Health Promotion Practice Guidelines (PDF 5MB) - South Australian ...

Health Promotion 

Practice Guidelines

Acknowledgements 

We would like to acknowledge and thank staff from across SA Dental Service 

who contributed to the development of the Health Promotion Practice Guidelines. 

Reference to the Evidence-based oral health promotion resource, developed for the 

Department of Human Services by Dental Health Services Victoria in association with the 

University of Melbourne Dental School, has been invaluable in the production of this document. 

For more information 

SA Dental Service 

Health Promotion Unit 

GPO Box 864 

ADELAIDE SA 5001 

Ph: 8222 9016 

Fax: 8222 9020 

TTY: 8222 8390 

www.sadental.sa.gov.au 

This publication may be reproduced in whole or in part for work, 

study or training purposes, subject to the inclusion of an acknowledgement of the source. 

© Department of Health, Government of South Australia, 2012

Contents 

1. Foreword, Executive Director, SA Dental Service 2 

2. Introduction, Director of Health Promotion, SA Dental Service 3 

3. Oral health in Australia 4 

4. Impact of oral disease 5 

5. Social determinants of oral health 6 

6. SA Dental Service as a setting for oral health promotion 8 

7. Applying health promotion principles within SA Dental Service 9 

8. Components of effective oral health promotion 10 

9. SA Dental Service Health Promotion Programs 11 

• Aboriginal Oral Health Program 

• Population Oral Health Program (Lift the Lip) 

• Crunch & Sip® 

• Smoking Cessation Program 

• General Anaesthetic Families Project 

• Supported Residential Facilities Program 

• Better Oral Health in Residential Care Program 

• Northern and Southern Aged Care Projects 

10. Community events and expos 13 

11. Oral health information resources 14 

12. Workforce development 14 

13. Guidelines for effective health promotion 15 

• Preschool children 15 

• Children aged 6 -12 years 21 

• Adolescents 27 

• Adults 31 

• People with special needs 37 

14. Ineffective health promotion strategies 41 

15. Undergraduate students 42 

16. Useful documents 44 

17. Summary of Evidence 45 

18. References 55 

Health Promotion Practice Guidelines SA Dental Service 1

1 

Foreword 

Prevention has to be a key part of any balanced set of 

strategies to improve the oral health of the South 

Australian population. Our public dental service has a 

long track record of striving to build effective prevention 

into the way it does business. 

In the early 1970s SA Dental Service introduced the 

‘Dental Health Education Unit’ with a focus on using 

evidence to plan the prevention strategies. A decade 

ago the then Board of Directors endorsed the creation 

of the Health Promotion Division of SA Dental Service 

to increase the focus on population health promotion 

and to lift its profile and influence in the organisation at 

all levels. 

In recent years the Dental Service has put considerable 

resources into the development of ‘clinical practice 

guidelines’ to assist clinicians to achieve the largest 

possible improvements in oral health within the clinical 

resources available. A few years ago an audit of health 

promotion in our service showed that staff needed 

similar support in health promotion. In this way the idea 

of the ‘Health Promotion Practice Guidelines’ was born. 

These comprehensive guidelines, developed after 

consultation with many clinical staff, provide the 

evidence for effective health promotion that will reduce 

oral health inequities and improve oral health outcomes. 

Training will be made available to support staff in using 

these guidelines. 

Health Promotion is not easy and it takes time to deliver 

results, but we have already seen the stemming of the 

decline of decay rates in children, increased attendance 

of Aboriginal people and increased smoking cessation 

to know that it works and is worth the effort. 

We already have a world class clinical service that has 

been recognised for its quality and effectiveness. These 

Health Promotion Practice Guidelines aim to ensure that 

clinical staff can complement these clinical services with 

successful contemporary health promotion. 

Dr Martin Dooland 

Executive Director 


2 

SA Dental Service Health Promotion Practice Guidelines

2 

Introduction 

In 2008 an audit of health promotion strategies 

confirmed that the SA Dental Service has: 

• a commitment to health promotion practice 

• health promotion principles incorporated into its 

key directions 

• resources allocated to health promotion 

• strong health promotion leadership. 

In response to the audit, it was recommended that 

health promotion practice guidelines be developed to 

support staff to plan and implement effective health 

promotion activities in their clinics and local 

communities. 

The development of the guidelines has been made 

possible through extensive reviewing of the evidence, 

mapping current practice and procedures and 

consultation with staff. 

The guidelines will provide the structure and support to 

enable staff to develop a range of local initiatives that are 

supported by the Dental Service. We believe that they 

will encourage staff commitment to health promotion, 

disease prevention and early intervention that will lead to 

improved oral health outcomes. 

Please use the guidelines to plan and prioritise your oral 

health promotion directions at the local level. 

Christine Morris 

Director Health Promotion 


The guidelines are designed as a practical summary of 

clinical and community based promotion strategies that 

are effective and should be adopted and what 

strategies are ineffective and should be avoided. The 

sections clearly outline what is possible in each of the 

target groups. 


3 

Oral Health in Australia 

Australia’s National Oral Health Plan 2004-2013: Healthy 

Mouths Healthy Lives aims to help all Australians to: 

• retain as many of their teeth as possible 

throughout their lives, 

• have good oral health as part of their general good 

health, and 

• have access to affordable and quality oral health 

services. 

Dental problems are very common in the Australian 

population. 

Despite significant improvements in the oral health of 

Australian children over the last 20-30 years, in recent 

years some of these gains have been lost and children 

in all socio-economic groups are now experiencing 

more decay. 

Many preschool children develop extreme and very 

extensive dental decay frequently requiring 

hospitalisation for treatment under general anaesthetic. 1 

Dental extractions and restorations are the most 

common reason for children under the age of 15 years 

to undergo general anaesthesia in hospital in Australia. 2 

Among Australian adults, there are persistent high levels 

of oral disease. 26% of adults have untreated dental 

decay, 23% have moderate to severe gum disease, 

15% experience toothache often or very often. 3 

Disadvantaged Australian adults generally suffer poorer 

oral health outcomes, with higher incidence of tooth 

loss, dental caries and gum disease. 

The oral health of Aboriginal and Torres Strait Islander 

people is significantly worse than the general Australian 

population. Aboriginal children experience approximately 

70% more dental caries than non-Aboriginal children, 

whilst Aboriginal adults have a higher prevalence of 

severe periodontal disease. 4 

A population health approach, that combines both 

public health and clinical services, and addresses the 

social determinants of oral health, is the most effective 

way to maximise oral health outcomes for all Australians, 

particularly those with poor oral health. 

4 


4 

Impact of Oral Disease 

Good oral health is essential for overall health and 

wellbeing. A healthy mouth has a positive impact on 

physical, mental and social wellbeing. 

The impact of oral disease is not only on the individual, 

but also on the community generally through health 

system and economic costs. 5 

Poor oral health can cause pain, interrupt sleep, affect 

the ability to eat a healthy diet, impact on social 

interaction and cause difficulty with speech. It can also 

adversely affect other health conditions. For example, 

periodontal disease may contribute to cardiovascular 

disease and low birth weight babies, aspiration 

pneumonia, and nutritional deficiencies in children and 

older adults. 

Dental caries is the second most costly diet-related 

disease in Australia, with an economic impact 

comparable to that of heart disease and diabetes. 

Annual expenditure on dental care in Australia was 

$6.1 billion in 2007-08. 6 

The inter-connected effect of oral disease on individuals, 

health systems and communities is shown below. 

• Difficulty eating 

• Poor diet 

• Pain and discomfort 

• Dental infection 

Oral Disease 

• Impact on general 

health, eg: nutritional 

status, links to peptic 

ulcers and 

cardiovascular health 

• Poor appearance 

• Low self-esteem 

• Decreased 

employment 

opportunity 

• Decreased quality 

of life 

Health system costs 

• High cost of treatment 

for oral disease 

• General practitioner 

visits 

• Hospital admissions 

Economic costs 

• Decreased productivity 

• Days lost at 

work/school 

• Increased burden to 

community 

The impact of oral disease (source: DHS 1999) 


5 

Social Determinants of Oral Health 

The social determinants of health are the conditions in 

which people are born, grow, live, work and age, 

including the health system. 7 They directly impact a 

person’s ability to achieve good health outcomes. 

Disadvantaged groups, who generally have the worst 

health outcomes, are known to experience these 

impacts more frequently. 

