Health Boards are responsible for the application of Duraphat® through a protocol and ensuring that staff who apply it are competent to undertake this. The Protocol for the supply and application of Duraphat® varnish to children aged two years and upwards in the Childsmile Nursery and School Programme must be read, agreed to and signed by all dental healthcare staff involved in its use. The protocol must be easily accessible to all healthcare staff in the clinical setting.
Class lists
Class lists are required to populate the HIC system. Local Education Departments may be happy to provide class lists for the nurseries/schools – if this information is provided electronically it can be forwarded directly to HIC to be added to the database. In the event of a class list not being provided to the DHSW this should be escalated to the Childsmile Coordinator.
If a local Education Department is unwilling to provide class lists, the total class numbers have to be obtained from the schools and added to the database to ensure that sufficient stocks of consent packs are given to the schools. It will also help to give accurate consent rates. If class lists are not available the children’s data will need to be manually entered into the HIC system on receipt of the completed consent forms.
Fluoride varnish consent
On the first occasion that a child is offered the Childsmile Nursery/School programme, parents will receive a consent form which requires to be returned to the school. This form requires to be completed only once.
Medical History Update
For subsequent fluoride varnish applications, a fluoride varnish update information letter, which asks for an update of medical history and other details (every six months), will be sent to the parent of the children via the nursery/school.
Managing Consent
Details/information obtained from these documents should be entered into the HIC system as per HIC User Guide.
The Childsmile consent process provides guidance on how children’s consents will be processed.
All fluoride varnish consent forms and returned fluoride varnish update information letters with changes to medical history are sent to HIC for scanning. Local procedures for sending confidential information should be followed.
Refused Consent
Children whose parents have said no to fluoride varnish in the past should have the opportunity to access the programme on each occasion that it is offered in their nursery or school. The numbers of full consent packs for any class is the difference between the number of children in the class and the number who have a personalised fluoride varnish update information letter printed.
Opt Out Process
A procedure and paperwork for parents who want to opt their child out of Childsmile is available from local Coordinators.
Childsmile letters
Letters used to correspond with parents, and the HIC User guide describing how the letters are generated from the HIC system, are available from the Childsmile HIC help section. The HIC system can only be accessed from NHS computers.
Supporting Consent
Ensuring a high consent rate may require additional support locally to ensure that Fluoride Varnish is available to all especially the most vulnerable.
Supporting consent on a one-to-one basis requires that all aspects of the Childsmile Programme are explained to parents. Offer the parent the consent form to take away and consider, or offer to help them to fill it in at the time of meeting.
If completing the form with the parent:
- ask the parent to read the supporting oral health information and check whether they have understood this
- ask if the child has any allergies (especially sticking plaster) or has ever been admitted to hospital for severe allergies or asthma. If they have, fill in the form, noting any allergies and ticking the boxes regarding allergies and hospitalisation for allergies or asthma and keep in the child’s record. Remember, this child may not be eligible for the fluoride varnish part of Childsmile Nursery or Childsmile School. They should have a full individual risk assessment carried out by a dentist and a decision taken on whether it is clinically appropriate for fluoride varnish to be applied.
- ask the parent to sign and date the form
- if the parent wants help to find a dentist for their child follow local procedures for this.
- If the parent wishes to take the consent form away to consider, arrange a suitable method of contacting them via the nursery/school or by telephone in order that the consent process can be followed up.
Communication
Gaining a rapport with both the child and their parent/guardian/carer is essential in building a relationship and establishing positive two way communication.
The fluoride varnish training involves the use of behavioural management and brief intervention techniques to aid communication;
- Welcome and introduce yourself by name
- Be caring and non-judgemental
- Show compassion and empathy
- Use active listening
- Be aware of body language
- Ask open and engaging questions
This page is currently under review if you have any feedback please email nss.childsmile@nhs.scot