Service Delivery Model

The provider will need to develop a service delivery model detailing the approach to:

Identifying eligible settings/children (if applicable) - consider:
- How will the provider get the required information about settings from the local authority education and public health teams?
- How will settings be contacted? And when? Sending out a joint letter, to settings, from the Director of Public Health and provider may be more influential than a letter from the provider alone.
- How will refusal of settings be handled?
- How will the supplies be sourced and delivered?

Identifying any locally existing supervised toothbrushing programmes or oral health promotion initiatives

Delivering the service
- Consider if any activities will be outsourced and if so, how will this be managed, and if that service delivery meets the requirements of the service spec.

How will the consent process of participants be managed, including refusal?

Will an oral health champion be appointed in each setting?

How will staff training in settings be delivered and assessed? This may be determined by the commissioners, but if not, the provider needs to consider what is more appropriate - delivering training in-person or online? Assess how well you think the training will be cascaded down to other staff members and how often it may need to be delivered.

Age range of children - what additional considerations may need to be made for settings with younger children (2-year-olds)?

How will the provider engage with the parents via the setting?
- Including parents with additional needs, language barriers, literacy barriers, lack of internet access. Consider engaging parents in oral health sessions.

How will they:
- encourage parental supervised toothbrushing at home including providing information on the importance of the continuance of toothbrushing over holidays?
- use the supervised toothbrushing programmes as an opportunity to identify, address and promote the health of children more generally (Making Every Contact Count)

How will they make the club available to children with special educational needs and/or disabilities?
- Considerations include tailored training, availability of more support, types of toothbrushes and toothpaste.

How will access to a dental professional for advice, if needed, be provided?

How will on-going support be provided and maintained to settings?

Decisions about the different configurations of toothbrushing (see below for more details) to use for example dry or wet brushing and the choice of toothbrush rack (toothbrush holder) system
- For example, one company may provide a toothbrush rack system where the brushes are the same colour as the racks, that have spaces with names and pictures on the racks and names and pictures on their brushes. Whereas another company has multicoloured brushes and no space to write names on the toothbrush racks.

Different models of supervised toothbrushing programme delivery

It is important to emphasise that the aim of supervised toothbrushing is daily toothbrushing. Discuss with the settings the different models of delivering the toothbrushing club to enable them to decide what works best for them to achieve this.
For example, consider the following:

Dry or wet method brushing

The number of children with special needs. What implications might this have? Particularly if they need additional supervision.

The staff-to-child ratio and the implications of the method chosen

Where will the children brush? Will the children be sat on the carpet to brush, or sat at a table?

The age range of the children. What implications might this have?

When will the children brush? How compatible is the time chosen with their daily schedule?

Further considerations:

Centres of religion

Consider approaching local centres of religion/faith to reach a wider audience. An example of this is the project in Bradford. This project raised oral health awareness in mosques, introducing the Prophet Mohammed as a role model to encourage young children to look after their teeth and eat well.
Poster programmes

Advertising information about the programme through public advertisement, such as banners on buses, at bus stops, and across available poster-stands. Also, in places where families and people who work with young children and families are likely to visit such as local library, swimming pool, children’s centres and supermarkets. Consider if you need to provide posters in additional languages to address potential language barriers
Health visiting teams

Working with health visiting teams to coordinate information, raising awareness of toothbrushing programmes to new parents, and offering information to them.
Link with other campaigns

Consider approaching other healthy lifestyle campaigns, to coordinate work and spread information more widely. An example of such a campaign is the GULP (Give Up Loving Pop) campaign which raises awareness on the negative impact sugar has on teeth and overall health.
School initiatives

Consider finding existing health/oral health initiatives to help raise awareness of the Supervised Toothbrushing Programme. There are several initiatives already in place across different areas of the country, such as ‘Book, Brush, Bed’, which seek to instil healthy and regular routines.
Social media

Being very active on social media about the programme. This raises awareness for parents, settings within a particular area, and perhaps possibilities for shared peer-to peer learning.
Local magazine or newspaper

Consider raising awareness through your local magazine or newspaper. You can advertise the presence of the programme or engage the community through local competitions. One such example is where a provider liaised with the local council and local supermarket to advertise a summer colouring competition of toothbrushes and toothpaste. The local councillor decided the winner, and in collaboration with the supermarket, they were provided with a fruit hamper, toothbrushes and toothpaste as a prize.
Involve local library services

If possible, provide local libraries with the funds to send local nurseries/schools a resource box and discuss the possibility of providing all 3-year-olds a book on toothbrushing.
Community building

Liaise and build partnerships with family agencies supporting families such as charities, food banks, local farms, etc. Provide them with oral health training so everyone is giving consistent messaging.