Children Get a Healthy Smile

The oral health of young children in Hong Kong is a worry because nearly half of them have dental caries, or cavities, one of the highest rates in the world. Until recently, awareness of the problem has been low and treatment even more problematic because it is hard to get pre-school children to sit still in a dentist's chair. Dr Chun-Hung Chu and his team have been working to change that.

Dr Chu, Clinical Associate Professor in Faculty of Dentistry, is a specialist in Family Dentistry who returned to academia in the 1990s to investigate how to address this problem of children's oral health. The result is a programme that has reached more than 10,000 kindergarten-age children in Hong Kong so far.

"It takes years to train a paediatric dentist and years to solve the decay of only one child. When I look at society, many children are suffering. When the decay is untreated, it causes pain and local and systemic infection.

"By the time children enter primary school and the school dental health care service, many of the teeth with caries can't be saved and need to be extracted. It's already too late."

Dr Chu's solution is to apply the research he developed and to involve the wider community in bringing better oral health treatment and education to children.

His PhD focused on applying an agent – silver diamine fluoride – to stop teeth with decay from getting any worse. The agent is "painted" on the teeth and avoids the fearful prospect of dental chairs and drills.

"The best way to prevent decay is through proper teeth brushing using toothpaste and fluoridated water. Where there is decay, results of my PhD study showed that the silver diamine fluoride treatment can stop it from progressing. You don't need to treat every child with it, just the ones at risk," he says.

This was tested with children in Guangdong and showed good results, so he contacted church organizations to test the application here and offer oral health education training for teachers and pupils. Fourteen kindergartens were selected for the project in 2008 in collaboration with the Hong Kong Christian Service and the Alliance Church.

The success of that venture encouraged bigger thinking. In 2010 the project received funding from the S.K. Yee Medical Foundation and Colgate-Palmolive Co. Ltd to expand to 100 kindergartens. Additional NGOs such as Baptist Church and Tung Wah Group of Hospitals were involved.

A full-time dentist was hired to check the children's teeth and apply the silver diamine fluoride to high-risk children. Talks were also organized for parents to raise awareness and answer questions, in addition to the teacher training.

"Dental caries is totally preventable and we hope by educating parents, it will improve oral hygiene practices in children," Dr Chu says.

The response to the service has been overwhelmingly positive: 96 per cent of kindergartens surveyed said they were very satisfied or satisfied with it.

The success has been heartening for Dr Chu, who sees the project as a chance to help others and practice his Christian values.

"This is a passion for me. It gives me great satisfaction to offer help to society. I can go into the kindergartens and serve the children in an environment that's familiar to them, screen out the at-risk children early and provide care, and do some early prevention work. It's very meaningful work," he says.

The hope now is that funding will be provided so others such as NGOs can take over the project and carry it forward in future.