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Supporting healthy oral habits from the start

Last year the University of Leeds received £109,000 through Better Start Bradford’s Innovation Fund to improve oral health for 0-3’s in Bowling and Barkerend, Bradford Moor and Little Horton by delivering their ‘Enhancing the HABIT’ project with the area’s Health Visitors as soon as COVID-19 allows.

HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing) is a Medical Research Council funded research intervention which supports Health Visitors to have effective conversations around baby and young children’s oral health with families.

In this latest update, Dr. Amrit Bhatti, a Research Assistant at the School of Dentistry, University of Leeds, shares how the team, led by Dr. Peter Day, have been consulting with local families through WhatsApp to shape their materials to support families and their babies with good oral health.

Dr. Amrit Bhatti’s Update

It has been a real challenge to undertake our project during the pandemic. In this brief story, we just wanted to update on our progress and share some learning.

Our Enhancing the HABIT project is about establishing good oral health habits (such as toothbrushing with fluoride toothpaste and limiting sugary foods and drinks) for young children and is critical for healthy teeth and a beautiful smile in adult life.

In Bradford, around two in every five children have tooth decay by the age of five. HABIT is a project working with health visitors and parents in the Better Start Bradford area. Health Visitors see all babies at 9-12 months old and we know that parents value their advice and support.

Within this visit, there is an excellent opportunity to talk about oral health. The HABIT resources were developed to support these oral health conversations between Health Visitors and parents. Our initial research, soon to be published, showed that the oral health conversations were well received and led to positive changes in children’s’ toothbrushing behaviours. 

The team at the University of Leeds are working on a project to improve the HABIT leaflets and videos further. We want to ensure that the resources are appropriate and accessible to different communities within the Better Start Area. Despite the barriers we may have faced with engaging with communities during lockdowns and restrictions, the research team has spoken to parents about the HABIT resources using WhatsApp. Parents were found with the help of the Better Start Bradford team and wider Neighbourhood engagement workers. We will continue to explore avenues which are accessible to parents in these identified communities during this lockdown period.

Using WhatsApp meant that the research team could access communities that would have otherwise been difficult to reach. Parents felt comfortable using WhatsApp video as a platform they are familiar with, instead of Zoom, Skype or Microsoft Teams. 

We’ve had some great feedback about the resources that we have developed so far. One parent said: “I didn’t know you had to do that [parental supervised brushing] until you guys come out. Even our ten-year-old still needs a little bit of help on getting to the back and stuff. So that kind of helped us out, but with regards to brushing I wasn’t sure of the amount that you put on the toothbrush or anything like that.” 

Another parent of a baby said: “At first, I was a bit nervous… I always thought I was hurting him when I was brushing his teeth. After speaking to my Health Visitor in quite a bit of detail they showed me how to try different ways until you find one that works well. So, what we do is, I brush his teeth then I let him do it and then I go back over them at the end.”

We are also working with Health Visitors on how best to train them to use the HABIT resources. Training events are booked for late April with around 50 health visitors already booked on. These sessions will be interactive, and we have worked with actors, parents and senior Health Visitors to develop ‘real-life’ scenarios, which have been recorded through Zoom to imitate how messaging will be shared until life returns to normal.



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