Missing links: A qualitative study investigating perceptions of teachers and parents of infant children in two Welsh primary schools with different socioeconomic profiles, with regard to oral health

Aim: This qualitative study explores the perceptions of teachers and parents of infant children in primary schools positioned and servicing affluent and deprived populations, as intermediate and end users of oral health promotion services in the Vale of Glamorgan, Wales.

Methods: A qualitative focus group methodology was chosen as the most appropriate way of exploring these issues. In addition, this method was combined with individual face to face interviews of the teaching staff.

Two primary schools within the Vale of Glamorgan were chosen each representing different geographical locations within the area as well as different socioeconomic profiles.

Head teachers invited parents to form a focus group of 8 participants. The head teachers from each school also agreed to be interviewed and invited one other teacher from their school to part-take in a face to face interview.

Results: One school was successful in forming a focus group of 8 individuals for the study, the other was unsuccessful in forming a group but one parent was available for a face to face interview. Head teachers and teachers were interviewed in each school.

Six themes emerged from the analysis of the data. These included:

The dentist

Design to Smile ((D2S)

Oral Health Education messages

Positive role modelling

Responsibility

School Policy

Increased levels of tooth related problems were reported in school 1 whereas in school 2 tooth related problems were not reported. School 1 was involved with the Welsh Government program D2S which showed positive outcomes. Confused messages were reported by both teachers and parents which suggests that different approaches are needed in the delivery of the messages. Access for effective ongoing continuing care was problematic for the parents of the children who had experienced dental caries.

Conclusion: There were clear differences in the perceptions of disease experiences of children in the staff and parent(s) of each school, with dental disease impacting on some of the children of school 1. Clear benefits were verbalised to the scheme D2S for school 1 in terms of the development of behaviours in both children and parents.

This study shows positive outcomes for D2S, however there is evidence of continued isolated, compartmentalised and uncoordinated approaches to the provision of oral health promotion.

More effective downstream approaches need to be developed in order to improve opportunities for oral health. These can be addressed through: Resource allocation for teaching, Training service deliverers, Dental service development.