Getting Our Teeth Stuck into the Problem.

Opportunistic Public Health Messaging within the A+E Department


  • Rosanne Verow Barts NHS Trust
  • Nicola Davey QIC Learn
  • Richa Ajitsaria QIC Learn


Accident and Emergency, Dental Health, Health Promotion



Tooth decay is the main reason for children to be added to the Child Protection Register for neglect in Tower Hamlet. Staff in A+E see many children a day but frequently don’t stop to address dental health.


We used process maps and fishbone diagrams to explore the problem. We aimed that by the March 2022 8 out of 10 children aged between 1-17 years old seen in paediatric A+E will have been asked when the last time they visited a dentist was. This will be measured by looking retrospectively at documentation in the medical notes.


Change ideas were tested using staff voting and 10 PDSA cycles were performed. These broadly fitting into the themes of information gathering, information sharing, providing resources, teaching, and incentivising staff through competition. Changes ranged from emails highlighting the key project messages, leaflets on how patients can find an NHS dentist and a tooth fairy leader board for the staff who ask the most patients about dental check-ups.

In the month that we have started this project, change has been noticeable going from no children being asked when they last visited the dentist, to one in five children. Staff have fed back how easy it is to ask families about their last dental visit and multiple reprints of the "how to find an NHS dentist" were needed. 

Nurses achieved higher figures than doctors however this may have reflected triage being the most effective place to have these discussions. 


This was a multi-disciplinary project involving patients. It shows that A+E is an ideal place for health promotion with staff interacting with large numbers of children every day. We have not yet reached the numbers, we aimed for, but perhaps more importantly we raised the awareness of oral health within the department and started conversations around its importance.

The next stage is to have a question about dental attendance added to the electronic tirage form and explore further with parents to see if increased awareness results in increased attendances to see a dentist.




How to Cite

Verow, R., Davey, N. ., & Ajitsaria, R. (2022). Getting Our Teeth Stuck into the Problem.: Opportunistic Public Health Messaging within the A+E Department. London Paediatrics, 1(1). Retrieved from