November sees the departure of BSPD’s PR consultant, Caroline Holland, who has developed and finessed the media relations role – promoting the mission and purpose of the Society – over the last seven years.

Caroline’s vision for BSPD has meant that over this period the Society is now seen as the go-to authority voice on matters of paediatric dentistry. With a raised profile and awareness, BSPD now sees itself called upon by media to give an informed opinion on behalf of the UK’s leading paediatric clinical and research professionals. She has overseen a new consistency to oral healthcare messaging and a greater awareness amongst both the dental profession, and the general public of the latest developments in children’s oral health and the Society’s recommended preventative approach.

This new era of collaboration during which Caroline has been a leading force along with BSPD’s spokesperson, Professor Claire Stevens and the Society’s Presidents has also enabled the BSPD to take a significant role in influencing policy – engaging with special interest groups and political decision makers. The result is that today, BSPD is now in a strong position to campaign for and implement improvements in children’s oral health in the UK.

Professor Claire Stevens CBE, Spokesperson, BSPD said: “We are very sad to say goodbye to Caroline and wish her well. As I reflect back over the last seven years, I believe her key achievements are the support she gave to developing BSPD’s mission to improve the oral health of children and young people and the development of the Society’s position statements on key issues.

“Caroline strove to focus on highlighting the wide-ranging knowledge and skills that a paediatric dentist must have in order to treat children, who present with the most complex challenges. She recognised, and was keen to promote, the restorative skills needed to treat young people who have suffered trauma. She understood both the restorative and orthodontic skills required to treat children who have a complex genetic condition – and their specialist skills in periodontology, or oral surgery. She promoted paediatric dentistry specialists’ ability to work in a multi-disciplinary team.

She appreciated the dedication needed by these experts who specialise in managing children and young people, as well as their parents, with kindness and respect.”

Professor Claire Stevens added: “She has also facilitated a new structure to engage our Society’s 13 regional branches – and achieved excellent media coverage for our annual conferences.

“Another of Caroline’s stand-out achievements was being instrumental in the strategic design of BSPD’s launch of Dental Check By One (DCby1) which is one of the Society’s great successes in recent years. Caroline managed to get the message out to the wider public through achieving press coverage on TV and in national press. We know that taking your baby to the dentist when their teeth first come through or by the age of one at the latest gets them off to a healthy start. It is this insight that drove the Society’s flagship Dental Check By One campaign – which is now established as national guidance in the UK. BSPD is immensely proud of DCby1 – and the work that Caroline did to support its launch.”

BSPD stretches back over almost 70 years and throughout its history, has campaigned for improving standards in children’s oral health. The last few years have seen a picking up of pace for the Society with its membership number doubling to more than 800 members – with a broadened membership profile.

Professor Claire Stevens added: “I am proud to say that Caroline gave BSPD the confidence to be ambitious. Her passion for the wellbeing of children and the role that good oral healthcare plays within that have been her enduring focus and we at the Society have undoubtably benefited from her drive and determination – as she leaves BSPD’s reputation at an elevated level.”

The role of PR consultant to BSPD will be taken over from November by Kate Clark who can be contacted at kate@kateclarkpr.co.uk / 07990 525639.

A new research initiative is being established to take the dental profession’s understanding of molar incisor hypomineralisation (MIH) and its impact on patients into a new era. Led by Greig Taylor, a BSPD member and Chairman of CONNECT, a research collaborative for trainees, the initiative will bring together academics keen to share knowledge as well as to gain the input of children and young people in optimum management of the condition.

A common childhood condition, MIH causes weakened tooth enamel, usually in one or more of the first permanent molars, which are more prone to dental decay as a result; incisor teeth can be affected too.

Until the turn of this century, teeth with weakened enamel might have been referred to as ‘cheesy molars’ due to their pitted appearance. A seminal paper (1) published exactly 20 years ago, however, established the use of the classification molar incisor hypomineralisation.

There have been numerous studies of MIH in recent years including a paper (2) in 2017 which showed that the global burden is high. Evidence from a paper (3) in the International Journal of Paediatric Dentistry (based on 70 studies) suggests that the prevalence in children is roughly 14%.

