deprived areas where rates of tooth decay are much higher.

Dr Djuretic reported that CLCH already trains all Early Years staff, who then train parents, and CLCH has been commissioned to take part in the project. Packs with brushes are provided for families but also education from breastfeeding onwards, improvement of access to dental services and food intake are also important. The Healthy Early Years London Award has a component on tooth brushing and oral health and Barnet has carried out initiatives with schools so that they offer water only and no fizzy drinks.

A Member asked whether childminders are also educated as part of the contact with the 40 Early Years settings and suggested distributing tooth brushing packs at food banks.

The Member also enquired about the metrics, baseline, and methodology to be used as part of the mini oral health needs assessment, and how Solutions 4 Health could be used to enable the implementation of changes. They felt it would be helpful to have more information after the meeting if possible.

Dr Djuretic agreed to take back the helpful suggestion about food banks as this would not be difficult to implement.

Action: Dr Djuretic

Dr Djuretic stated that her team had been chasing Public Health England (PHE) for six months to try to get data on children’s oral health across the whole of Barnet and had also been trying to get data from NHS England (NHSE) on equalities in access to dental services in Barnet, ideally from before the pandemic as the pandemic data would not be typical. Dr Djuretic added that then an evidence review would be carried out on interventions that work best, as well as discussions on best practice with other local authorities. Additional support would then be provided for those with the poorest outcomes.

A Member stated that for those families in dire circumstances, their situation is likely to get worse over the coming months due to the economic situation. It would be helpful to have Ward data to be able to target the areas most in need, but she was aware that Childs Hill, Burnt Oak, and Colindale have active food banks.

Another Member noted that, whilst educating parents, it is important to inform them about gingivitis and its links with dementia in later life.

It was hoped that Dental Awareness Days in schools could take place more often as a way of informing people.

Dr Djuretic noted that there would be an evaluation of current interventions to try to find out why they are not improving the situation.

A Member noted that in Section 5.11 the report references an-out-of-date corporate plan. Dr Djuretic apologised and would correct this.

Action: Dr Djuretic

The Member also enquired where the figure of ‘one third’ came from (page 19) for the number of children in Barnet suffering from tooth decay. At the Children’s Partnership Board, the figure given was 25% i.e. one quarter. Dr Djuretic would check this but agreed the figure was about 25%.

Action: Dr Djuretic

The Member stated that if after teaching parents and undertaking other work had still not improved the situation, the study should look into why this had not worked and what happened to make the parents forget the importance of looking after children’s teeth. He also enquired whether having to wear a face mask for eight hours a day would make a difference to bacteria build-up in children’s mouths leading to an increase in tooth decay. Dr Djuretic noted that there was no evidence to the best of her knowledge, and that she is not aware of this subject being researched. She added that 0-5-year-olds were not required to wear masks.

Dr Djuretic agreed that some qualitative research with parents could be carried out on what are the barriers to oral health and why some children still develop tooth decay despite all the interventions.

Action: Dr Djuretic

A Member reported that she was aware of a Primary School in another Borough that had set up sessions of tooth brushing in schools which included all children, due to the reports of children having teeth removed at an early age. She added that the idea of providing toothbrushes and toothpaste in food banks was a good one, noting that there are two strategically placed food banks in Woodhouse Ward.

Another Member asked whether details on the 40 settings for the project could be provided, including whether any of these are private nurseries. Dr Djuretic offered to forward the details to the Committee.

Action: Dr Djuretic

A Member suggested looking at the drivers for why some families were not prioritising children’s oral health in Barnet, as part of the research. Dr Djuretic responded and said this could be considered but the cause of tooth decay also included food and liquid intake, for example a large proportion of some cultures are giving young children fruit juices rather than water. Barnet uses brushing as a ‘hook’ to also teach parents and teachers on other aspects.

Another Member stated that deprivation is one of the factors, but not the only factor, so the project should not exclude groups of society who are seen as unlikely to suffer from tooth decay. Parental neglect could occur in any family.

The Chairman noted that it had been reported at a previous meeting of the HOSC that fizzy drinks had been removed from school meals and replaced by water with fruit slices. She enquired whether this was still the case. Dr Djuretic responded that some children probably do bring in packed lunches with fruit juice and, although Barnet Council could advise schools, it is the school’s choice whether to ban fizzy drinks on site. The Healthy School Initiative should be addressing this issue.

Cllr Moore made a declaration of interest by virtue of the fact that she is a School Governor and she was aware of chocolate and juice packs being banned in one school.

A Member reported that the Prevention Team in the Council tries to highlight healthy lifestyles and the same could happen with oral health. Dr Djuretic noted that booklets are already being circulated on this.

Dr Djuretic reported that she would bring an update with a detailed plan when the needs assessment is completed in the second half of the year.

Action: Dr Djuretic

RESOLVED that:

1.    the Committee noted the report and progress made in Oral Health Promotion services, especially the additional supervised toothbrushing intervention in the most deprived areas of Barnet.

2.    the Committee noted that the Public Health team is planning to conduct a mini oral health needs assessment in 2022. The findings would be reported to the Committee in the second half of the year.