New campaign encourages welfare recipients to brush teeth in New Zealand

By - Bad Breath Expert

SUMMARY:  New Zealand's recent oral health campaign is raising eyebrows. See how it stacks up compared to U.S. methods.

Posted: October 8, 2014

brush your teeth

The good, the bad and the ugly - that's the wrap the recent oral health campaign has been getting in New Zealand, where the country's health ministry is sending regular text reminders to young welfare recipients urging them to brush their teeth. 

Advocates regard the program as an innovative solution to the country's oral health problem and a fresh way to reduce the number of emergency dental care grants, but civil libertarians and welfare advocates have labeled the project as degrading, demoralizing and distasteful. 

Belinda Smith, from the Canterbury district health board, said the ministry was worried about the widespread emergency dental care grants given by the Social Development's Work and Income service to unemployed young adults. What's more, oral health issues such as tooth decay and gingivitis are more prevalent among those in lower socio-economic brackets. 

"We wanted to remind people to brush their teeth," Smith told The Guardian. "We know about the success smoking cessation services has had with text reminders, and knew young adults are always on their phones, so we thought we'd give it a go, too."

Trial proves effective
A "large number" of people were recruited for the 10-week trial, for which each received a series of motivational text messages reminding them to brush their teeth. The messages also asked them to respond with whether they'd brushed today.

Brushing rates jumped from 53 to 73 percent during the trial. Despite the trial's success, others argue the campaign leaves a sour taste in their mouths. 

Paul Blair, a spokesman for the Rotorua People's Union, said the program unfairly targeted the unemployed.

"It just deepens the stereotypes that beneficiaries can't do anything themselves, get a job, even brush their teeth," Blair told The Guardian.

According to the 2009 New Zealand Oral Health Survey, dental decay was the most prevalent chronic and reversible disease in New Zealand. The survey also showed that adults living in areas of higher socioeconomic deprivation had significantly poorer oral health and lower attendance rates at the dentist.  

An international issue: Oral health 
But oral health issues among lower socioeconomic demographics are not confined to New Zealand's borders. A similar trend is happening in the U.S., where adults with less than a high school education experience untreated tooth decay nearly three times that of adults with at least some college education, according to the Centers for Disease Control and Prevention.

The widespread discrepancy has been linked to several factors, including limited access to dental health services, diets higher in sugar and other carbohydrates, greater smoking rates and a lack of awareness of oral health problems. 

However, instead of a text message campaign, government-funded health groups in the U.S. are trying to tackle the situation a bit differently. Healthy People 2020 is the American incentive to address health disparities and increase quality of care. To achieve this goal, the group has taken intervention methods such as implementing community water fluoridation and school-based dental sealant programs. Currently, the campaign is approaching its goal, having 79.6 percent of community water containing fluoride. 

Moreover, school-based dental sealant programs are seeking to patch up oral health problems in the classroom. The Surgeon General's report on oral health indicates the sealants, the thin plastic coatings applied to the tiny grooves on the back of teeth - where most tooth decay children and teens occurs - can reduce decay in school children by more than 70 percent. 

Health experts point out that good oral hygiene habits start at a young age. Brushing, flossing and eating smart can become ingrained into children's routines, which will benefit them later in life. 

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