Another important development from the last two decades is the development of BSPD’s position statement (4), launched in January 2020, ensuring that the condition is widely taught and recognised. According to our position statement, about one million children in the UK have teeth that are affected by MIH and in most cases, the treatment can and should be managed in primary care. Only the most severe cases or those which require multidisciplinary management should be referred into secondary care.

The European Academy of Paediatric Dentistry undertook a systematic review to understand worldwide trends in the scientific evidence around MIH and gaps in knowledge with a view to guiding future research on the topic. Its updated policy document (5) to which BSPD’s Mr Taylor, Dr Cheryl Somani and Professor Ferranti Wong contributed, has just been published.

Mr Taylor said the knowledge gap that has been identified is around a shortage of clinical studies on treatment, mainly extractions, and on the patient’s quality of life. He added: “There is definitely a genetic component to MIH but we still don’t fully understand what causes it. Our best course of action is to focus on prevention and early identification.”

He is now in discussion with other BSPD academics interested in working together in the UK and internationally to develop the evidence base further. Professor Claire Stevens, spokesperson for BSPD, said: “We see high numbers of children who have MIH and need treatment. I am delighted that Greig and others are going to be working together to fill the knowledge gap on MIH and to ensure that the advice and resources that we develop for our young patients are co-designed with them.”

References:

• Weerheijm K L; Jalevik, B; Alaluusua, S. Caries Research; Basel35, Iss. 5,  (Sep/Oct 2001): 390-1.
• https://pubmed.ncbi.nlm.nih.gov/29221956/
• https://onlinelibrary.wiley.com/doi/abs/10.1111/ipd.12323
• https://www.bspd.co.uk/Portals/0/MIH%20statement%20final%20Jan%202020.pdf
• https://pubmed.ncbi.nlm.nih.gov/34669177/

A landmark statement from the UK’s four Chief Medical Officers in support of water fluoridation has contributed to the growing momentum in favour of this most cost-effective of measures to reduce dental decay.

In response to the CMO’s statement, the British Society of Paediatric Dentistry (BSPD) has updated its position statement to incorporate their key comments. Also welcome is the ensuing statement from the Chief Dental Officer for England, Sara Hurley. She said that the CMOs’ statement was “welcome endorsement of water fluoridation’s health benefits and safety” from the UK’s most senior doctors.

BSPD’s position statement was first published in 2014 and updated in 2019 and in October 2021. Each iteration has been the work of the eminent international authority on water fluoridation, Emeritus Professor Andrew Rugg-Gunn.

Emeritus Professor Andrew Rugg-Gunn

The need to address health inequalities underpins the Commissioning Standard for Dental Specialties: Paediatric Dentistry and is an explicit campaigning commitment in BSPD’s mission statement.

Many surveys have revealed that it is children in the most deprived areas who benefit most from water fluoridation; for instance, Public Health England’s 2018 report showed that dental decay is reduced by 52% in children living in the most deprived areas compared with 23% for children in the least deprived areas.

BSPD is calling for water fluoridation to be implemented in more deprived areas of the UK to reduce oral health inequalities.

Professor Claire Stevens, spokesperson for BSPD, said that in addition to reducing the prevalence and severity of dental decay among children in the most deprived areas, community water fluoridation reduces hospital admissions of young children requiring tooth extraction under general anaesthetic – by up to 68%. 

She added: “Dental decay is costly for the NHS, with £54.6 million spent on hospital-based tooth extractions for children and adolescents in 2019–20. This financial burden can be reduced by implementing preventive measures, including community water fluoridation. Dental decay is almost always preventable, but we need urgent investment in evidence-based preventive interventions if we wish to see a reduced demand on stretched secondary care services.” 

BSPD’s Outstanding Innovation Award (OIA) which celebrates inspiring and innovative schemes to improve the oral health of children enters its sixth year in 2022.  Entries are invited from people who have established a scheme with a demonstrable impact on children’s oral health. By creating positive publicity around innovative schemes, BSPD’s aim is to encourage, promote and disseminate good practice.

The prize for the winner is free attendance for a day of the BSPD conference and the opportunity to make a presentation. The winner of the Outstanding Innovation Award for 2021 was Simon Hearnshaw who entered on behalf of the North Yorkshire and Humber Local Dental Network for their “In practice prevention scheme”. This innovative scheme, which targeted families in deprived areas, demonstrated that with the right approach, flexible commissioning works.

