Health visiting teams and children’s oral health: a scoping review

Abstract

Background Recent policies have recommended early-life interventions to prevent caries. The four nations of the UK each have a national universal children’s health programme, through which health visitors and their wider team (HVTs) promote health in the early years. HVT visits offer an opportunity to support parents to improve their child’s oral health. A scoping review was conducted to provide a descriptive synthesis of the current literature related to the role of HVTs in improving the oral health of children 0–5 years old and to identify significant gaps for future research. This review informed the feasibility study of the First Dental Steps Intervention, a targeted health visitor-led infant oral health intervention in England. Methods Electronic database searches for peer-reviewed literature were performed using Medline via Ovid and Web of Science (1946–2021). The quality of included intervention studies was assessed using the Effective Public Health Practice Project tool. Additionally, a grey literature search was conducted (key organisations, bibliographic and thesis databases, forwards and backwards citation, Google). Results Thirty-nine publications, published between 1980 and 2021, were included. The majority of included papers were from the UK. The quality of intervention studies (n = 7) ranged from weak to strong. Thematic analysis identified the following themes: (1) professional knowledge, education, and training; (2) involvement of HVs in the delivery of oral health interventions; (3) effectiveness of interventions; (4) perspectives of HVs providing oral health advice and acceptability; and (5) barriers and facilitators to promoting oral health. The grey literature search identified 125 sources. HVT involvement was reported in a variety of source types: reports, guidance documents, evaluations, reviews, and training resources. HVTs were involved in oral health by providing oral health packs, brushing and oral health advice, registration and attendance, oral health training, risk assessment, and referral to dental services. Conclusion The current literature suggests that HVTs are well placed to improve children’s oral health. Facilitators and barriers are encountered by HVTs in promoting oral health which should be considered by commissioners. There is a need for future high-quality studies that address the inadequacies found and provide further evidence of the effectiveness of HVT’s oral health interventions.

The Public Health Approach to Oral Health: A Literature Review

“…Healthcare delivery included non-dental health workers, change care model-which focused on changing the oral care model-teledentistry, and mobile health (referring to the use of mobile devices for healthcare purposes, hereafter 'mHealth'). Here, non-dental health workers had the most mentions [31][32][33][34][35][36][37][38], followed by mHealth [39][40][41] and teledentistry [42,43]. In this case, teledentistry was separated from mHealth as articles that focused on mHealth involved OH education using social and/or digital media whereas those that mentioned teledentistry emphasized its use to increase access to OH services and OH screening.…”

“…Within education and awareness, identified components were OH education, OH behaviour change motivation, behaviour guidance, and OH advocacy. The majority of articles had some component of OH education in their strategies [13,14,[16][17][18][19][20][21][22][23][25][26][27][31][32][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49], followed by a component related to OH behaviour change motivation [18- We then analysed the data to identify the main components of said strategies and grouped them in clusters based on their thematic similarities-focusing on educational, service-related, intervention, and policy aspects of OH. There were four clusters: (1) education and awareness, (2) OH services and access, (3) interventions and treatments, and (4) policy, environment, and population health.…”

“…Within education and awareness, identified components were OH education, OH behaviour change motivation, behaviour guidance, and OH advocacy. The majority of articles had some component of OH education in their strategies [13,14,[16][17][18][19][20][21][22][23][25][26][27][31][32][33][34][35][37][38][39][40][41][42][43][44][45][46][47][48][49], followed by a component related to OH behaviour change motivation [18][19][20][21][22]31,33,34]. OH education was most commonly found in articles that cited strategies using non-dental health workers [31][32][33][34][35]37,38] and community-based strategies [13,14,…”

“…OH status was included within this cluster, as opposed to interventions and treatments, as it refers to the current condition of OH as identified by a health worker. Within this cluster, the component 'access to OH services' was the most prevalent [27,32,[34][35][36][37]40,42,43,45,49,50], followed by OH status [14,16,18,19,39]. The cluster interventions and treatments included four components: OH restorative treatment, chemical interventions (fluoride and/or chlorhexidine), mechanical interventions (toothbrush), and teledentistry.…”

“…The final cluster, policy, environment, and population health, included the following components: OH policies, food environment, population health, and evidence-informed OH. The OH policies [32,51] and population health [12,29] components were the most prevalent.…”