The foundation dentist
'Rocks' may not be quite the answer that you expect when you ask a group of children the question; 'what can harm your teeth?'
Despite having an element of truth behind it, this six-year-old's response caused my colleague and me to have a fit of the giggles together with the rest of the class in response to this very imaginative answer!
This was just one of the more memorable moments that I experienced when I joined up with Oliver, a fellow foundation dentist, to visit a primary school in Hull to talk about teeth as part of this year's Oral Health Day initiative to create greater dental awareness in the region.
What had started as a limited attempt to reach out to the children in the local community ended up being voted the winning project for the FGDP Yorkshire Deanery 'best practice' day'. The project is now in the process of becoming a new addition to the East Yorkshire foundation training programme, as of this year.
Can foundation dentists actually make a small difference in their communities then?
The problem
My trainer's practice is based in Hull city centre which is recognised as an area of high treatment need, so I have access to all the caries, retained roots and calculus I could wish for. This was just the opportunity I needed as a newly qualified dentist to get my gloved hands dirty and consolidate my theoretical knowledge by repeating basic dental treatments.
A stream of children started to appear in the surgery; one rampantly carious mouth after the other. I spent appointment after appointment giving advice to the accompanying adult and the child about diet and oral hygiene together with practical demonstrations; at the same time allowing the child to acclimatise to the dental environment before even picking up a handpiece to drill and fill.
It was quite disheartening when the same patients would routinely attend with no improvement or willingness to improve their oral health. The sheer volume and frequency of diagnosed caries in deciduous dentitions suggested this was a problem that needed attention.
My scheme study group became accustomed to my weekly rants regarding this issue during our case-based discussions. Over time the lack of progress I was making with these patients became increasingly frustrating. It was clear that the short time I spent with each patient in the practice was not as effective as I had hoped.
The barriers
Examining the way I worked in the practice allowed me to identify the following barriers to progress:
- Time - oral hygiene instruction was not regarded as a stand-alone activity. It was more a reinforcement of the messages that were rushed at the tail-end of the appointment.
- Environment - the dental clinic must be a very daunting place for a child since the surrounding equipment and setting is unfamiliar.
- Isolation - most children are accustomed to learning alongside their peers in a classroom setting and as a result of this a one-on-one preventative education session can be intimidating to some children.
- Guardians/Parents - more often than not the presence of a guardian is a positive factor, however on occasions it could have a detrimental effect.
Action plan
My list of the barriers led to a discussion with my trainer about the possibility of promoting oral health in the local community. Over the next few weeks, ideas were brainstormed, schools were contacted, posters printed, activities organised, prizes bought and support recruited.
With no real idea of what to expect, Oliver and I found ourselves standing in front of a classroom of bright eyed 6-7 year olds who were waiting to learn why two dentists were visiting their school that day.
We began by introducing ourselves and explained what our jobs entailed. This was followed by masks, gloves and mirrors were passed around the class. The rest of the day included interactive activities around prevention, specifically focusing on toothbrushing technique and diet.
Prizes were up for grabs throughout the day and to ensure that no-one went home empty handed, goodie bags were distributed to each child at the end. The bag contained dentally themed colouring pages and puzzles, straws, stickers and a tooth brushing chart. We asked the children to fill in the tooth brushing charts at home over the following week in an attempt to encourage them to put into practise what they had learnt that day.
At the end of the day, the children really seemed to have been enjoyed themselves and we were rewarded by enquiries about a return visit. This was very touching and we both thoroughly enjoyed the time that we spent at Wold Primary School. It was the first time since the start of my foundation year that I had felt successful in promoting prevention effectively within the community.