Other previous winners of OIA are:

• 2020 Linzi Maybin for her Happy Teeth Outreach project
• 2019 Helen Rogers for establishing CONNECT Trainees
• 2018 Ben Underwood for Brush DJ, the music-based toothbrushing app
• 2017 Ingrid Perry for Teeth Team

The deadline for submission to be considered for OIA 2022 is 31 December 2021. More information can be found here: https://www.bspd.co.uk/Professionals/Awards-and-Prizes/The-Outstanding-Innovation-Award

The role of dentists in advocating for patients was reinforced in multiple sessions at BSPD’s 2021 annual conference hosted by the Merseyside branch and chaired by specialist in paediatric dentistry, Dr Clare Ledingham. Whether in the context of food manufacturing practices and marketing or the care and management of vulnerable children, dentists can and should lobby for change.

Dr Clare Ledingham

In the first session, a Sugar Summit, three expert panellists discussed diet, obesity and food marketing from very different perspectives. First on the virtual platform was Dr Alison Tedstone, Chief Nutritionist at the Office for Health Improvement and Disparities, who provided valuable background on UK food policy.   

She described how in 2016 the government launched its obesity strategy, resulting in the levy on soft drinks. Targets were set to reduce the sugar content of food by 20% but a disappointing reduction of only 3% has been achieved to date. The sugar content of breakfast cereals, drinks and yoghurts has decreased but the sugar content of confectionary has increased. “As dentists you are well placed to call for things to be better,” she said.

Dr Emma Boyland and Professor Amandine Garde, both based at the University of Liverpool, were the two other speakers on the panel. Their presentations demonstrated how food marketing, product placement and advertising infringed children’s right to a healthy start in life.  

The UK may be small but we have the third largest market in the world in terms of digital marketing, behind only the USA and China, said Dr Boyland. While unhealthy products are regulated here, brands are not. Dr Boyland demonstrated how advertising for big brands – a global fast food chain and a sparking drink conglomerate for example – depict healthy lifestyle imagery to sell inherently unhealthy products.

Professor Amandine Garde

Professor Amandine Garde continued on the corporate theme saying that industry strategy was to delay or annul regulation of food products by invoking legal argument. A report from European Consumer Organisations, which she initiated, demonstrates how children are being targeted by unhealthy food advertising, undermining their human rights.

Making an impassioned case for change, Professor Garde said children should be protected from diet-related disease and a government led response to the marketing of unhealthy foods was warranted.

The ensuing discussion was no less fascinating, with many delegates asking questions leading to a lively debate on what could be learned from the handling of tobacco marketing which led to a successful reduction in cigarette smoking.

Next up was a session with the theme of vulnerable children featuring two Charlotte Waites, one a community dentist and Chair of the British Dental Association England Community Dental Services Committee and the other a Director of a Mental Health Charity in Wales and their presentations were complemented by a talk from Developmental Paediatrician Aideen Naughton.

Dr Charlotte Waite

Dr Charlotte Waite (the dentist) explored the battle to advocate for children and families who suffer inequalities. She concluded her talk in rousing fashion by thanking BSPD members for what they do to advocate for children, highlighting that with an emerging new Health Bill, dentists will need to be vocal for the profession and for patients.

She urged her audience to be that voice, saying: “Keep speaking up, keep being the person who says “yes, but, what about” and be that person who represents those unheard voices. Together we can make sure that dentistry is not the missing piece in the healthcare puzzle.”

The final keynote session of conference was The Sights and Sounds of Childhood and the speakers were Dr Hannah Barham-Brown, a GP and disability campaigner, Dr Lola Solebo Consultant Paediatric Ophthalmologist at Great Ormond Street and Melanie Thomas, a music therapist. Sally Hibbert, a Consultant in Paediatric Dentistry, formerly from Liverpool but now based in Australia gave an insightful talk about transitional care to round off the event.