The underlying causes of poor oral health can be 

attributed to many of the same social determinants, 

primarily income and income distribution, education, 

employment status, housing and social integration. 3 

The social determinants of oral health are outlined 

below. 

The social determinants of oral health are likely to be 

similar to those that contribute to poor general health. 

Economic, political 

and environmental 

conditions 

Social, family and 

community context 

Oral health related 

literacy and behaviour 

Individual factors 

Socio-economic 

status,family income, 

education, employment 

and living conditions 

Social and family norms 

regarding oral health 

knowledge, attitudes, 

beliefs, values, skills 

and behaviours 

Diet 

Age 

Health and social policy 

Peer groups 

Oral hygiene 

Sex 

Access to affordable, 

nutritious foods and 

drinks 

Cultural identity 

Smoking 

Genetic and 

biological endowment 

Access to transport 

Social support 

Alcohol 

Access to timely, 

affordable and 

appropriate oral health 

care and information 

Self-esteem 

Injury 

Social marketing 

Self-efficacy 

Oral health literacy 

Exposure to fluoride 

Use of oral health 

services 

Adapted from Watt and Fuller 

6 


While most dental treatments repair disease, thereby 

alleviating symptoms and limiting dysfunction and 

disability, most dental services do not alter the upstream 

causes of disease, which instead are influenced more 

broadly by social determinants. 1 This demonstrates the 

importance of focusing on primary prevention. 

Primary prevention aims to support and promote good 

health and reduce or eliminate factors that contribute 

to poor health. It is directed at both whole population 

or applied to one-on-one clinical settings. Primary 

prevention interventions have been shown to be 

effective in improving health and reducing and better 

managing treatment services in both the short and 

long term. 

Tooth decay is a disease of social deprivation, 

just as it is a disease of bad diet (indeed, 

these two factors are frequently found 

together). The key to eventual control of 

decay thus lies in improving the broad social 

environments for affected populations just as 

much as it does in intervening to improve the 

oral environment. 

Adapted from Burt et al., 2008 

Dental disease “is a condition which is 

probably, of all the conditions in Australia, the 

most strongly socio-economically related. 

The people who have the worst oral health 

are the most disadvantaged in the 

community….there is a large amount of 

dental disease in the community, and we 

need a strategy to deal with it.” 

(Senate Select Committee on Medicare, 2003) 


6 


as a Setting for Oral Health Promotion 

SA Dental Service is committed to working with the 

community to enable South Australians to achieve 

better oral health and wellbeing through: 

• health promotion 

• timely dental treatment with a focus on 

prevention and early intervention 

• support for education and research. 

The dental service has clinics located across the state 

for eligible children and adults. Clinical staff are well 

placed to deliver effective health promotion programs 

and activities that contribute to improving the oral health 

of their client’s and local communities. 

In planning health promotion in SA Dental Service we 

are distinguishing between health promotion activities 

that are incorporated into local practice and those 

activities that are strategic or that can be achieved 

through the Health Promotion Unit. 

Responsibilities of SA Dental Service Health Promotion Unit 

Facilitate health 

promotion at the 

organisational level 

Lead health promotion 

activities and programs 

Develop oral health 

information resources to 

support oral health 

promotion activities 

Support clinical staff and 

managers to achieve 

health promotion 

outcomes 


Provide workforce 

development to increase 

knowledge of staff about 

oral health promotion 

Develop strategic 

partnerships that 

increase oral health 

practice and knowledge 

Promote oral health as an 

integral part of general 

health 

Responsibilities of local dental clinic teams and business units 

Individual oral health information 

Clinical prevention 

Local dental clinic teams and business units 

Client consultation 

Implementation of local 

partnerships 

Community action and 

support of local policy 

interventions 

8 


7 

Applying Health Promotion Principles 

within SA Dental Service 

Health promotion is a key component of public and 

population health and is underpinned by an extensive 

body of theory, evidence and knowledge. 

The following principles, adapted from the Ottawa Charter, 

Jakarta Declaration and Bangkok Charter, are useful when 

thinking about health promotion in SA Dental Service. They 

guide the organisation in its policies, strategies and actions 

in the development and implementation of health promotion. 

Focus on the health of the population 

The aim is to improve the health of the whole population 

as well as addressing specific sub groups with high 

needs. This involves working at a population level as 

well as focussing on individuals. 

Focus on promotion of health, prevention of 

illness and early intervention 

Investment in prevention, early intervention and a focus 

on what keeps people healthy is an investment for 

better long term health outcomes. An excellent example 

of this is the Population Oral Health Program identifying 

children at risk of dental disease and referring them for 

clinical prevention such as fluoride. 

Reduce health inequities 

We recognise that determinants of health are complex 

and we are working in partnership with others to 

address the special needs of disadvantaged groups 

and to reduce differences in health status between 

groups. In particular no program should increase the 

health differential between groups. 

Work in partnership 

Working in partnership with a range of government, nongovernment, 

general practice, private and community 

organisations whose activities can impact on or influence 

oral health is a key strategy already in place. These 

partnerships can also enhance activities at the local level. 

Use multiple strategies 

It is important to use a comprehensive mix of strategies 

including clinical prevention, early intervention and health 

promotion across multiple settings. 

Evidence evaluation and accountability 

Good evidence is used to underpin oral health 

promotion strategies, with a focus on long and short 

term health outcomes. Process, impact and outcome 

evaluation to measure interventions are used to monitor 

effectiveness. Effectiveness of interventions is then used 

to identify further priorities and develop strategies. 

Aboriginal Cultural Respect Framework 

We recognise and respect the unique cultural needs 

and values of Aboriginal and Torres Strait Islander 

people. This is supported in SA Dental Service through 

cultural awareness training. 

Cultural Accountability 

We recognise and respect the unique cultural needs 

and values of our diverse population. 

Sustainability 

It is critical that oral health promotion interventions are 

planned as sustainable outcomes and put into the 

operational plan to promote this. We need to recognise 

that behaviour change is complex, difficult and takes time. 

Workforce development 

It is important to develop a flexible and innovative 

workforce with skills in contemporary health promotion 

and public health care. The organisation, teams and 

individuals need to have the resources, skills, 

knowledge and support to undertake quality health 

promotion and prevention work. In addition the clinical 

workforce will need to be trained so that they can 

actively participate in more “upstream” activities to 

improve oral health outcomes. 

Innovation 

One of SA Dental Service’s values is ‘creativity and 

innovation’. We need to challenge existing practice to 

improve the way we work. This can involve thinking 

outside the square and concentrating on solutions not 

problems, with an emphasis on action on health 

promoting environments as well as individual strategies. 


8 

Components of Effective Oral Health Promotion 

Clinical Prevention 

• Focuses on dental staff providing clinical services 

to prevent dental caries and control periodontal 

disease. 

• Dental professionals decide on the intervention 

and work with clients to identify their needs. 

Health Education and Information 

• Involves delivering consistent oral health 

information to clients in a clinical or community 

setting. 

• May not influence behaviour change, particularly in 

cases where clients have competing priorities and 

complex social situations. 

• Information should be targeted to a client’s specific 

needs. 

Health Counselling 

• Aim is to encourage individuals to adopt healthy 

behaviours. 

• Incorporates methods of talking to clients, such as 

brief intervention and motivational interviewing. 

• Recognises that influencing human behaviour is 

difficult and complex. 

• Recognises that the client is the driver of the action 

and may choose to take no action. 

Community Participation and Action 

• Focuses on ways to integrate oral health into 

general health. 

• Ensures that people from all age groups including 

children, and people from diverse social, cultural, 

economic, linguistic, physical and geographical 

backgrounds have the opportunity to participate. 

• Multiple strategies are essential and will vary upon 

the profile of and the needs of the consumers and 

community being engaged. 

Partnerships 

• Involves SA Dental Service staff working in 

partnership with other organisations to increase the 

capacity to promote health. 

• Recognises that organisations often have common 

and overlapping health promotion goals. 

• Ensures effective communication and information 

sharing. 

Policy 

• Recognises the need for a balance between 

government interventions and personal 

responsibility approaches. 

• Local teams will not usually be responsible for 

influencing policy change. 

• The Health Promotion Unit have a role to play in 

supporting the development of healthy public 

policy and organisational practice. 

