december 16, 2017
When
Paul and I were helping communities fight off incinerator proposals in
North America (between 1985 and 1995) we found that we could only go so
far saying “no.” To
win the battle you
have to say “yes” to something else. Politicians do not want to be confronted with the “status quo” versus “chaos.”
Things got easier when we and others showed there were better, safer and cost-effective alternatives than either incineration or mega-landfills (see Paul’s book The Zero Waste Solution… (Chelsea Green, 2013). In the case of fighting tooth decay –especially among children from low income families- there is also a better solution than fluoridation, which is far safer, more appropriate, more cost-effective, and better for the overal health of the child. That solution has been used very effectively in Scotland for several years. It is called “Childsmile.” Below are some of the principles, practical details and the history of this program. But first an update on our annual Fundraiser.
The Childsmile program in Scotland
have to say “yes” to something else. Politicians do not want to be confronted with the “status quo” versus “chaos.”
Things got easier when we and others showed there were better, safer and cost-effective alternatives than either incineration or mega-landfills (see Paul’s book The Zero Waste Solution… (Chelsea Green, 2013). In the case of fighting tooth decay –especially among children from low income families- there is also a better solution than fluoridation, which is far safer, more appropriate, more cost-effective, and better for the overal health of the child. That solution has been used very effectively in Scotland for several years. It is called “Childsmile.” Below are some of the principles, practical details and the history of this program. But first an update on our annual Fundraiser.
Fundraiser update
Yesterday
saw a large jump in our total. First, we were able to reach $50,000,
which triggered a pledge of $2,000 from one of our super angels and then
donations came in steadily throughout the day eventually reaching a
total $56,145 from a total of 220 donors. We are still a long way from our mini-goal of $120,000 by Christmas Eve but as we found last year things vary by the day.
Please
give what you can afford over this weekend. The next bulletin will be
coming to you on Monday, but you can follow the progress of our
fundraiser on our home page (www.FluorideALERT.org ).
Thank you all for your donations. Every donation counts. At times FAN feels like a worldwide family.
Thank you all for your donations. Every donation counts. At times FAN feels like a worldwide family.
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How to Donate:
You can make a donation at our secure online server, or by check, payable to Fluoride Action Network, and mail to:
FAN
c/o Connett
104 Walnut Street
Binghamton, New York 13905
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The Childsmile program in Scotland
Childsmile
has become the model program for the prevention of dental caries in
young children in Scotland. Implemented in 2001 to target children from
deprived areas, it has proven to be far more effective than the
fluoridation of public drinking water in the U.S. and other fluoridating
countries. Unlike fluoridation, it does not force children to swallow
fluoride. However, Childsmile does target children at greatest risk of
caries for fluoride sealants and they do encourage the use of toothpaste
with fluoride. There is a similarly successful program called the Nexø
Program in Denmark that does not use fluoride toothpaste or sealants. We
will discuss Nexø in another bulletin.
• It’s a program to encourage nursery children to brush their teeth
• It involves staff at all Scottish nurseries offering free supervised tooth-brushing every day.
• It also helps parents establish a healthy diet from the earliest stage.
•
According to Public Health Minister Michael Matheson, “By this simple
measure, NHS costs associated with the dental disease of five-year-old
children have decreased dramatically.”
•
Glasgow researchers found that the scheme had reduced the cost of
treating dental disease in five-year-olds by more than half between 2001
and 2010.
• It costs about £1.8m a year.
• It has saved more than £6m in dental costs, according to a new study.
In a Scottish Government press release in September 2017:
“The
Childsmile programme, with its emphasis on prevention, rather than
treatment has resulted in significant improvements in children’s oral
health across Scotland. Our aim is that every child has access to
Childsmile.”
I
think the success of Childsmile is because from the government down,
the Scottish people want health equality and they are willing to
collaborate to achieve it. Secondly, the target of the program is
prevention, not treatment.
