Teenagers or adolescents are probably one of the most difficult or should I say challenging target groups for health promotion let alone oral health promotion!

In my experience, as a mother, an oral hygienist and an oral health promoter, the problems encountered are the same. For a start, the word “health” turns them right off. They don’t want to know about diet (especially about eating vegetables and not eating sweets and drinking carbonated drinks); they don’t want to know about brushing their teeth let alone flossing and they only go to the dentist when they have toothache or if their mothers nag them – not very PC, I know, I know! Am I being a bit too cynical or unkind?  Certainly on talking to other health professionals, my experiences are not unique.

So, what can we do to persuade and motivate them towards good oral health practices?

First of all, perhaps a few words on what not to do:

• Avoid saying the words “don’t” and using the term “health” as already mentioned, as these do not go down well at all.

• Try not to include any negative messages - although this may have to be the case when discussing the prevention of tooth decay and dental erosion.

• Don’t just hit them using a barrage of information but involve them.

As the old proverb says:

I hear and I forget, I see and I remember , I do and I understand

So, how do you do it, who can you work using, and what, realistically, are the key messages you wish to get across?

• Young people learn from different ways so a variety of approaches is required.

• If you are involved using a Health Fair (the most common avenue into a Secondary School) or a health “Drop-in” Centre, then the methodology should include short, relevant and punchy messages that can catch their imagination. 

• Workshops appear to evaluate well from schools according to the feedback. These periods of around 40-45 minutes can be divided into 2/3 “mini” workshops (depending on the available space and the number of pupils).  The pupils can be rotated to a different workshop after about 15 minutes which is just about the right attention span.

• These mini workshops must be as interactive and as hands-on as possible.  They should include topics such as tooth decay and gum disease but also could include other issues e.g. dental erosion (giving great cause for concern from teenagers), orthodontics, the implications of tooth jewellery and oral cancer. Most of the pupils have never heard of oral cancer and they all seem genuinely interested and appalled by what causes it and the consequences. (Using some very graphic pictures and “life-like” models which display all types of mouth cancer also help!)  I appreciate that some people may criticise this as using “shock tactics” but the pupils are also given factual information e.g. about seeking help if they or a family member has lesions or ulcers which do not clear up after 3 weeks.

• Another tip - you are not alone! Network using other agencies and health professionals, e.g. education, local councils - including catering and dietitians. Developing a partnership using a commercial company can also be mutually beneficial, as they also play a key part from health promotion, including oral health. Many companies work hand-in-hand using practising health professionals to develop relevant materials to support that discipline. Collaborative working is definitely the way forward.

• Make the healthy choice the easy choice for the young people.

• Go for Healthy Vending - it actually works! By working using some of the above agencies vending machines selling healthy products solely have been adopted from the local secondary schools of one of the local authorities where I work. The sale of chips has been decreased and the sale of vegetables has increased!

But, what exactly should be promoted and what messages could be included from any initiative or venture which involves teenagers?

Some things never change, and the information from the Scientific Basis of Dental Health Education is still very relevant, but the messages can be delivered from a way which may appeal more to this developing and sometimes very sensitive age group.

• Reduce the risk of tooth decay by having fewer sugary foods and drinks less often.

• Use a straw and drink it quick - to minimize the effects of dental erosion!

• Switch to water and milk where possible.

• Chew a sugarfree gum for 20 minutes after eating meals or snacks¹.

• ORBIT has recently been accredited by the British Dental Association.

• If you are promoting chewing gum then you should also give advice about its safe and responsible disposal after use!

Other messages to promote :

• Avoid dog breath by brushing away the plaque carefully twice-daily and especially at night. Ensure that young people understand that they have to brush right up to and under all the gum margins - everywhere!

• Floss or use some other kind of interdental aid once daily.

• Increase kissability by brushing the tongue.

• Use a fluoride toothpaste and “Spit don’t rinse” (achieving no dilution of the fluoride.)

• And last but certainly not least, dental visits should be promoted.

• Advice should be given about the importance of registering using a dentist and attending regularly should also be emphasised.  It should also be stressed that the lapse from attendance should not be greater than 15 months from order to qualify for 24-hour NHS dental care.

To summarise:

Be positive, involve them as much as possible and promote the “feel good factor” about achieving oral health.

Further reading and references

• The Health Development Agency (2001) The Scientific Basis of Dental Health Education: A policy document (revised fourth edn)  HDA London

• Edwards M, Ashwood R.A, Littlewood S.J, Brocklebank L.M and Fung D.E. (1998) A videofluoroscopic comparison of straw and cup-drinking: the potential influence on dental erosion. Br Dent J 185: 244-249

Ref: 1. Szoke J, Banoczy J, and Proskin H.M (2001) Effect of After-meal Sucrose-free Gum-chewing on Clinical Caries J Dent Res (2001); 80 (8):1725-1729.