10 


9 


Health Promotion Programs 2012-2013 

In recent years, SA Dental Service has successfully 

implemented a number of population oral health 

promotion programs aimed at changing the focus from 

treating disease to early intervention and prevention. The 

programs target particularly vulnerable groups, such as 

people living in supported residential facilities, older 

people, Aboriginal people and young children. 

Successful oral health promotion programs incorporate 

multiple strategies and interventions. These include: 

• integration of oral health into general health programs 

• targeting of high risk populations 

• tailored approaches based on active participation 

and addressing social, cultural and personal norms 

and values 

• development of referral pathways to improve and 

increase access to dental services 

• involvement of non-dental professionals with oral 

health screening and referrals 

• application of fluoride. 

Aboriginal Oral Health Program 

The Aboriginal Oral Health Program has a number of key 

strategies to increase access of Aboriginal people to SA 

Dental Service, including: 

• ensuring Aboriginal adults are referred through the 

Aboriginal Liaison Program for priority, free dental 

care 

• increasing the number of Aboriginal teenagers 

accessing dental care using a Teen Dental 

Voucher 

• ensuring Aboriginal children are accessing dental 

care through a variety of referral pathways from 

other health professionals 

• ensuring Aboriginal preschool children are referred 

through the Lift the Lip program for dental care 

• working with health professionals who see 

pregnant women regularly to increase their oral 

health knowledge 

• developing a range of oral health resources for 

Aboriginal people. 

The following is a summary of the oral health promotion 

programs currently running within SA Dental Service. 


Population Oral Health Program (Lift the Lip) 

The Children’s Population Oral Health Program aims to 

reduce the caries experience of children aged 0 -5 

years. Program areas are as follows: 

• improving the oral health of pregnant women 

• improving the oral health and oral health 

knowledge of new mothers 

• developing consistency between oral health and 

general health messages 

• early identification and development of referral 

pathways for preschool children through CaFHS 

Nurses, GPs, Practice Nurses and Child Care 

Centres 

• referred children receive priority dental care. 

Crunch & Sip® 

Crunch and Sip® is an initiative of the Go for 2&5® fruit 

and vegetable campaign and is based on the program 

developed in WA. Schools implement a formal break to 

eat fruit and vegetables and drink water in the 

classroom. 

Smoking Cessation Program 

The aim of the Smoking Cessation Program is to 

contribute to the improvement of client’s oral and 

general health by providing information to increase 

awareness of support services available to clients who 

are interested in managing their tobacco dependence. 

The program provides a referral pathway for clients to 

the QUITLINE. 

Supported Residential Facilities Program 

The aim of the Supported Residential Facilities (SRF) 

Program is to improve the oral health of residents living 

in SRFs across South Australia. Many SRF residents 

have some form of disability or impairment and 

experience social isolation, low incomes, and poor 

access to health services. The program provides 

support for SRF residents to access dental treatment 

which is provided in a timely manner and free of charge. 

Better Oral Health in Residential Care Program 

The Better Oral Health in Residential Care Program 

incorporates an evidence-based, oral health best 

practice model for people in residential aged care 

homes that utilises a portfolio of resources, including 

new educational resources and an existing Oral health 

Assessment Tool Kit for GPs. 

Northern and Southern Aged Care Projects 

The aim of the Northern and Southern Aged Care 

Projects is to improve the oral health of community living 

older people by: 

• integrating oral health questions in to the Adelaide 

Aged Care Assessment Team home assessment 

• providing support to manage their oral health care 

at home 

• providing priority access to preventive dental care. 

General Anaesthetic (GA) Families Project 

The aim of the GA Families Project is to work with 

families who are currently on the waiting list for general 

anaesthetic for dental treatment to increase awareness 

of the factors that lead to poor oral health and build 

capacity for families to improve oral health outcomes. 

12 


10 

Community Events and Expos 

The Health Promotion Unit organises oral health 

promotional displays for a number of health events and 

expos throughout the year. The effectiveness of SA 

Dental Service involvement with these events is 

increased where the core oral health messages can be 

linked to existing health promotion programs and 

strategies. 

Pregnancy, Babies and Children’s Expo 

The Pregnancy, Babies and Children’s Expo is a 3 day 

annual event which provides an opportunity for SA 

Dental Service to promote the importance of children’s 

oral health and services available. 

SA Water National Water Week 

SA Water National Water Week is held in the Botanic 

Gardens annually. SA Dental Service coordinate health 

promotion activities and provide resources to promote 

drinking tap water amongst primary school aged children. 

Nunga Lunches and Community Health Events 

As part of the Aboriginal Oral Health Program SA Dental 

Service participate in a wide range of events to promote 

oral health amongst the Aboriginal population of SA. 

Oral health information is provided and, where possible, 

referral of attendees to the dental service through the 

Aboriginal Liaison Program or the Lift the Lip Program. 

School Dental Days 

The aim of School Dental Days is to increase access of 

high risk primary school aged children to School Dental 

Service clinics. 

In most cases, SA Dental Service work in partnership 

with Department for Education and Child Development 

and Community Health, across SA, to organise events 

that combine health promotion activities with supported 

visits to the local school dental clinic. 

Aboriginal Power Cup 

The Aboriginal Power Cup was developed in response to 

key recommendations in Monsignor Cappo’s To Break 

the Cycle report. It is an early intervention strategy to 

engage young people at risk in sporting activities to 

encourage them to continue with their education and 

make positive lifestyle choices. The Aboriginal Oral Health 

Program team coordinate a dental display with oral health 

assessments for attending community members. 


11 

Oral Health Information Resources 

SA Dental Service have an extensive range of oral 

health information resources available for dental and 

non- dental professionals to use when consulting with 

clients. These can be displayed and handed out to 

clients at community events and expos also. 

It is recommended that resources be targeted to each 

individual client’s concern. Research shows that 

providing clients with a large amount of information at 

the one time does not lead to the client changing their 

behaviour. 

Resources can be ordered from the Health Promotion 

Unit (Phone: 8222 9016). 

12 

Workforce Development 

SA Dental Service recognises the need to provide 

clinical staff with adequate tools, knowledge and 

support to undertake quality health promotion and 

prevention work in their daily practice. 

As part of implementing the Health Promotion Practice 

Guidelines, all clinical staff will attend ongoing clinical 

health promotion training. Following this, nominated SA 

Dental Service staff will be offered the opportunity to 

participate in more specific training to support the 

planning and delivery of health promotion initiatives in 

their local community. 

14 


13 

Guidelines for Effective Health Promotion 

Preschool Children 

Good oral health for infants and young children 

underpins good oral health throughout life. The Lift the 

Lip Program is an effective way of identifying early 

childhood caries and referring children aged 0-5 for 

priority dental care. 

We support the involvement of our clinical staff with 

targeted tooth brushing programs in preschool settings, 

and application of fluoride varnish for high-risk, young 

children, as a way of reducing tooth decay. 

Motivational interviewing of parents can be effective in 

altering oral health behaviours and reducing dental 

caries in young children. 

Classroom oral health education lessons with preschool 

children have not been shown to have any significant 

effect on prevention of dental caries, and are therefore 

not recommended by SA Dental Service. 


Preschool Children – Chair side (clinical) interventions 

Strategy 

Activity 

Desired 

Outcomes 

Useful Documents 

and Links 

Recall 

Assign personalised recall 

based on risk assessment. 

High risk clients 

• 12 months 

Medium risk clients 

• 18 months 

Low risk clients 

• 24 months 

• Oral disease 

prevention 

• Improved oral health 

outcomes 

• Statewide Dental 

Service Risk 

Standardisation and 

Personalised 

Preventive Packages 

Fluoride 

For high risk clients: 

• apply fluoride varnish 

every 6 months 

• provide children aged 

18 months – 2 ½ years 

and mother/carer with 

toothbrush and fluoride 

toothpaste. 

• Caries prevention 


outcomes 


Service Risk 


Personalise Preventive 

Packages 

• Fluoride Varnish 

Clinical Practice 

Guidelines 


resources 

• Fluoride – a guide for 

parents and clients 

• Fluoride Varnish – 

instructions for clients 

and parents 

Parent Consult 

•Oral hygiene 

Consult with parents 

regarding: 

• toothbrushing 

• fluoride toothpaste 

• Lift the Lip. 

Demonstrate toothbrushing 

technique. 

