Abstract
BackgroundParental supervised brushing (PSB) when initiated in infancy can lead to long-term protective home-based oral health habits thereby reducing the risk of dental caries. However, PSB is a complex behaviour with many barriers reported by parents hindering its effective implementation. Within the UK, oral health advice is delivered universally to parents by health visitors and their wider teams when children are aged between 9 and 12 months. Nevertheless, there is no standardised intervention or training upon which health visitors can base this advice, and they often lack the specialised knowledge needed to help parents overcome barriers to performing PSB and limiting sugary foods and drinks.Working with health visitors and parents of children aged 9–24 months, we have co-designed oral health training and resources (Health Visitors delivering Advice in Britain on Infant Toothbrushing (HABIT) intervention) to be used by health visitors and their wider teams when providing parents of children aged 9–12 months with oral health advice.The aim of the study is to explore the acceptability of the HABIT intervention to parents and health visitors, to examine the mechanism of action and develop suitable objective measures of PSB.Methods/designSix health visitors working in a deprived city in the UK will be provided with training on how to use the HABIT intervention. Health visitors will then each deliver the intervention to five parents of children aged 9–12 months. The research team will collect measures of PSB and dietary behaviours before and at 2 weeks and 3 months after the HABIT intervention. Acceptability of the HABIT intervention to health visitors will be explored through semi-structured diaries completed after each visit and a focus group discussion after delivery to all parents. Acceptability of the HABIT intervention and mechanism of action will be explored briefly during each home visit with parents and in greater details in 20–25 qualitative interviews after the completion of data collection. The utility of three objective measures of PSB will be compared with each other and with parental-self reports.DiscussionThis study will provide essential information to inform the design of a definitive cluster randomised controlled trial.Trial registrationThere is no database for early phase studies such as ours.
Highlights
Parental supervised brushing (PSB) when initiated in infancy can lead to long-term protective homebased oral health habits thereby reducing the risk of dental caries
In England, 12% of 3-year-olds and 25% of 5-year-olds are affected by caries, with figures rising to 17 and 37% for children living in deprived parts of Yorkshire [3]
A child whose teeth are affected by caries is likely to experience pain and discomfort [4], as well as dietary changes [5, 6], and in the long term, caries may have a negative impact on speech development [7], overall health [8], quality of life [9, 10], self-esteem and social confidence [9, 11]
Summary
Parental supervised brushing (PSB) when initiated in infancy can lead to long-term protective homebased oral health habits thereby reducing the risk of dental caries. A child whose teeth are affected by caries is likely to experience pain and discomfort [4], as well as dietary changes [5, 6], and in the long term, caries may have a negative impact on speech development [7], overall health [8], quality of life [9, 10], self-esteem and social confidence [9, 11] It has a wider societal impact on school readiness, attendance and educational outcome [12, 13]. Caries is the most common reason for young children (over 30,000 children) to be admitted to hospital for dental care under general anaesthetic with this alone costing the NHS approximately £36 million a year [15]
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