The project was able to reach not only the patient in question, but the patient’s 5-year-old younger sister also. In the London area almost 1/3rd of 5-year-old children have had dental decay, and the percentage of children with active decay is higher than the national average in this cohort (Royal College of Surgeons, 2012). Thus this is an example of the invaluable opportunity the project has provided to gain access to a wider reach of patients within the patients family, whom may otherwise not have received dental care.

The initiative was taken to take a history and complete a limited intra-oral examination. This allowed us to provide tailored oral hygiene instruction and preventative advice specific to each patient, Including evidence based advice from the delivering better oral health toolkit. For these children it was the first time they had been shown how to brush which is invaluable knowledge they can take forward. This advice given would aid the parent also; as they are advised to supervise their child’s brushing until they are capable of doing so well themselves

It was found that the patient had a diet high in fruit juices & fizzy drinks, as well as a high number of snacks such as sweets and biscuits. After learning more about the patient’s dietary habits, we were able to provide realistic and achievable goals for the family to follow, aiding in reducing the risk of dental caries for the whole family.

It was learnt that neither children had been for a dental check up before. We were able to give our contact details, as well as details of local NHS practices in the area, at which the patient could make an appointment. Again this is aiding in removing barriers of access to care, informing the family of the correct time to have dental check-up and aiding in arranging such visits. A way in which this can be developed in the future could be to have a follow up protocol, to ascertain if the parents had taken the child for a check up, and if not what could be done to promote them to visit a dentist.

Royal College of Surgeons. 2012. The State of Children’s Oral Health in England. [Online]. [Accessed 20/07/2016]. Available from: https://www.rcseng.ac.uk/fds/policy/documents/fds-report-on-the-state-of-childrens-oral-health

Children with asthma are at higher risk of (Stensson et al. 2010):
 Caries
 Gingivitis
 Dental erosion (Harrington et al. 2016)
 Candidiasis (Harrington et al. 2016)

Due to (Harrington et al. 2016):
 Increase intake of sugary drinks
 Mouth breathers
 Parental overindulgence
 Increased medication effects (Harrington et al. 2016)

The following key messages can be given out verbally or in written form (leaflets, pamplets, posters) by all of the medical professionals listed above.
Adapted from (Harrington et al. 2016)
1. Educate patients about their increased susceptibility to oral disease.
2. Encourage regular dental check-ups with enhanced prevention.
3. Advise mouth rinsing or tooth brushing after inhaler utilisation.
4. Advise the use of a spacer device to deliver asthmatic drugs directly to the airway.
5. Advise the use of sugar-free chewing gum, particularly after meals to increase salivary flow and buffer the acidic effects of medication.
6. Be aware that asthmatic patients tend to mouth breath, have a reduced salivary flow and tend to ‘wash away the taste of the medication’ all of which results in an increase of fluid intake.
7. Ensure that patients understand the implications of frequent intake of sugary drinks and advise the consumption of water only.