Parents, carers to assist with 

brushing. 


prevention 


outcomes 

• Behaviour change 


resources 

• Give your child’s teeth 

a healthy start 

• Anticipatory Guidance 

resources 

0-12 months 

12-24 months 

2-5 years 

• Toothbrushing 

Use motivational interviewing 

techniques when consulting 

with parents, carers. 

16 


Preschool Children – Chair side (clinical) interventions 

Strategy Activity Desired 

Outcomes 


and Links 


• Brief dietary 

intervention 


regarding: 

• breastfeeding 

• bottle feeding 

• tap water 

• sugar 

• dummies. 


prevention 

• Improved oral 

health outcomes 



resources 

• Snack ideas 

• Tap water 

• Sugar 

• Lift the Lip magnets 

Use motivational 

interviewing techniques 

when consulting with 

parents/ carers. 

Refer families for more 

comprehensive dietary 

advice. 


prevention 




Refer to the Hospitals 

and Health Services 

pages on the SA Health 

internet site for local 

community health 

centres and 

dietetic/nutrition 

services. 


Preschool Children – Effective Health Promotion Strategies 


Outcomes 


and Links 

Lift the Lip 

Program 

• Visit allocated Child Care 

Centres to Lift the Lip 

• Attend Immunisation 

Clinics to Lift the Lip. 


prevention 



• Guidelines for SA 

Dental Service staff 

Lifting the Lip in Child 

Care Centres and 

Preschools 

• Population Oral Health 

Program Plan 


resources 



• Sugar 

• Dental Care is Free for 

Toddlers and 

Preschoolers 


resources 

• Series of A4 Lift the Lip 

posters 


Parent 

information 

sessions 

Link with existing health 

promotion programs (eg Lift 

the Lip) and provide oral 

health information to 

parents of young children. 

Focus on: 

• pregnant women 

• CALD groups 

• Aboriginal groups. 


prevention 




resources 



• Sugar 


Toddlers and 

Preschoolers 


resources 

Targeted 

supervised 

tooth brushing 

in early 

childhood 

settings 

Work with Health Promotion 

staff to implement 

toothbrushing programs in 

areas with: 

• high caries risk 

• non-fluoridated water 

• children not brushing 

routinely at home. 


prevention 




resources 

• Caring for your child’s 

smile 

• Sugar 


18 


Preschool Children – Effective Health Promotion Strategies 


Outcomes 


and Links 

Targeted 

provision of 

fluoride 

toothpaste and 

toothbrush 

Supply fluoride toothpaste 

and toothbrush to families 

in areas with: 


• non-fluoridated water. 

For example: 

• CaFHS home visiting 

program 

• Aboriginal 

• CALD 

• rural and remote 

communities. 





resources 




Community 

health events 

and days 

Seek support and 

resources from the Health 

Promotion Unit to attend 

community health events 

and days to promote oral 

health and SA Dental 

Service. 

For example: 

• Children, Parent’s and 

Babies Expo 

• Nunga health days. 

• Increased 

knowledge 

• Profile of oral 

health increased 


resources 



• Sugar 


Toddlers and 

Preschoolers 


resources 

Fluoride varnish 

programs 

Under direction of Health 

Promotion Unit implement 

Fluoride Varnish programs 

in rural and remote 

communities. 








resources 



and parents 


20 



Children aged 6-12 years 

Despite significant improvements in dental caries rates 

over the past generation, many primary school aged 

children still experience tooth decay. The School Dental 

Service provides a range of preventive services, such 

as fluoride application and fissure sealing “at risk” teeth, 

for this age group. 

We support school based oral health interventions that 

link to existing health promotion programs, such as 

Crunch and Sip® and Right Bite. Health promotion 

events held at primary schools, that combine a range of 

health promoting activities with trips to the local school 

clinic, are an effective way of improving oral health 

outcomes for the children attending. 

Classroom oral health education lessons with primary 

school children have not been shown to have any 

significant effect on prevention of dental caries, and are 

therefore not recommended by SA Dental Service. 


Children aged 6-12 years – Chair side (clinical) interventions 


Outcomes 


Recall 




• 12 months 


• 18 months 


• 24 months 


prevention 




Service Risk 


Personalised Preventive 

Packages 

Fluoride 


• children under 10 years, 

apply fluoride varnish 


• children over 10 years, 

apply topical fluoride 

every 6 months. 





Service Risk 



Packages 

• Fluoride Varnish Clinical 

Practice Guidelines 


resources 





and parents 

Fissure sealants 

Fissure seal “at risk” molars. 





prevention 





Service Risk 



Packages 

• Fissure Sealant Clinical 



resources 

• Fissure Sealant 

resource 

22 


Children aged 6-12 years – Chair side (clinical) interventions 


Outcomes 



• Oral hygiene 


regarding: 


• fluoride toothpaste. 


technique. 


prevention 





resources 


smile 








intervention 


regarding: 

• tap water 

• sugar. 






prevention 





resources 


• Tap water 

• Sugar 

Refer family for more 


advice. 





community health centres 

and dietetic/nutrition 

services. 


Children aged 6-12 years – Effective Health Promotion Strategies 


Outcomes 


Link with 

existing school 

based health 

promotion 

programs 

Under direction of Health 

Promotion Unit, work with 

existing programs in schools 

(such as Crunch and Sip® 

and Rite Bite) to deliver oral 

health information to parents 

and children. 


prevention 



• Increased 

knowledge 

• Health Promotion: 

Better Health Better 

Learning 

• Rite Bite 

www.gofor2and5.com.au 

www.crunchandsip.com.au 

Parent 

information 

sessions 

Work with local community 

groups, schools and external 

organisations to provide oral 

health information to parents 

of school aged children. 

Focus on: 

• CALD groups 


• low socio-economic areas 

with high caries rates. 


prevention 




resources 


smile 

• Tap water 

• Sugar 


Targeted 

school based 

toothbrushing 

programs 


staff to implement toothbrushing 

programs in areas 

with: 


• non-fluoridated water 

• children not brushing 

routinely at home. 


prevention 





resources 


smile 

• Sugar 


School dental 

days 


staff to co-ordinate oral 

health information sessions 

and visits to the local school 

dental clinic for high risk 

children including: 


• CALD. 


prevention 



• Increased 

knowledge 


resources 


smile 

• Tap water 

• Sugar 


Community 

health events 

and days 

Attend local community 

health events and days to 

promote oral health and 


For example: 

• Nunga health days 

• Water Week. 

• Increased 

knowledge 

• Profile of oral 

health increased 


resources 


smile 

• Tap water 

• Sugar 


24 



26 



Adolescents 

SA Dental Service is supportive of clinical staff working 

with adolescents to encourage them to take 

responsibility for their own oral health. This may be done 

in a clinical setting, or through involvement with access 

programs that target high risk teenagers. 

We promote use of the Medicare teen dental voucher 

amongst all eligible families, with a focus on Aboriginal 

teens through the Aboriginal Oral Health Program. 

The Smoking Cessation Program provides a pathway to 

the QUITLINE for adolescents interested in quitting. 

Motivational interviewing of adolescents can be 

effective in altering oral health behaviours and reducing 

dental caries. 

Classroom oral health education lessons with primary 

school children have not been shown to have any 

significant effect on prevention of dental caries, and are 

therefore not recommended by SA Dental Service. 


Adolescents – Chair side (clinical) interventions 


Outcomes 


Recall 




• 12 months 


• 18 months 


• 24 months 


prevention 




Service Risk 


Personalised 



resources 

• Continuation of care 

postcard 

Fluoride 


• Apply topical fluoride 


• Recommend 

concentrated fluoride 

products for use at home. 





Service Risk 


Personalised 





resources 





and parents 


Fissure seal “at risk” molars. 





Service Risk 


Personalised 





resources 


resource 

28 


Adolescents – Chair side (clinical) interventions 


Outcomes 


Parent, Teen 

Consult 


Consult with parents, teens 

regarding: 




technique. 


prevention 





resources 


• Gingivits/ periodontitis 

brochure 




adolescents. 

Parent, Teen 

Consult 


intervention 

Consult with parents, teens 

regarding: 

• tap water 

• sugar 

• erosion 

• smoking cessation 

• oral piercing 




adolescents. 


prevention 





resources 

• Oral health for young 

people 

• Dental erosion 


• Tap water 

• Sugar 

• Oral piercing and oral 

health 



advice. 


prevention 








community health centres 

and dietetic/nutrition 

services. 


