The pilot suggests that people at risk of developing type 2 diabetes could be identified in primary, community and secondary dental care settings. The main challenges facing dental staff were time constraints, limited manpower and the low number of patients who visited their GP for further advice.

This systematic review aimed to assess the association between food and drink consumption around bedtime-specifically, food and drinks containing free sugars-and the risk of dental caries in children. Five electronic databases were searched (PubMed, Ovid Medline, EMBASE, Web of Science, and Scopus) to identify studies that investigated any relationship between food and drink around bedtime and dental caries in 3-to 16-y-old children. The Agency for Healthcare Research and Quality domain guidelines were used to assess the quality of the individual studies, while GRADE guidelines assessed the quality of studies based on the body of evidence. From 1,270 retrieved titles, 777 remained after removal of duplicates. Of these, 72 were reviewed in full. Eighteen studies fulfilled the inclusion criteria and were included in the analysis: 13 cross-sectional, 4 cohort, and 1 casecontrol. Studies were categorized into 3 age groups: 3-to 5-y-old, 6-to 11-yold, and 12-to 16-y-old children. Based on the Agency for Healthcare Research and Quality criteria, 6 of the 18 studies were rated as providing good-quality evidence; 8 were rated as fair; and 4 were categorized as being of poor quality. It was not possible to conduct a meta-analysis, because of the considerable variations in the type of bedtime exposure and outcome measures. The studies showed a consistent positive association across the 3 age groups, with all 7 studies on preschool children reporting significant positive associations. However, the quality of the body of evidence pertaining to the consumption of food and drinks at bedtime (specifically, food and drinks containing free sugars) and risk of caries was rated as "very low." The results suggest that restricting free sugars before and at bedtime may reduce the risk of caries, but studies with improved design are needed to confirm this. Knowledge Transfer Statement: This is the first systematic review of the evidence assessing the association between caries risk in children and the consumption of food or drinks at bedtime-specifically, foods and drinks containing free sugars. Although the data showed a consistent positive association, the quality of evidence was very low. This means that the current recommendation to restrict food and drinks containing free sugars before bedtime in children, while based on a sound physiologic premise, is supported only by very low-quality published evidence as measured by GRADE guidelines.

ObjectivesTo assess the number of parents who visited community pharmacies in London seeking pain medications for their children’s pain and specifically for oral pain, to identify which health services parents contacted before their pharmacy visit and to estimate the cost to the National Health Service (NHS) when children with oral pain who visit pharmacies also see health professionals outside dentistry.DesignA cross-sectional study.Setting1862 pharmacies in London in November 2016–January 2017.ParticipantsParents, carers and adolescents purchasing over-the-counter pain medications or collecting pain prescriptions for children (0–19 years).Brief interventionA survey administered by pharmacy staff to participants and a guidance pack.Main outcome measuresThe number of parents who visited pharmacies seeking pain medications for their children’s pain and oral pain and the number of parents who contacted health professionals outside dentistry before their pharmacy visit. Estimated costs of visits by children with oral pain to health professionals outside dentistry.ResultsOne in two (951) pharmacies participated collecting information from 6915 parents seeking pain medications for their children. The majority (65%) of parents sought pain medications to relieve their children’s oral pain. Only 30% of children with oral pain had seen a dentist before the pharmacy visit, while 28% of children had seen between one and four different health professionals. The cost to the NHS of children contacting health professionals outside dentistry was £36 573, extrapolated to an annual cost of £373 288. Replicating these findings across all pharmacies in England could mean that the NHS spends an estimated £2.3 million annually when children with oral pain inappropriately use multiple health services.ConclusionMost parents who visited pharmacies for children’s pain medications in London sought pain medications for children’s oral pain. Children’s inappropriate contact with multiple health services when they have oral pain adds significant costs to the NHS.

Introduction: Tooth decay is the most common reason for non-emergency hospital admissions in 5-9 year olds. As such, it is included in the England school curriculum at 8-9 years to facilitate improved oral hygiene and prevent tooth decay. Aim: Measure student and teacher baseline oral hygiene knowledge; determine effect of the e-Bug oral hygiene lesson on student knowledge; explore teacher views on the lesson. Methods: Mixed methods evaluation. Baseline student and teacher knowledge questionnaires. Intervention classes received the e-Bug lesson. Post-intervention student questionnaires and semi-structured teacher focus groups. Results: 121 students completed baseline questionnaireresults indicate high knowledge about which foods/drinks are bad for teeth; low knowledge about tooth decay and appropriate tooth brushing behaviours; confusion over what foods and drinks contained sugar. 58 students received the intervention; 10 out of 17 questions in lessons showed significant increase in correct responses (p < 0.05). No significant improvements reported in the control. Overall teachers were very positive about the lesson and suggested some improvements. Conclusion: Children have gaps in oral hygiene knowledge. Teachers acknowledge oral hygiene as a priority which should be taught more frequently, citing e-Bug as a valuable oral hygiene educational resource. Curriculum leaders should be encouraged to increase oral hygiene education using a whole school approach.

BackgroundIn England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated interview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing the re-occurrence of dental decay in young children with previous dental extractions.Methods/DesignThis 2-year, two-arm, multicentre, randomised controlled trial will include 224 child participants, initially aged 5 to 7 years, who are scheduled to have one or more primary teeth extracted for dental caries under general anaesthesia (GA), relative analgesia (RA: inhalation sedation) or local anaesthesia (LA). The trial will be conducted in University Dental Hospitals, Secondary Care Centres or other providers of dental extraction services across the United Kingdom. The intervention will include a brief negotiated interview (based on the principles of motivational interviewing) delivered between enrolment and 6 weeks post-extraction, followed by directed prevention in primary dental care. Participants will be followed up for 2 years. The main outcome measure will be the dental caries experienced by 2 years post-enrolment at the level of dentine involvement on any tooth in either dentition, which had been caries-free at the baseline assessment.DiscussionThe participants are a hard-to-reach group in which secondary prevention is a challenge. Lack of engagement with dental care makes the children and their families scheduled for extraction particularly difficult to recruit to an RCT. Variations in service delivery between sites have also added to the challenges in implementing the Dental RECUR protocol during the recruitment phase.Trial registrationISRCTN24958829 (date of registration: 27 September 2013), Current protocol version: 5.0.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-1010-9) contains supplementary material, which is available to authorized users.