A pilot of a school-based dental treatment programme for vulnerable children with possible dental neglect: the Back2School programme

Abstract

The general dental practitioners and community dental services of Barts Health NHS Trust in City and Hackney and Tower Hamlets PCTs in East London currently provide a school-based oral health prevention programme. The programme provides dental screening for three- to six-year-olds, fluoride varnish application twice during the school year and engaging with the families to encourage dental attendance. An evaluation of the programme suggested that children with a dental treatment need, identified by the screening, were not being taken for further dental care. The aim of this 'Back2School' pilot was to evaluate the use of mobile dental units in the provision of care to this group of children. The objectives were to assess if this care was acceptable to the children and their families, to evaluate dental treatment provided, patient attendance, costs of the service and whether it would be a viable method to provide dental care. The rotation of the mobile dental unit in this pilot offered ten sessions of dental care over five days in three different locations. The locations were chosen near the five schools covered by the community dental service. A total of 63 children were seen; 33 females and 30 males, which included 7 walk-in patients. Five children had extractions and the number of fillings ranged from one to six. Of the 63 children seen only 8 (13%) had attended a dentist before, 59 (93%) of the children were rated 'high risk' for dental disease, 61 (97%) of the children received a fluoride varnish application and 95.2 UDAs were achieved. Feedback was positive overall. The use of a community-based mobile dental unit has the potential to be a cost-effective method to remove barriers to dental care access, both for the treatment of vulnerable children and as a first point of contact in the dental care pathway.