Adolescents – Effective Health Promotion Strategies 


Outcomes 


Medicare Teen 

Dental Voucher 

• Encourage families to 

utilise voucher. 

• Promote use of vouchers 

amongst Aboriginal 

families. 


prevention 



Medicare Teen Dental 

Plan 2012 

Smoking 

Cessation 

Program 

Implement Smoking 

Cessation Program and 

record interventions. 



Range of QUIT resources 

available from Health 

Promotion Unit 

Access 

programs 

Promote and encourage 

access to dental services 

amongst high risk 

adolescent groups 

including: 



• CALD. 


prevention 




resources 

• Sugar 

• Tap water 


• Welcome to School 

Dental Service 

• Erosion 

• Oral Piercing 

30 



Adults 

Over the past decade, SA Dental Service has had a 

significant impact on the oral health of vulnerable adults 

living in SA, through a number of targeted health 

promotion initiatives. These include the following: 

• Better Oral Health in Residential Care Program 

• Aged Care Program 

• Aboriginal Liaison Program 

• Supported Residential Facilities Program 

• Homelessness Project. 

The success of these programs is based on the 

incorporation of an oral health check into a general 

health check and subsequent provision of referral 

pathways for eligible clients. 

Providing oral health information to pregnant women, 

and assisting them to access to dental services, is an 

effective way of improving their oral health and the oral 

health of their newborn baby. 

The Smoking Cessation Program provides a pathway 

to the QUITLINE for eligible adults who are interested 

in quitting. 

Motivational interviewing of adults can be effective in 

altering oral health behaviours that contribute to 

dental disease. 


Adults – Chair side (clinical) interventions 


Outcomes 


Fluoride 




• Recommend home 

care products (gels and 

foams). 





Service Risk 


Personalised 





resources 





and parents 

Client Consult 


Consult with client 

regarding: 


• fluoride toothpaste 

• erosion 

• gingivitis/ periodontitis 




clients. 





resources 


• Dental care for adults 

• Erosion postcards 

• Gingivitis/ perio 

brochure 

Client consult 


intervention 

Consult with clients 

regarding: 

• tap water 

• sugar. 




clients. 





resources 


• Tap water 

• Sugar 

Refer client for more 


advice. 






centres and dietetic/ 

nutrition services. 

32 



Adults – Effective Health Promotion Strategies 


Outcomes 


Link high risk 

eligible adults to 

existing health 

promotion 

programs 

In collaboration with 

Project Staff: 

• provide referral 

pathways for eligible 

adults to access dental 

care 

• involve non-dental 

health professionals with 

screening and referring 

clients. 

• Improved access 

to dental care 



Specific program 

resources. 

Annual reports for all 

SA Dental Service Health 

Promotion Programs are 

available on the SA Dental 

Service Website. 

Implement SA Dental 

Service Health Promotion 

Programs: 

• Aboriginal Liaison 

Program 

• Aged Care Projects 

• SRF Project 

• Chronic Disease Project. 

Improve oral 


for eligible 

Aboriginal and 

Torres Strait 

Islander adults 

• Train non-dental health 

professionals to assess 

and refer clients for 

priority, free dental care 

through the Aboriginal 

Liaison Program. 

• Distribute culturally 

appropriate oral health 

information resources. 






Aboriginal Oral Health 

Program resources 

Assist pregnant 

women to 

improve their 

oral health and 

the oral health of 

their newborn 

baby 

• Work with antenatal 

groups to provide oral 

health information. 

• Focus on the mother’s 

oral health, the impact 

on their general health 

and baby’s oral health. 

• Work with mother’s 

groups to provide oral 

health information. 

Focus on key messages 

including transfer of 

bacteria. 

• Attend the Pregnancy, 

Children and Babies 

Expo to promote oral 

health and SA Dental 

Service. 

• Reduce the 

transmission of oral 

bacteria to child 

• Increase 

knowledge of oral 

health 

• Raise profile of oral 

health and SA 

Dental Service 


resources 



• Sugar 

• Pregnancy postcard 


resources 


Toddlers and 

Preschoolers 

• Snacks 

• Gingivitis/ periodontitis 

resource 

• Aboriginal pregnancy 

resources 

34 


Adults – Effective Health Promotion Strategies 


Outcomes 


Improve oral 

health 

outcomes for 

frail and older 

people in the 

community and 

in residential 

care 

Work with Project Staff to 

support eligible clients to 

access dental care through 

the: 

• Better Oral Health in 

Residential Care 

Program 

• Southern Oral Health for 

Older People Project 

• Northern Oral Health for 

Older People Project. 





• Access Better Oral 

Health in Residential 

Care Resource 

Portfolios 

• Oral Health Training Kits 

available from 

SA Dental Service, 

Service Planning 

Ph: 8222 9093 

Smoking 

Cessation 

Program 

Implement Smoking 

Cessation Program and 

record interventions. 



• Reduction in 

number of adult 

clients smoking 

Range of QUIT resources 

available from Health 

Promotion Unit 

Community 

Health Events 

Attend community health 

events for specific high risk 

client groups. 

For example: 


• Homeless. 


prevention 



• Increased 

knowledge 


resources 

• Oral health care for 

adults 

• Tap water 

• Sugar 

• Diabetes 


36 



People with Special Needs 

The oral health of people with special needs is often 

compromised due to difficulties with maintaining an 

adequate toothbrushing technique and healthy diet. 

people in residential care, training and support of health 

and welfare workers, timely access to dental care and 

oral health information sessions have been shown to be 

most effective. 

SA Dental Service supports oral health promotion 

interventions that incorporate oral health plans for 


People with Special Needs – Chair side (clinical) interventions 


Outcomes 


Recall 




• 12 months 


• 18 months 


• 24 months 


prevention 




Service Risk 


Personalised 


Fluoride 




• Recommend 

concentrated fluoride 

products for use at 

home. 





Service Risk 


Personalised 






resources 





and parents 

Fissure 

sealants 

Fissure seal “at risk” 

molars. 





Service Risk 


Personalised 





resources 


resource 

38 


People with Special Needs – Chair side (clinical) interventions 


Outcomes 


Parent, Client, 

Carer Consult 


Consult with parents, 

clients, carers regarding: 



Demonstrate 

toothbrushing technique. 


prevention 





resources 


• Gingivitis/ periodontitis 

resource 

Recommend use of 

electric toothbrush. 



and theories of behaviour 

change when consulting 

with parents, clients and 

carers. 

Parent, Client, 

Carer Consult 


intervention 

Consult with parents, 

clients, carers regarding: 

• tap water 

• sugar. 




parents/ clients and 

carers. 


prevention 





resources 


• Tap water 

• Sugar 



advice. 


prevention 









centres and dietetic/ 

nutrition services. 


People with Special Needs – Effective Health Promotion Strategies 


Outcomes 


Train and 

support health 

and welfare 

workers 

Provide oral health 

education sessions with a 

focus on: 

• oral hygiene instruction 

(for clients and carers) 

• causes of dental 

disease 

• referral pathways to 

dental care. 


prevention 





to dental services 


resources 

• Sugar 

• Tap water 


• Welcome to SA Dental 

Service 

• Dental care is free for 

toddlers and 

preschoolers 

Implement oral 

health programs 

in residential 

facilities 

Ensure people living in 

residential care can 

access: 

• oral health plans, 

• dental health aids, and 

• timely access to dental 

care via programs such 

as the Supported 

Residential Facilities 

(SRF) Program. 


prevention 




to dental services 


resources 

• Sugar 

• Tap water 




Service 


Supported Residential 

Care Program Plan. 

Increase oral 

health literacy 

of people with 

special needs 

and their carers 

Deliver oral health literacy 

sessions to people with 

special needs and their 

carers. Focus on: 

• oral hygiene instruction 

(for clients and carers) 

• use of electric 

toothbrushes as 

appropriate 

• causes of dental 

disease 

• dental services 

available. 


prevention 



• Increased 

knowledge 



resources 

• Sugar 

• Tap water 




Service 

40 


14 

Ineffective Health Promotion Strategies 

Ineffective Strategy Activity Effective Strategy 

Classroom lessons 

Extensive dietary advice 

Resource packs 

“Goodie Bags” 

Oral health 

information sessions 

One-off lessons with 

children at Child Care 

Centres, Preschools, 

Primary Schools and 

High Schools. 

