Study supporting the implementation of ’Childsmile’ Fluoride Varnish guidance in General Dental Practice

Childsmile is a national Government-funded programme delivering multidisciplinary primary caries prevention, anticipatory care and appropriate management of caries via NHS dental services (and other settings including nurseries and primary schools). It is designed to improve the dental health of children in Scotland and to reduce inequalities both in dental health and access to dental services.

The Practice-based component promotes oral health from birth to 16 years of age with advice, support and clinical prevention tailored to the needs of the individual child by primary care dental services. Childsmile has been integrated into Statement of Dental Remuneration (SDR) and all Dental Practices delivering NHS care to children are expected to deliver Childsmile interventions. These incorporate: dietary advice; toothbrushing demonstration for parents and carers; fluoride advice; and clinical prevention via the application of sodium fluoride varnish, as appropriate.

Despite evidence for improved oral health through the wider Childsmile programme, there are reports that delivery of this key preventive intervention to children registered with an NHS dentist in Scotland is still varied, and substantially below HEAT target H9. Around 14% of children in the relevant age group received 2 applications in 2013/14 against the target: "At least 60% of 3- and 4-year-old children in each SIMD quintile to receive at least two applications of fluoride varnish per year by March 2014".
Recent quantitative evidence suggests that varnish is not being applied to children’s teeth in GDP as often as current clinical guidelines would advocate. There are further concerns about the quality of the preventive advice, particularly relating to diet/ nutrition. Glasgow Dental School Community Oral Health group are proposing this PhD as part of their Prevention-in-Practice (PiP) research theme.

This proposed project will draw from work already carried out including two published national surveys of Dental Nurses and General Dental Practitioners and over 40 in-depth interviews with Practice- staff as well as key stakeholders in public health and Government.

Aims
The main aims of this project and key stages are:
a) To synthesise (survey and interview) evidence currently being gathered at Glasgow Dental School on the reasons for this translational gap between guidance and varnish application in practice.

b) To design, and pilot, an intervention, based on these previous steps, to improve the uptake and quality of the preventive consultation.

This is likely to be a complex intervention and will require collaboration with behavioural scientists and a trials design specialist. Outcomes and control groups will be developed in conjunction with the Childsmile Central Evaluation and Research Team (CERT) Executive.

You will develop skills in public health, trials design, statistics and qualitative research and evaluation, and will be given training in other more generic and transferrable research skills through our college’s Graduate School (http://www.gla.ac.uk/colleges/mvls/graduateschool/ ).

You will be based within the Community Oral Health Research Group within Glasgow Dental School (http://www.gla.ac.uk/schools/dental/research/) and will be part of a thriving and active community of postgraduate research students.

Applications can be made via the University of Glasgow’s online application system: http://www.gla.ac.uk/research/opportunities/howtoapplyforaresearchdegree/

When applying, please choose ’MVLS - PhD’ from the drop down menu and enter the project title in the free text box.

Start date: 6 January 2016