Case Studies

The Smile Sack Programme - NHS Tees (Oct 2008 - ongoing)

Programme aims:

To support the development of good oral health behaviour in children through the medium of play

Background:

The Smile Sack programme is part of a suite of initiatives within the Tees Oral Health and Commissioning Strategy to improve the oral health of children, and reduce inequalities both in dental health and access.

It involved the development, piloting, distribution, and evaluation of educational games and activity packs to targeted priority nursery and reception classes in Teesside. The aim was to help children learn about healthy eating and good oral hygiene practices from an early age, through the medium of play. The healthy eating messages were selected for their ability to have a positive impact on oral health.

Learning Days Ltd was commissioned to produce a selection of game ideas and resources for nursery teachers to use in the classroom that incorporated a ‘take-home’ selection of resources to engage parents. We worked with the Tees Oral Health Promotion Team and other professionals and with local schools. The target recipients were priority schools and their parents in Teesside that were in the top 40% of localities with the highest levels of dental disease experience. 59 priority schools plus 15 pre-school nurseries were selected. These schools were already part of an in-school tooth brushing programme at nursery and reception level. Additionally, 8 Special Schools in these areas were included.

The project commenced during October 2008. The finished resources were distributed to schools during November 2009 and the evaluation study carried out during July 2010.

Outcome:

A set of educational activities and resources that promotes oral health messages within a nursery and home setting - the 'Smile Sack'

Smile Sack collection

The key messages for children and their parents:

Oral Health:

• Brush teeth twice a day, especially last thing at night

• Use a pea sized amount of fluoride toothpaste

• Spit out toothpaste not rinse with water

• Use the correct strength fluoride toothpaste i.e. family strength fluoride toothpaste

• Assist/supervise children to brush their teeth

• Visit the dentist regularly

Healthy eating (messages selected for their ability to have a positive impact on oral health):

• Eat tooth-friendly snacks between mealtimes - it is much better for your teeth and health

• Sugary foods and drinks are best eaten at mealtimes

• Drinking plain milk and water is good for your teeth

Key results

Teacher feedback:

• 100% said that games improved their pupils' awareness of brushing teeth

• 90% said the games improved their pupils' awareness of healthy snacks and drinks, sugary snacks and drinks and frequency of brushing

• The Smile Sack resources have been pitched at the right level "Child friendly, lovely to hold and touch. Very colourful"

• Teachers (and parents) have observed changes in behaviour of children - they are talking about healthy/unhealthy foods and understanding the link between unhealthy foods and tooth decay.

Parent feedback:

• 80% said the games improved their child's awareness of healthy snacks and sugary snacks.

• 60% noted that their children had increased awareness of the need to clean their teeth with the remainder stating that they were already aware.

• 60% of parents reported that using the Smile Sack resources had encouraged them to consider what snacks their children ate between meals

• 40% reported making changes in the tooth brushing routines e.g. longer brushing times

Lessons to share:

The raised awareness of healthy eating and good oral health practices in the home setting is complemented by the use of the take home resource. The full use of the take home bag scheme should be encouraged.

Follow up activity:

As a result of the evaluation study results the programme has been extended to another 25 targeted schools and a new combination of resources provided to local Children's Centre, specifically for their Home Visits staff.

Home visits resource sets:

As an extension to the programme, a new collection of the resources have been combined into packs for the Home Visit staff of local Children's Centres. These packs enable staff to fully engage parents and their younger children utilising a series of games and stories during home visits.