Diet diaries. 

Lengthy consults including 

dietary information and 

recommendations outside 

of the scope of a dental 

professional. 

Providing parents with 

packages of information 

resources to take home. 

One-off sessions with 

community groups 

• School dental days 

• Parent information sessions 

• Targeted toothbrushing 

programs 

• Brief dietary intervention 

• Referral to local dietician or 

community health service 

• Target 1-2 oral health topics to 

discuss with parent 

• Explain information covered in 

resources 

• Repeat information at follow up 

appointments 

• Link community group sessions 

to existing Health Promotion 

programs 

• Ensure referral pathways to 

dental services are well defined 

• Refer to Health Promotion Unit 

to send out resources to 

distribute in lieu of attending 

sessions. 


15 

Undergraduate Students 

The SA Dental Service Health promotion Unit works in 

partnership with: 

• Gilles Plains TAFE, Advanced Diploma of Oral Health 

• The University of Adelaide, Bachelor of Oral Health 

• The University of Adelaide, Bachelor of Dental Surgery 

to ensure undergraduate students develop an 

understanding of general and oral health promotion. 

We annually present information about the theory of 

health promotion, social determinants of oral health and 

program planning to students and meet with them to 

discuss oral health promotion projects they may be 

considering as part of their studies. 

42 


Strategy 

Suggested Programs 

and Activities 

Outcomes 


Implement a 

health 

promotion 

initiative as 

part of an 

existing 

health 

promotion 

program 

Population Oral Health 

Program 

• Attend Child Care Centre or 

Immunisation clinic to Lift the 

Lip of children aged 0-5. 

• Detection of 

early signs of 

tooth decay 

and referral for 

dental care 


health 

outcomes 

• Increased 

awareness of 

causes of 

Early 

Childhood 

Caries 

amongst 

families 

• Guidelines for SA Dental 

Service Staff Lifting the Lip in 

Child Care Centres and 

Preschools 

• SA Dental Service Population 

Oral Health Program Plan 2012 

Health Promotion Unit resources 

• Give your child’s teeth a 

healthy start 

• Sugar 

• Dental care is free for 

toddlers and preschoolers 

• Anticipatory guidance resources 

• Lift the Lip posters 


Aboriginal Oral Health 

Program 

• Attend Aboriginal specific 

Child Care Centre to Lift the Lip. 

• Develop and implement an 

information and training 

session for Aboriginal Health 

Workers and their clients, as 

part of the Aboriginal Liaison 

Program. 

• Work with Aboriginal families 

in the primary school setting 

to organise a “Dental Day”, 

including a visit to the local 

school dental clinic. 

• Attend a community health 

event for Aboriginal families. 

• Improved 

access to 

dental care 


health 

outcomes 

• Aboriginal Oral Health 

Program Plan 2012 

• Aboriginal Oral Health 

Program resources 

Better Oral Health in 

Residential Care Program 

• Reinforce national roll out of 

Better Oral Health in 

Residential Care training of 

aged care staff. 

• Provide oral health promotion 

and oral hygiene techniques 

consistent with key messages 

from Better Oral Health in 

Residential Care Model. 

• Liaise with SA Dental Service 

Planning to discuss possible 

residential aged care facilities 

and links with nursing and 

visiting dental staff. 

• Active support 

of the national 

Nursing Home 

Oral and 

Dental Health 

Plan to 

improve the 

oral health 

outcomes of 

residents 

• Access Better Oral Health in 

Residential Care Resource 

Portfolios 

• Oral Health Training Kits 

available from 

SA Dental Service, 

Service Planning 

Ph: 8222 9093 


16 


When planning health promotion initiatives, reference to the following documents may be useful: 

• Healthy Mouths Healthy Lives – Australia’s National Oral Health Plan, 2004 – 2013 

• South Australia’s Oral Health Plan, 2010 - 2017 

• The South Australian Primary Prevention Plan, 2011 - 2016 

• The Aboriginal Health Care Plan, 2010 – 2016 

• Ottawa Charter for Health Promotion 

• The Jakarta Declaration 

44 


17 

Summary of Evidence 

Preschool Children 

Chair side (clinical) interventions 

Recall 

1. Bader J. (2005), Risk based recall intervals recommended. Evidence-based Dentistry, vol 6, pp 2-4. 

2. Gibson C, Moosajee A. (2008), Selecting appropriate recall intervals for patients in general dental practice: 

An audit project to categorise patients according to risk. Dental Update, vol 35, pp 188-194. 

3. Patel S, Bay C. (2010), A systematic review of dental recall intervals and incidence of dental caries. Journal 

of the American Dental Association, vol 141(5), pp 527-539. 

Fluoride 

4. Sheiham A. (2002), Fluoride varnishes for preventing dental caries in children and adolescents, Cochrane 

Database of Systematic reviews. 

5. Petersson LG. et al (2004), Professional fluoride varnish treatment for caries control: A systematic review of 

clinical trials, Acta Odontol Scand, vol 62(3), pp 170-176. 

6. Spencer AJ. (2006), The use of fluorides in Australia: Guidelines. Australian Dental Journal, vol 51(2), 

pp 195-199. 


7. Harrison R, Benton T, Everson-Stewart S, Weinstein P. (2007), Effect of motivational interviewing on rates 

of early childhood caries: A randomised trial, Paediatric Dentistry, vol 29, pp16-22. 

8. Weinstein P. (2006), Provider versus patient centred approaches to health promotion with parents of young 

children: What works/ does not work and why, Paediatric Dentistry, vol 28, pp. 172-176: discussion 

192-198. 

9. Weinstein P, Harrison R, Benton T. (2006), Motivating mothers to prevent caries: Confirming the beneficial 

effect of counselling, Journal of the American Dental Association, vol 137, pp. 789-793. 

10. Yevlahova, JS. (2009), Models for individual oral health promotion and their effectiveness: A systematic 

review. Australian Dental Journal, vol 54, pp190-197. 

Effective Health Promotion Strategies 

Lift the Lip Program 

11. Kagihara LE, Niederhauser VP, Stark M. (2009), Assessment, management and prevention of early 

childhood caries. Journal of the American Academy of Nurse Practitioners, vol 21, pp 1-10. 

12. dela Cruz GG, Rozier RG, Slade G. (2004), Dental screening and referral of young children by paediatric 

primary care providers. Pediatrics, vol 114, pp e642-e652. 

13. Grant JS, Roberts MW, Brown WD, Quinonez RB. (2007), Integrating dental screening and fluoride 

varnish application into a paediatric residency outpatient program: Clinical and financial implications. 

Journal of Clinical Paediatric Dentistry, vol 31, pp 175-178. 



Parent information sessions 

14.Gajanan K Kulkarni. (2010), Oral health promotion programs from infancy to childhood. Canadian Dental 

Association Journal, vol 75(10), pp 684- 685. 

15. Vincent R et al (2010), Effectiveness of a presentation on infant oral health care for parents. International Journal 

of Paediatric Dentistry, vol 20, pp 37-42 

Targeted supervised tooth brushing in early childhood settings 

16. Jackson R, Newman H, Smart G, Stokes E, Hogan J, Seres J, Brown C. (2004), A supervised toothbrushing 

program in primary school children. North West London Community Dental Service, UK. 

17. Jackson RJ, Newman HN, Smart GJ, Stokes E, Hogan JL, Brown C, Seres J. (2005), The effects of a 

supervised toothbrushing program on the caries increment of primary school children, initially aged 5-6 years. 

Caries Research, vol 39, pp 108-115. 

18. Curnow MMT, Pine CM, Burnside G, Nicholson JA, Chesters RK, Huntington E. (2002), A randomised 

controlled trial of the efficacy of supervised toothbrushing in high-caries risk children. Caries Research, vol 36, 

pp 294-300. 

Targeted provision of fluoride toothpaste and toothbrush 

19. Davies GM, Worthington HV, Elwood RP, Bentley EM, Blinkhorn AS, Taylor GO, Davies RM. (2002), A 

randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months 

on reducing caries in 5-6 year old children. Community Dental Health, vol 19, pp 131-136. 

20. Davies GM, Worthington HV, Elwood RP, Blinkhorn AS, Taylor GO, Davies RM, Considine J. (2003), An 

assessment of the cost effectiveness of a postal toothpaste programme to prevent caries among 5 year old 

children in the North West of England. Community Dental Health, vol 20, pp 207-210. 

