The Oral Welfare Excel Accreditation Scheme for Children

A few years ago Denplan introduced a system they called Excel Accreditation. It set the highest standards for dental surgeries and for clinical practice. They also introduced a comprehensive range of patient information leaflets and the Oral Health Score, a way of calibrating oral health so that changes can be monitored and the appropriate information and advice given. As a practice we are proud to have maintained our Excel Accreditation for the past four years. We are the only practice in West Norfolk to do this and regard the Oral Health Score as a proven tool in preventive care.

This way of working has been applied until now only to adults. Denplan wish to apply it to children and have initiated a pilot study to trial a modified version. 40 practices have been chosen from 80 applicants and we are proud to be one of them. The modified Oral Health Score will apply to children in three age groups; 0-5, 6-11 and 12-18. This is because young people’s mouths change very quickly and different criteria for oral health apply at different stages of development. They have proposed alongside this an Oral Well-being Score. In my view this represents a huge step forward, firstly because it recognises that health is much more than the absence of disease. The Denplan system recognises this, in that it is fundamentally a preventive system. Prevention is more about promoting health or well-being than it is about combating disease so a way of measuring well-being is essential. Secondly because if children and parents are to understand that a healthy mouth and a great smile is achievable for every child and how to achieve it, their attitudes and beliefs about dental health have to be considered as a regular part of their routine care. The Oral Well-being Score is being designed to achieve exactly that and is in my view a truly ground-breaking departure from the traditional approach.

To enlarge on that a little, dental health is not a matter of luck. People who don’t routinely eat sugar and who can keep their mouths clean can expect a lifetime of sound and stable dental health. Our dental health depends on what we eat and what we do and is therefore a behavioural issue. Effective dental care is not about fillings, crowns, veneers, extractions and dentures. It’s about teaching, encouraging and supporting healthy behaviour. The Oral Well-being Score works towards this in that it examines the attitudes and beliefs which govern our children’s behaviour. It is arrived at through a questionnaire which covers the following four areas:

1. How a child feels about their dental visit.
2. Their awareness of their own dental health.
3. The child’s dental quality of life.
4. The child’s confidence in their ability to maintain their own
dental health.

It will provide a formal framework for discussion around these issues and a way of benchmarking well-being so that progress or the lack of it can be measured. As a dentist I can repair the effects of disease but eliminating disease can only be achieved through a change in the patient’s behaviour. This doesn't’t mean that disease is the patient’s fault. It means that the remedy is in the patient’s hands and is available to adults and children alike, when given the right support. The Oral Well-being Score is a guide to finding the right support.

The pilot study will last about 6 months. The programme will also include a pediatric dental education programme for the whole dental team so that the practice can always be sure that we are in line with the latest techniques and treatments. All of this programme is aimed at improving our children’s oral health and maintaining it into adulthood.