Shaking up the system

By Amelia Seselja BOralH, MBA

I’M OFTEN ASKED how I got involved in oral health promotion. Although I started my professional working life in a clinical role, I have built my career from my involvement in oral health promotion.

I want to share two examples of projects that I have developed and led in community oral health promotion. These projects are vastly different in their target groups, objectives, scale and strategies. The first, is a grass-roots oral health education program for children in my local community. The second, is a national program that provided much needed dental treatment for victims of domestic violence.

Although completely different, both projects accomplished wonderful outcomes for the community and importantly made a lasting contribution. Hopefully, by sharing my experience, I can encourage others to take advantage of opportunities to work and volunteer in oral health promotion.

After graduating from university, I worked for a wonderful dental practice in my hometown. While working in my clinical role, I began a side project, developing an oral health promotion program for the practice. This program came about for a number of reasons. I really enjoyed the therapy component of my role, working with children and creating a positive dental experience for them. I wanted to grow our therapy department, and I wanted children and their families to want to come and see us. I was very aware though, that many children in our community did not have a dental home. I was seeing and treating many children for the first time only when they presented with a toothache and were booked in for an emergency appointment. I knew I needed to find a way to engage with my community, promote key preventative messages and reinforce the importance of establishing a dental home from very early on. I wanted children and families in my community to have a positive first experience with a dental professional, and this school program enabled that.

I started small, working with just one school that I had a connection with (my youngest sister’s primary school). I found that it was easier to build a relationship with a school when you had a personal link. E.g., it’s your old school, your children’s school, or you have a friend who teaches at that school. No matter how minor the connection is, it provides the perfect introduction opportunity to run a school-based program.

Initially, I piloted the program with just a few classes. This allowed me to facilitate smaller sessions and build my confidence, as well as improve and adapt the content that I had developed. After successfully implementing the initial program, I developed new lesson plans for different year levels and added resources such as ‘a tooth-friendly lunch box guide’ for the school to share with parents.

This oral health education program continued to evolve, and over several years became part of the school’s permanent program. In addition to my clinical role in the practice, delivering these education sessions became an important part of my responsibilities.

Over time, I progressed to training other team members on how to prepare and deliver these sessions. With more team members equipped to facilitate these sessions, our practice was then able to scale the program and deliver it to other schools across the community. Having several team members skilled to deliver these sessions, ensured the sustainability and longevity of the program.

Not only did this school program help children in our local community understand the importance of establishing good oral health habits, but this program was also a fantastic practice builder.

Through the groundwork of this program, we were able to create a referral pathway back to the practice and create a dental home for children in our community. A referral pathway is a key strategy in oral health promotion. Using these classroom sessions to educate, screen, and refer I was able to connect with many parents from the school communities and build trust and rapport with children that would ultimately become our patients.

Of course, there were challenges in getting a program like this started. The hardest part was carving out the time from the clinical schedule and justifying why we were giving free educational sessions and not billing. It was a juggle to find the time to create these sessions, liaise with the various schools and even find time to pack oral health take-home bags for the students. In practical terms, for me, it meant I did a lot of this extra work during my lunch breaks and after hours.

Similarly, when I started working at a paediatric practice, I was able to take my experience and learnings in this area and adapt them to set up an oral health education program for working with children with special needs. This time, not only working closely with the teachers at schools but also with the specialists to develop and implement the sessions. Once again, this work generated a referral pathway back to the practice and established a dental home for the children.

If you want to run an oral health education school program, I would highly recommend it. It is such a fantastic way to connect with your community outside the dental setting, which is important when it comes to oral health promotion. Weighing up the extra work involved in getting these kinds of programs off the ground, against the long-term benefits, in my opinion, is worth it.

I found school sessions such a rewarding part of my job and I learned so much from establishing and implementing them. I saw firsthand the positive impact these oral health education sessions had, not only for the practice but for the wider community.

If you are interested in running a schoolbased program, but short on time and resources, there are fantastic tools and resources already available. Colgate’s Bright Smiles, Bright Future program has so many well-developed resources for both preschool and primary school children that can be used for these sessions, you can order a kit with everything you need, and better yet these kits are free!

If you are looking for extra resources and activities such as dental health crosswords, colouring sheets and even extra lesson plan ideas for students, check out the American Dental Association’s Mouth Health Page. There are so many key dates throughout the year too that you can link to an oral health education session, such as World Oral Health Day and Dental Health Week. You can also do these education sessions with your local library or community groups.

Rebuilding Smiles® was one of the most challenging, yet rewarding programs that I delivered during my time working for the Australian Dental Association. This program provides much-needed access to dental care for victims of domestic violence. Victims of domestic violence can present with oral health problems as a result of abuse, this has a significant influence on oral health behaviour and oral health status.

This project was complex to develop; it had many moving parts and several multifaceted factors to consider. For example, what was the model of care?

How could we build partnerships with key agencies working with such a vulnerable group? How could we support the patients during their treatment journey? How would we support our volunteers? And, how could we fund this program?

Significant planning, problem-solving, and coordination are required in oral health promotion. This program required a coordinated and collaborative approach with a range of stakeholders to enable the delivery of care. When we first rolled out the program, it was piloted in just one Australian state.

If you are looking to develop and scale a program, a pilot is critical. In the case of Rebuilding Smiles, the pilot program allowed us to evaluate our lessons learned. It helped us identify what was and wasn’t working and what had been missed in the planning stages. It enabled us to improve a number of aspects of the program before it could be scaled and rolled out nationally.

The pilot program also gave us the ability to be able to report on the outcomes of the program. Reporting is vital to a successful oral health promotion program, as reporting allows you to share your outcomes with your key stakeholders. Reporting allows you to also gain attention for your program, and this is important for several reasons, especially if you are looking to scale your program. You may use your reporting to leverage the media (either traditional or social media). This is a great way to promote your program to those who the program has been designed for and attract potential funding partners, volunteers and supporters to enable you to scale up your program. This program was particularly rewarding to see come to life. Witnessing what this program meant to those in the community was an important moment in my career. A quote from one of the first patients who went through our

program will always resonate with me “This program has not only helped me, it has flowed on to help my children, and enabled me to be at my best to offer more to my community”.

Rebuilding Smiles was established in 2016 and is still running today, this is a good sign that the program has been developed to be sustainable. Although I am not directly involved, I am very proud to work for Colgate which has been and remains a key funding partner for Rebuilding Smiles.

My work in this space has allowed me to build networks with a diverse group of people, develop partnerships and has opened many doors for me professionally. Being involved in oral health promotion at all levels has given me a unique skill set and the experience to be able to develop a vast range of oral health promotion programs, strategies, campaigns, policies, and resources. With every project I developed, there were always many lessons to be learnt. These lessons built my experience, insights and knowledge of the different target groups, as well as the different strategies for oral health promotion.

This work is equally as challenging as it is rewarding, because the truth is, oral health promotion is complex. There is not one simple solution or strategy to improve the oral health of everyone in our community. Rather, oral health promotion requires long-term and collaborative approaches with coordinated actions, across multiple levels. The responsibility must be shared amongst a range of stakeholders, including government, industry, community, dental professionals, and individuals.

By getting involved you not only gain experience and build your knowledge and skill set, it also means that you are part of the actions that aim to ensure all Australians can enjoy and maintain good oral health throughout their lives.