This was the first fully virtual BSPD conference and the organisers were delighted by how well it worked. The online platform promoted engagement and discussion and the social events – particularly the balloon-modelling session led by Dr David Johnson, BSPD’s honorary treasurer – worked well. The principal partners were Oral B and Alexion and  Kyowa Kirin was an executive partner.

As ever, BSPD’s Teachers’ Branch organised their study day to coincide with conference and this year’s theme was ‘Current Concepts in Training and Education’. It opened with Dr Sandra Zijlstra-Shaw from the University of Sheffield, who spoke about the characteristics of a good clinical teacher. She was joined by former student Miss Katie Ruaux who described her experience of interprofessional learning and co-creation, and the advantages of combining the two approaches.

Delegates were led 35,000 feet into the sky for the next session, where they were introduced by the team from Black Box Dentistry to human factors, sharing lessons learned from the aviation industry. Dr Fran O’Leary from Glasgow Dental Hospital demonstrated how principles of human factors could be applied to overcome workflow issues in paediatric dentistry.

Dr Laura Gartshore from the University of Liverpool gave delegates a ‘call to action’ when opening the theme on ‘Lessons in Leadership’, challenging delegates to tackle gender imbalance, while Miss Sarah Simpson from Newcastle Dental Hospital outlined the benefits of a leadership fellowship. The final theme, Going Green in Dentistry, was a masterclass in sustainability, with Dr Brett Duane from Trinity College, Dublin and Dr Ahmed Kahatab from The Dental Suite giving delegates both practical advice and plenty of food for thought. The Teachers branch study day sponsor was SDI.

The new President of BSPD is Professor Sondos Albadri, Professor and Honorary Consultant in Paediatric Dentistry in Liverpool and one of the most respected names in paediatric dentistry. Her inauguration will take place on 5 October, at BSPD’s annual conference organised by our Merseyside branch.

It’s tradition that the President tours all BSPD’s branches during their year in office and delivers a lecture reflecting on their career and academic interests. Professor Albadri ‘s topic is  ‘2021 vision: A new perspective on hindsight’ and she will reflect on her career, on the management of childhood trauma and on the lessons learned from the pandemic.

She said: “We now live with the threat of a pandemic and prevention has never been so important. The hindsight we have acquired post pandemic should underpin our work going forward and as President I want to build on what that means for us and for our patients.”

One of the impacts of the pandemic has been to highlight the degree to which children from deprived areas are disadvantaged by poor oral health. Another priority for Professor Albadri will be to support initiatives which help reduce growing inequalities in children’s oral health.

Prof Albadri is, among many other roles, Clinical Lead for the University of Liverpool’s Institute of Life Course and Medical Sciences (ILCaMS). She has become involved in research exploring the link between oral health and chronic  inflammatory conditions in children . She said: “This is about collaborating to understand the science behind inflammatory diseases and understanding that the mouth is gateway to the body.”

Since her young days in Baghdad, Prof Albadri knew she wanted to be an academic, but she did not believe she could ever become a Professor. How wrong she was! She rose rapidly to the top of the academic ladder in paediatric dentistry in the UK, becoming a Professor at the age of 43.

In the year ahead, she looks forward to inspiring younger paediatric dentists, making sure that they know that they can succeed, as she has done.

Read a full profile of Sondos Albadri under the spotlight section of the upcoming October 2021 edition of The Probe.

BSPD welcomes new recall guidance designed to ensure the most vulnerable children and young people (CYP) get access to dental care as swiftly as possible. Published this week, the guidance supplements existing NICE recall guidance, which recommends CYP are seen at least annually.

A new implementation tool supports the guidance. Red, amber and green colour-coding provide dental teams with a clear direction on the CYP who should be prioritised for recall. In future, all dental practices should ensure the youngest and most vulnerable children are prioritised for care.

News of the updated guidance was issued in a joint bulletin from the Office of the Chief Dental Officer (OCDO) for England, Sara Hurley and Simon Kenny, National Clinical Director for Children and Young People, a collaboration underscoring the importance of the initiative.

BSPD’s Dental Check by One campaign, launched in 2017, was driven by the recognition that an early appointment with a dentist was an opportunity for the family to get preventive advice. With 100,000 more children seeing a dentist in 2018/19, DCby1 was starting to take effect. This positive change was halted by the pandemic.

