As a health interventionist of the Youth Dental Health Department in Frankfurt, Germany, I am involved in the conceptual development of several projects aimed at improving dental and dietary health amongst children. Participants for this program include children, parents, nurseries and kindergarten staff, which puts me in charge of designing appropriate teaching methods for transmitting health messages to very different groups.
Nursery and Kindergarten Branch
My current focus is a project called “Healthy Breakfast” and “Sugar-Free Morning” (link) implemented in childcare facilities all across Germany to improve nutritional education, eating habits and health of children and carers. This includes advising children, carers and parents about fun and easy ways to get children to eat and enjoy a healthy breakfast. By eliminating added sugars from the morning hours, we can reduce overall sugar intake in order to reduce the risk of dental caries, obesity and associated diseases.
“Healthy Breakfast” and “Sugar-Free Morning” are implemented in almost all childcare facilities across our district, thus, helping to reduce health inequalities and raise children’s social and psychological well being:
All children experience at least one shared meal daily. They learn to enjoy their food, take their time eating and enjoy each other’s company. It is an important opportunity for carers to learn about children’s home environment and children can share their experiences, thoughts and feelings.
All benefit from a wholesome, nutritious diet and get all the vitamins and minerals they need instead of filling up on energy-dense but nutrient-poor foods such as sugary cereal.
Less sugar and more fibre and nutrients derived from whole-meal products means that energy is released throughout to provide stable energy levels for learning, playing and quiet time instead of sending children on an exhausting blood-sugar roller coaster.
All children get to know healthy foods and learn to enjoy a wide variety of different foods. They learn to overcome their innate neophobia (link), the fear of trying novel foods.
In Frankfurt, Germany, I am in charge of 25 nurseries and kindergartens. The program focus varies depending on the age group. Very young children have a chance to get to know the dentistry team to get used to dental care and reduce anxieties surrounding dentists, instruments and treatments.
We like to read books and tell stories about empowered children who love to take care of their teeth. We show parents that help their children to brush their teeth clean, from all sides, every day. And we tell children and parents about friendly, supportive dentists who will work hard to help you keep your teeth healthy. Unfortunately, it is actually very hard to find a book that does not use fear, punishment, control, restriction or other negative outcomes and unpleasant experiences to encourage dental care. The books that we do recommend (link) are useful, because they create a positive and fun image of toothbrushing, they describe the dentist as a partner and helper, and because they promote images of parents that assume responsibility for their children’s teeth by supporting appropriate eating habits and teaching effective dental hygiene (link). Older children can take part in healthy eating modules by making and eating their own veggie- and fruit skewers.
All children receive free toothbrushes and toothpaste and learn The Toothbrushing Song. Children learn to appreciate their teeth and how to best take care of them. More recently, we even put together a Toothbrushing Rap!
Modules for parents usually include information about healthy eating practices (link), advise on pacifier use (link) and bottle feeding (link), and toothbrushing training (link). Toothbrushing training is an important exercise, because it gets parents and children used to joint toothbrushing and helps to protect teeth from caries from day 1. Just like breastfeeding, certain tricks and techniques help to make tooth brushing a fun and easy endeavour for everyone involved.
Modules for carers (link) usually focus on creating an environment within the nursery or kindergarten that promotes health and breaks down barriers to positive health behaviours. By teaching nursery and kindergarten staff to implement the “Healthy Breakfast” and “Sugar-Free Morning” every day, to support and advice parents, and to practice toothbrushing with all children every day, we can actively promote health equality. All children get to experience a healthy, sugar-free breakfast and learn to take care of their teeth, regardless of their socioeconomic background. Health behaviours and habits establish early on in life, and habits that are adopted early on in life are often carried on into adulthood. Teaching children about healthy eating and toothbrushing contributes to lifelong health and wellbeing.
College and University Branch
In 2016, the Ministry of Education (Germany) decided to start teaching our modules directly to child care students in colleges and universities as part of their degree. As part of the Youth Dental Care Panel, I was actively involved in adapting the modules, designing the curriculum and teaching the content at colleges and universities across Germany. Main topics include dental development, dental care, healthy eating, advising and supporting parents and legislation and policy. Activities, games and exercises help students to put theory into practice.
This allowed me to work with groups of students of all ages, backgrounds, career orientations and experiences. Some of my students were highly experienced working with children from previous, related occupations and had decided to go back to college or university for a career change. Others had just graduated from high school and barely completed their first work experience in a childcare setting.
Some wanted to work with very young children, others focussed on kindergarten or day care settings and another group of students was looking to work with children with special needs or those placed in forest kindergartens. Classroom sizes ranged from 15 to 65 students at a time, and I enjoyed having to come up with different teaching methods, exercises, games and activities for each class.
I enjoyed being able to carry out the project from start to finish, from choosing content, appropriate teaching methods, developing activities and exercises to piloting, reviewing and improving the program. Now I am in charge of the college and university branch of the Youth Dental Care Department for the state Hessen, which includes 38 colleges and universities. I teach at approximately 10 schools myself, reaching over 2000 students. The remaining schools implement the program with the help of fellow health interventionists or trained teachers.