Community health events and days 

21. Blair Y, Macpherson L, McCall D, McMahon AD. (2006), Dental health of 5 year olds following community based 

oral health promotion in Glascow, UK, International Journal of Paediatric Dentistry, vol 16, pp 388-398. 

22. Blair Y, Macpherson L, McCall D, McMahon AD. (2004), Glasgow nursery-based caries experience, before and 

after a community development-based oral health program’s implementation. Community Dental Health, vol 21, 

pp 291-298. 

Fluoride varnish programs 

23. Spencer AJ, Bailie R, Jamieson L. (2010), The strong teeth study: Background, rationale and feasibility of 

fluoridating remote Indigenous communities. International Dental Journal, vol 60, pp 250-256. 

46 



Children aged 6-12 years 


Recall 

24. Bader J. (2005), Risk based recall intervals recommended. Evidence-based Dentistry, vol 6, pp 2-4. 

25. Gibson C. & Moosajee A. (2008), Selecting appropriate recall intervals for patients in general dental 

practice: An audit project to categorise patients according to risk. Dental Update, vol 35, pp 188-194 

26. Patel S. & Bay C. (2010), A systematic review of dental recall intervals and incidence of dental caries. 

Journal of the American Dental Association, vol 141(5), pp 527-539. 

Fluoride 

27. Sheiham A. (2002), Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane 

Database of Systematic Reviews. 

28. Petersson LG. et al (2004), Professional fluoride varnish treatment for caries control: A systematic review 

of clinical trials. Acta Odontol Scand, vol 62(3), pp 170-6. 


pp 195-199. 


fluoridating remote Indigenous communities, International Dental Journal, vol 60, pp 250-256. 


31. Ahovuo-Saloranta A, Hiiri A, Nordblad A, Worthington H, Mäkelä M. (2008), Pit and fissure sealants for 

preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database of 

Systemic Reviews, (4):CD001830. 

32. Kervanto-Seppälä S, Pietilä I, Meurman JH, Kerosuo E. (2009), Pit and fissure sealants in dental public 

health: Application criteria and general policy in Finland. BMC Oral Health. 9:5. Epub. 

33. Mejàre I, Lingström P, Petersson LG, Holm AK, Twetman S, Källestål C, Nordenram G, Lagerlöf F, 

Söder B, Norlund A, et al. (2003), Caries-preventive effect of fissure sealants: A systematic review. 

Acta Odontol Scand, vol 61(6), pp 321-330. 


34. Harrison R, Benton T, Everson-Stewart S, Weinstein P. (2007), Effect of motivational interviewing on rates 

of early childhood caries: A randomised trial. Paedatric Dentistry, vol 29, pp16-22. 

35. Weinstein P. (2006), Provider versus patient centred approaches to health promotion with parents of 

young children: What works/ does not work and why. Paediatric Dentistry, vol 28, pp 172-176: 

discussion 192-198. 


effect of counselling. Journal of the American Dental Association, vol 137, pp 789-793. 


review. Australian Dental Journal, vol 54, pp 190-197. 




Link with existing school based health promotion programs 

38. Kwan SY, Petersen PE, Pine CM, Borutta A. (2005), Health promoting schools: An opportunity for oral health 

promotion, Bulletin of the World Health Organisation, vol 83, pp 677-685. 

39. Moyses ST, Moyses SJ, Watt RG, Sheiham A. (2003), Associations between health promoting schools’ 

policies and indicators of oral health in Brazil. Health Promotion International, vol 18, pp 209-218. 

40. Stokes E, Pine CM, Harris RV. (2009), The promotion of oral health within the healthy school context in 

England: A qualitative research study. BMC Oral Health, vol 9, pp 3. 

Parent information sessions 

41. Gajanan K Kulkarni. (2010), Oral health promotion programs from infancy to childhood. Canadian Dental 

Association Journal, vol 75(10), pp 684-685. 

Targeted school based toothbrushing programs 

42. Jackson R, Newman H, Smart G, Stokes E, Hogan J, Seres J, Brown C. (2004), A supervised toothbrushing 

program in primary school children. North West London Community Dental Service, UK. 

43. Jackson RJ, Newman HN, Smart GJ, Stokes E, Hogan JL, Brown C, Seres J. (2005), The effects of a 

supervised toothbrushing program on the caries increment of primary school children, initially aged 5-6 

years. Caries Research, vol 39, pp 108-115. 

44. Curnow MMT, Pine CM, Burnside G, Nicholson JA, Chesters RK, Huntington E. (2002), A randomised 

controlled trial of the efficacy of supervised toothbrushing in high-caries risk children. Caries Research, 

vol 36, pp 294-300. 

Community health events and days 

45. Blair Y, Macpherson L, McCall D, McMahon AD. (2006), Dental health of 5 year olds following community 

based oral health promotion in Glascow, UK. International Journal of Paediatric Dentistry, vol 16, pp 388-398. 

46. Blair Y, Macpherson L, McCall D, McMahon AD. (2004), Glasgow nursery-based caries experience, before 

and after a community development-based oral health programs implementation. Community Dental Health, 

vol 21, pp 291-298. 

48 



Adolescents 


Recall 

47. Bader J. (2005), Risk based recall intervals recommended. Evidence-Based Dentistry, vol 6, pp 2-4. 

48. Gibson C. & Moosajee A. (2008), Selecting appropriate recall intervals for patients in general dental practice: 

An audit project to categorise patients according to risk. Dental Update, vol 35. pp 188-194. 

49. Patel S. & Bay C. (2010), A systematic review of dental recall intervals and incidence of dental caries. Journal 


Fluoride 




clinical trials. Acta Odontol Scand, vol 62(3), pp 170-176. 


pp 195-199. 




54. Ahovuo-Saloranta A, Hiiri A, Nordblad A, Worthington H, Mäkelä M.(2008), Pit and fissure sealants for 


Systematic Reviews. (4):CD001830. 


health: Application criteria and general policy in Finland. BMC Oral Health. 9:5. Epub. 

56. Mejàre I, Lingström P, Petersson LG, Holm AK, Twetman S, Källestål C, Nordenram G, Lagerlöf F, Söder B, 

Norlund A, et al. (2003), Caries-preventive effect of fissure sealants: A systematic review. Acta Odontol 

Scand, vol 61, pp 321-330. 

Parent/ Teen Consult 

57. Harrison R, Benton T, Everson-Stewart S, Weinstein P. (2007), Effect of motivational interviewing on rates of 

early childhood caries: A randomised trial. Paedatric Dentistry, vol 29, pp16-22. 


children: What works/ does not work and why. Paediatric Dentistry, vol 28, pp 172-176: discussion 192-198. 








Medicare teen dental voucher 

61. Australian Government, Department of Health and Ageing, Report on the Review of the Dental Benefits Act, 

2008. 

Smoking cessation program 

62. Carr AB and Ebbert JO. (2007), Interventions for tobacco cessation in the dental setting, Cochrane 

Database of Systematic Reviews, Art. No.: CD005084. DOI: 005010.001002/ 14651858. 

CD14005084.pub14651852. 

63. Terrades M, Coulter WA, Clarke H, Mullally BH, Stevenson M. (2009), Patient’s knowledge and views about 

the effect of smoking on their mouths and the involvement of their dentists in smoking cessation activities. 

British Dental Journal, vol 207, pp E22: discussion 542-543. 

64. Reibel J. (2005), Tobacco or oral health. Bulletin of the World Health Organisation, vol 83, pp 643. 

Access programs 

65. Stannard J. (1998), Access for “at risk” youth to dental services: Development and evaluation of the Kinkston 

Road and Callblock Youth Health Centre dental project. 30th annual conference, Public Health Association: 

Hobart: 13-16 September, 1998. 

Adults 


Fluoride 

66. Marinho VCC, Higgins JP, Logan S, Sheiham A. (2002), Fluoride varnishes for preventing dental caries in 

children and adolescents, Cochrane Database of Systematic Reviews. 



68. Spencer AJ. (2006),The use of fluorides in Australia: Guidelines. Australian Dental Journal, vol 51(2), 

pp 195-199. 