BSPD spokesperson, Claire Stevens, commented: “We are glad to see publication of this guidance which should improve oral health among the most vulnerable and vitally, help reduce inequalities.”

She said that children aged between two and five would be unlikely to manage multiple extractions in a dental chair and usually needed a general anaesthetic.

“Consultants and specialists in paediatric dentistry hope very much that the impact of the recall guidance will be to reduce the number of very young children being referred to us for a general anaesthetic.”

Newly published guidance¹ to improve how children and young people (CYP) experience healthcare is welcomed by the British Society of Paediatric Dentistry (BSPD). Drafted by NICE (The National Institute for Health and Care Excellence), the guidance entitled ‘Babies, Children and Young People’s Experience of Healthcare’ is designed to ensure the preferences and feelings of young patients are consistently central to their treatment.

This approach is already espoused by BSPD whose members have researched and published systematic reviews² highlighting the importance of making the voice of the child central to research and put children and young people in control of their dental treatment³.

The NICE guidance covers issues such as safeguarding, disabilities, consent, shared decision-making and sets out that healthcare staff should communicate with:

• Kindness, compassion and respect
• Cultural sensitivity
• A non-judgemental attitude

It is aimed at commissioners and providers of healthcare who now have a responsibility to apply the guidance where appropriate. It should also be read by non-clinical staff, such as receptionists.

Professor Paul Ashley, a member of BSPD as well as the NICE committee which drafted the guidance, said: “Children have a right to express their views on decisions affecting them. This guidance shows how listening to and treating children and young people with the respect and dignity they deserve can lead to better care.”

“Poor healthcare experiences increase likelihood of unmet healthcare need among CYP, which could mean worse health outcomes in adult life. Positive experiences of healthcare also plays an important part in health equality, ensuring that every contact counts to build up trust.”

He added: “Paediatric dentists are already adept at tuning in to their patients needs and wishes. This has become more challenging since the pandemic with remote check-ins replacing face-to-face care. Familiarity with dental clinics is fundamental to allow children and young people to develop confidence and trust in our services.”

References:

1. https://www.nice.org.uk/guidance/ng204
2. https://pubmed.ncbi.nlm.nih.gov/17683320/
3. https://www.sheffield.ac.uk/research/features/help-im-scared-dentist

The British Society of Paediatric Dentistry (BSPD) is the leading UK organisation of dental professionals dedicated to improving the oral health of children in the UK www.bspd.co.uk.

The British Society of Paediatric Dentistry’s (BSPD) patients are among society’s most vulnerable. They may have a complex condition, a dental anomaly or extensive decay but whatever their needs, they are children and should be prioritised. Yet a workforce shortage which has been ignored for more than a decade makes access to a specialist in paediatric dentistry a challenge in many areas of the UK.

New research into the UK’s dental specialist workforce suggests that the number of specialists in paediatric dentistry should be trebled to meet the needs of children aged 0-16. There are currently 227 specialists in paediatric dentistry working in the UK.

David Auld, Chairman of the BSPD specialists’ branch says urgent steps should be taken to incentivise specialist training. “You can see clearly on the map created by the study’s authors that there are areas of relatively good access very close to areas with much poorer specialist to child population ratio, often in more remote areas. “

“Children living in rural areas will have clinical needs just as children in urban populations do, although the specific needs aren’t looked at in this study.  I hope that individual health boards and regional NHS teams will look closely at these inequalities and take action to improve access for children to specialist-led care where it is required.”

The concept of developing specialist-led services is supported by BSPD which believes that by appointing consultants and specialists to leadership roles in areas where access is poor, the workforce can be up-skilled, developed and supported.

Urshla (Oosh) Devalia, BSPD’s Honorary Secretary and a Consultant in Paediatric Dentistr,y said that there are already parts of the country where specialists are being given a leadership role with a mandate to support GDPs in rural practices. However, more specialists are needed as well as more innovative models of care.

She said: ”There is no shortage of dental graduates wanting to train as a paediatric dentist but the recruitment system and the absence of collaboration between employers are barriers to developing the paediatric dental workforce.”

“We need to be working creatively and collaboratively to ensure that every child and young person is able to access highest quality, specialist-led paediatric dental services.”