COVID-19 has presented unprecedented challenges in many aspects of dentistry. At the time of writing, when a second wave in the UK is highly likely, uncertainties are felt by all and continue to grow.

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Favour Onudiwe

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Chi Wing Natalie Liu

As dental students at Barts and The London, Queen Mary University of London, we have launched a student volunteering initiative, Barts Community Smiles (BCS). Our group aims to broaden the public's knowledge in oral health and disease, correct common misconceptions and reinforce the importance of good oral hygiene.

Our work is primarily based in the London Borough of Tower Hamlets, where dental diseases are a serious problem. The latest Public Health England's Public Health Profiles revealed that the proportion of children in Tower Hamlets having visually obvious dental decay far exceeds the national average, ranking 7th in the whole of England.1 Similarly, rates of tooth decay and gum disease in adults were higher compared to the rest of the country.2 Poor oral health not only impairs function, but also affects wellbeing and is of course associated with other chronic diseases, as well as leading to absences from work and school. Given that fewer people were accessing dental services in Tower Hamlets, front-line preventive work is crucial as a first step to avoid oral diseases.

We use a combination of approaches to reach out to different age groups in the community. Through local school visits and participation in community festivals, we previously interacted with children and teenagers to provide advice for healthy living and mouth. In addition, we placed huge emphasis on raising awareness of oral diseases to the public at community clinics, hospitals, local mosques, and care homes. The promotions often tied in with national and international health campaigns, such as Sugar Awareness Week, World Oral Health Day, and Mouth Cancer Action Month.

Our work has been significantly disrupted by COVID-19. Government recommendations on social distancing has put a halt on the interactive nature of oral health promotion. On the other hand, an increased consumption of unhealthy commodities have been fuelled during the pandemic. The Oral Health Foundation pointed out that 70% of families with children under five reported more snacking in the household;3 the Obesity Health Alliance also reported 39% of adults were consuming more sweets and confectionery.4 Provision of dental services has been reduced and so have patients' incentive to seek dental care due to fear of contracting COVID-19. These have all contributed to an inevitable increase in dental pain and infections which were not treated in a timely manner.5 To adapt to the current pandemic, we have produced some online materials which will help disseminate key messages of protecting oral health.

For the first time this summer, the Wandsworth Food Partnership launched a SUGAR SMART campaign in collaboration with Public Health Wandsworth. We were asked to join in this campaign to address the overconsumption of sugar in the local area.

Normally, we would go into local children's settings like libraries, schools and educational community centres to interact with and educate children on the ways they could make healthier choices in relation to sugar. This would be through games, posters and quizzes. However, due to the limitations on social interaction, we came up with something new and put together a series of informative videos aimed at teaching children the health risks associated with sugar on oral and general health. These are especially needed during this time when access to health education from medical staff and in school settings is reduced.

After much research on the video software currently available, we decided to acquire a new software to make two animated videos. The first video gives tips on how to brush and how the lack of brushing leads to plaque accumulation and thus tooth decay. The second video demonstrates how to be smart about sugar consumption and the effect it has on both oral and general health. All advice and recommendations in both videos were sourced from Public Health England's Delivering better oral health toolkit - but it was tailored to younger children by using cartoons, animations and layman's terms.

Through this, we hope that we can cause some behavioural changes within the young people living in Wandsworth by giving them information and encouragement to change unhealthy behaviours to healthier ones. We are hoping for this project to lower levels of sugar consumption and consequently tooth decay within young people in Wandsworth.

Due to the positive reception and feedback from our collaborating organisation and public engagement, we are expanding the project by making more videos and online resources like these for our local GP surgeries, libraries and community centres. Our vision is to spread awareness of dental health through simple but consistent messages, and reach people who would normally not visit the dentist due to language or financial barriers.

The uncertainty of the future caused by COVID-19 is ever-growing. It has been hard for us to reach out to different organisations and local authorities about their plans for health promotion. It is a crucial time to give out prevention advice when dental access is limited. While overcoming technical and communications difficulties, your participation in public health campaigns will truly make a difference in the oral health and overall wellbeing of the community.