Background
Background
In 2000, the British Dental Health Foundation
called upon the Scottish Executive to implement fluoridation of the
public drinking water “to combat tooth decay problems afflicting
thousands of children.”
Four years later, in November 2004,
the BBC reported that the Scottish Executive decided not to fluoridate
its public drinking water and “was instead planning a range of other
measures to improve the dental health of children.”
Preceding this decision the opposition to fluoridation was “overwhelming.” According to The Scottish Herald,
“Thousands have raised objections to any move by the Scottish Executive
to introduce what has been described as mass medication…” A 2005 news article reported that “97% of responses from the public” opposed fluoridation.
In January 2002,
the Scottish Consumer Council warned that pressing ahead with the
proposals [to fluoridate] could expose the public to ‘adverse health
effects’;
In November 2002, the Shadow Health Minister Nicola Sturgeon “rejected any plans to add fluoride to water supplies.”
In September 2003,
the Green Party MSP [Member of the Scottish Parliament] Robin Harper
stated “We [the Scottish Green Party] oppose water fluoridation on
health and ethical grounds. Fluoridation breaches medical ethics and
human rights by forcing people to take medication against their will,
and has been linked to bone cancer and premature puberty.”
On the Ethical Aspects of Childsmile
There is a 2009 published full-text paper on the web (which was also published in Bioethics) titled Tackling
socially determined dental inequalities: ethical aspects of Childsmile,
the national child oral health demonstration programme in Scotland.
It’s a refreshing academic exploration of Childsmile, such as the
“programme’s twin aims of improving oral health and reducing health
inequalities; … the rationale for making particular elements universal
or targeted; … an examination of the political values and evidence base
in relation to the programme’s development; … the area of
cost-effectiveness of Childsmile and whether prevention should be
prioritised over treatment”; … and the consideration of “how Childsmile
‘scores’ in terms of utility and justice…”
More on Childsmile
“Childsmile
is the flagship national oral health improvement programme for
Scotland. The overarching aims of Childsmile are to improve the oral
health of children in Scotland and to reduce inequalities both in dental
health and in access to dental services. There is also potential for
other health impacts particularly with regard to diet and obesity. The
Childsmile Programme is the main route to delivering the dental HEAT
target.
“The Programme has three main arms:
1.
Childsmile Core is a Scotland-wide initiative involving universal
supervised nursery school toothbrushing provision extended to Primary 1
and 2 classes in most deprived areas [4-6 and 5-7 years of age
respectively]; in addition to the free distribution of toothpaste and
toothbrushes, oral health improvement packs are distributed to every
child in Scotland on at least six occasions during their first five
years.
2.
Childsmile Practice targets children from birth and promotes oral
health improvement and clinical caries prevention in dental practice,
salaried primary care dental services and local community settings. This
element has focused on reorientating dental practice to an anticipatory
care and team approach to children’s dentistry, and integrating dental
services with wider health services and community initiatives. There has
been significant workforce development in creating Dental Health
Support Worker roles within public health nursing teams, developing
referral pathways, and training Dental Nurses ( DN) in clinical
prevention including toothbrush demonstration, dietary advice and
support, and as the child gets older the application of fluoride
varnish.
3.
Childsmile Nursery and School targets the most deprived 20% of
nurseries and schools by identifying the 20% of establishments with the
highest proportion of children living in the most deprived local
quintile, as defined using SIMD. These nurseries and schools receive
additional preventive initiatives in the form of twice yearly fluoride
varnish applications to children’s teeth by Childsmile teams. These
teams comprise DNs and DHSWs. The Childsmile teams also deliver oral
health promotion advice to parents and carers. In addition, the
Childsmile Nursery and School programme contributes to the creation of a
health-promoting environment within nurseries and primary schools and
provides additional pathways of referral into dental services for those
who have not yet accessed dental care…” Read more of this longer article here.
To access the Childsmile articles on the FAN website go to http://fluoridealert.org/news/?country=united-kingdom&sub=childsmile
Thank you,
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