Client Consult 


early childhood caries: A randomised trial. Paediatric Dentistry, vol 29, pp16-22. 


children: What works/ does not work and why. Paediatric Dentistry, vol 28, pp 172-176: Discussion 

192-198. 

71. Weinstein P, Harrison R, Benton T, (2006), Motivating mothers to prevent caries: Confirming the beneficial 


50 




Link high risk eligible adults to existing health promotion programs 

72. Cohen LA. (2009), The role of the non-dental health professionals in providing access to dental care for 

low-income and minority patients. Dental Clinics of North America, vol 53, pp 451-468. 

73. Johnson H and Cristini S, (2002), Oral health training projects for carers working in group homes with adults 

with disabilities. Melbourne, SCOPE Victoria. 

Assist pregnant women to improve their oral health and the oral health of their newborn baby 

74. Kilpatrick N, Gussy M, Mahony E. (2009), Maternal and child oral health – systemic review and analysis: 

A report from the New Zealand Ministry of Health. Melbourne, Murdoch Children’s Research Institute. 

75. Douglass JM, Li Y, Tinanoff N. (2008), Association of mutans streptococci between caregivers and their 

children. Paediatric Dentistry, vol 30, pp 375-387. 

76. Twetman S. (2008), Prevention of early childhood caries (ECC): Review of literature published 1998 – 2007. 

European Archives of Paediatric Dentistry, vol 9, pp 12-18. 

77. Kowash MB, Pinfield A, Smith J, Curzon ME. (2000), Effectiveness on oral health of a long term health 

education program for mothers with young children. British Dental Journal, vol 188, pp 201-205. 


based oral health promotion in Glascow, UK.International Journal of Paediatric Dentistry, vol 16, pp 388-398. 



vol 21, pp 291-298. 

Improve oral health outcomes for frail and older people in the community and in residential care 

80. Spencer J, Dooland M, Pak-Poy A, Fricker A. (2006), The development and testing of an oral health 

assessment tool kit: for GPs to use in aged care facilities. Adelaide, SA, The Australian Research Centre for 

Population Oral Health, The University of Adelaide and SA Dental Service. 

81. Fallon T, Buikstra E, Cameron M, Hegney D, Mackenzie D, March J, Moloney C, Pitt J. (2006), 

Implementation of oral health recommendations into two residential aged care facilities in a regional Australian 

city. International Journal of Evdence-Based Healthcare, vol 4, pp 54-61. 

82. Rivett D. (2006), Compliance with best practice in oral health: Implementing evidence in residential aged 

care. International Journal of Evidence-Based Healthcare, vol 4, pp 62-67. 

Smoking Cessation Program 

83. Carr AB and Ebbert JO. (2007), Interventions for tobacco cessation in the dental setting, Cochrane 

Database of Systematic Reviews, Art. No.: CD005084. DOI: 005010.001002/ 14651858. 

CD14005084.pub14651852. 

84. Terrades M, Coulter WA, Clarke H, Mullally BH, Stevenson M. (2009), Patient’s knowledge and views about 

the effect of smoking on their mouths and the involvement of their dentists in smoking cessation activities. 

British Dental Journal, vol 207, pp E22: discussion 542-543. 

85. Reibel J, (2005), Tobacco or oral health. Bulletin of the World Health Organisation, vol 83, pp 643. 



Community Health Events 


based oral health promotion in Glascow, UK. International Journal of Paediatric Dentistry, vol 16, 

pp 388-398. 



vol 21, pp 291-298. 

People with Special Needs 


Recall 

88. Bader J. (2005), Risk based recall intervals recommended. Evidence-Based Dentistry, vol 6, pp 2-4. 

89. Gibson C. & Moosajee A. (2008), Selecting appropriate recall intervals for patients in general dental practice: 

An audit project to categorise patients according to risk. Dental Update, vol 35, pp188-194. 

90. Patel S. & Bay C. (2010), A systematic review of dental recall intervals and incidence of dental caries. Journal 


Fluoride 






pp195-199. 




95. Ahovuo-Saloranta A, Hiiri A, Nordblad A, Worthington H, Mäkelä M.(2008), Pit and fissure sealants for 


Systematic Reviews. (4):CD001830. 


health - application criteria and general policy in Finland. BMC Oral Health. 9:5. Epub. 

97. Mejàre I, Lingström P, Petersson LG, Holm AK, Twetman S, Källestål C, Nordenram G, Lagerlöf F, Söder B, 

Norlund A, et al. (2003), Caries-preventive effect of fissure sealants: A systematic review. Acta Odontol 

Scand, vol 61(6), pp 321-330. 

52 



Parent/ Client/ Carer Consult 


early childhood caries: A randomised trial. Paediatric Dentistry, vol 29, pp16-22. 


children: What works/ does not work and why. Paediatric Dentistry, vol 28, pp 172-176: discussion 

192-198. 






Train and support health and welfare workers 

102. Lime Management Group. (2009), Pension-level SRS oral health initiative. Melbourne. 

103. Johnson H, Cristini S. (2002), Oral health training project for carers working in group homes with adults with 

multiple disabilities. Melbourne, SCOPE, Victoria. 

104. Lange B, Cook C, Dunning D, Froeschle ML, Kent D. (2000), Improving the oral hygiene of institutionalised 

mentally retarded clients. Journal of Dental Hygiene, vol 74, pp 205-209. 

Implement oral health programs in residential facilities 

105. Disability Accommodation Services, Dental Health Services Victoria, Plenty Valley Community Health Inc. 

(2008), Final project report 2008. Melbourne, Disability Accommodation Services Victoria, Dental Health 

Services Victoria, Plenty Valley Community health Inc. 

106. Mehri M, Corbett T, Hui T. (1999), Train the Trainer at Kew Residential Services (KRS). Melbourne, School of 

Dental Science, The University of Melbourne. 

107. Fricker A and Lewis A. (2009), Better oral health in residential care: Final report. Adelaide Central Northern 

Health Service, SA Dental Service 

Increase oral health literacy of people with special needs and their carers 

108. Alomani F, Brown C, Williams KB. (2006), The effect of an oral health promotion program for people with 

psychiatric disabilities. Psychiatric Rehabilitation Journal, vol 29, pp 274 – 281. 

109. Alomani F, Williams K, Catley D, Brown C. (2009), Effects of an oral health promotion program in people 

with mental illness. Journal of Dental Research, vol 88, pp 648 – 652. 



Ineffective health promotion strategies 

Classroom lessons 

110. Calache H. (1990), The impact of a dental health promotion education program on the knowledge, attitudes 

and behaviour of primary school children (year 6) and their parents. Melbourne, Dental Health Services, 

Victoria. 

111. Vanobbergen J, Declerck D, Mwalili S, Martens L. (2004), The effectiveness of a 6 year oral health 

education program for primary school children. Community Dentistry and Epidemiology, vol 32, 

pp 173-182. 

112. Petersen PE, Peng B, Tai B, Bian Z, Fan M. (2004), Effect of a school based oral health education program 

in Wuhan City, Peoples Republic of China. International Dental Journal, vol 54, pp 33-41. 

113. Goel P, Sehgal M, Mittal R. (2005), Evaluating the effectiveness of school-based dental health education 

program among children of different socio-economic groups. J Indian Soc Pedod Prev Dent, vol 23, 

pp 131-3. 

Resource packs “Goodie Bags” 

114. Kreuter, Matthew W;Wray, Ricardo J. (2003), Tailored and Targeted Health Communication: Strategies for 

Enhancing Information Relevance. American Journal of Health Behaviour, ProQuest, pp S227. 

54 


18 

References 

1 

SA Dental Service data, unpublished 

2 

SA Health. South Australia’s Oral Health Plan 2010–2017. SA Dental Service, Adelaide, 2010 

3 

AIHW Dental Statisitics and Research Unit, 2008. The National Survey of Adult Oral Health, 2004 - 06: 

South Australia.Cat. No. Den 179. Dental Statistics and Research Series No. 43. Canberra: Australian 

Institute of Health and Welfare 

4 

South Australia’s Oral Health Plan, 2010 - 2017 

5 

Evidence based oral health promotion resource, 2011, Prevention and Population Health Branch, 

Government of Victoria, Department of Health, Melbourne, Victoria 

6 

Australian Institute of Health and Welfare 2009. Health expenditure Australia 2007-08, Cat. No. HWE 46. 

Canberra: AIHW 

7 

World Health Organisation, 2012 


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