This summer marks the 20th anniversary of Childsmile.
Childsmile is Scotland's national oral health improvement programme for children from birth to 17 years of age, which has helped transform the dental health of children in Shetland and across the country.
Childsmile was developed from two national demonstration projects including the National Supervised Toothbrushing Programme. Over the past two decades, the programme has expanded to provide targeted support for families, supervised toothbrushing, fluoride varnish applications and oral health advice from infancy through to the teenage years. In Shetland, Childsmile is delivered through dental clinics and early years settings and primary schools with support from Maternity, Child Health and Health Visiting teams in early childhood.
Michelle Sinclair, joint Oral Health Team Lead at NHS Shetland, said: “The mouth is a gateway to the rest of the body, and good overall health is impossible without good oral health. Over the years, Childsmile dental practice has given the children of Shetland — and their families — the opportunity to regularly discuss the prevention of oral disease with the Childsmile extended duty dental nurses.
“Toothbrushing and diet are a main focus of Childsmile dental appointments. Children can show us how they brush their teeth, have their brushing technique checked, and pick up personalised hints and tips to help them get the best results — a skill that will support them throughout their lives.
“Thanks to the toothbrushing programmes in early years settings and schools, most children are already fantastic brushers. It’s usually just about helping them reach those little nooks and crannies as they become more independent.
“When it comes to diet, we mainly discuss tooth‑friendly snacks and drinks between meals, and how to enjoy the occasional sweet treat without harming their teeth, we’re definitely not the ‘sugar police’!”
Zdenka Mlynarikova, Oral Health Support Worker at NHS Shetland, said: “I think Childsmile is a great way of introducing dental care to young children in a fun, engaging way. They usually participate in our visits with enthusiasm and are proud to share their achievements and progress with other staff and parents.”
Historically, Scotland faced significant challenges in children's oral health with epidemiological surveys, at one stage showing that approximately eight out of every ten five-year-old children in Shetland had experienced tooth decay. Today that picture has changed dramatically.
The latest figures show that more than 80 per cent of five-year-olds in Shetland now have no experience of dental disease, reflecting the sustained impact of prevention-focused programmes and the commitment of children, families, nurseries, schools and health professionals.
In addition to the benefits to health and wellbeing, Childsmile has also delivered substantial value for public spending. Research has shown that every £1 invested generated around £3 of NHS savings within five years, highlighting the long-term benefits of prevention-focused healthcare. Throughout Scotland, it is estimated that the early years toothbrushing programme for example, costs around £1.8 million annually while saving approximately £4.7 million in dental treatment costs.
Angela Hopwood, joint Oral Health Team Lead for NHS Shetland, said: "Childsmile has transformed the oral health of children in Shetland and throughout Scotland. The remarkable improvement we have seen over the last 20 years demonstrates what can be achieved through a consistent focus on prevention, partnership working and supporting families to establish healthy habits from an early age.
“As we celebrate 20 years of Childsmile within our small team, we also recognise the dedication of early years and school staff, dental teams, health visitors, parents and carers who have played such an important role in helping and supporting children enjoy healthier smiles and better starts in life. We could not have made these improvements alone."
While much progress has been made, Childsmile continues to work to reduce inequalities in oral health and ensure that every child in Shetland has the opportunity to benefit from good oral health.
Niki Kovacs, Oral Health Support Worker at NHS Shetland, added “While the Childsmile programme has delivered significant improvements in children’s oral health in Shetland, there is still important work to be done. The COVID-19 pandemic had a major impact on our community and many of the vital links between families and our support services was disrupted. Rebuilding those connections is the team’s key priority for the next few years.
“Part of Childsmile’s aim is to reduce health inequalities and ensure every child, regardless of their circumstances, has access to the same standard of oral healthcare advice, support and resources. The current cost of living crisis has made this work more important. Many families are facing financial pressures and may be forced to prioritise essential household costs over oral health products. By providing free dental packs, including toothbrushes and toothpaste, Childsmile removes financial barriers and ensures that children can establish healthy daily routines at home. Research shows a strong link between deprivation and poorer oral health outcomes. Access to free dental packs not only supports oral hygiene but also helps reduce inequalities by giving every child the opportunity to maintain healthy teeth. Small interventions such as these can have a lasting impact on children’s overall health, confidence and wellbeing. Supervised toothbrushing in early years settings and schools is about more than healthy teeth, it helps children develop independence, fine motor skills, self–confidence and positive daily routines that support overall development. The small team of dental health support workers in Shetland, are privileged to play an integral role in supporting children’s development and wellbeing from an early age.”
As Childsmile celebrates its 20th anniversary, the programme remains an internationally recognised example of how investment in prevention can deliver lasting improvements in children's health and wellbeing. Countries like Saudi Arabia, Malawi, Australia and Chile for example have adopted elements of Childsmile for their own oral health interventions.
Here in Shetland, the Oral Health Improvement Team is planning to extend the 20th anniversary celebrations through the summer months and into the new school term with a number of small events. The team would also like to hear from anyone, young and old, school staff, health professional or member of the public, who has had some experience or involvement in Childsmile over the years to help us build a Childsmile memory board. You can contact the team via the social media page or by emailing the team directly on shet.childsmile@nhs.scot.