“This morning, I’m going to give you the three secrets of successful tooth brushing,” says Dr. Khalida Reyad, in front of about fifteen children aged 5 to 7, whose smiles are toothless from the loss of their first baby teeth. Today, she speaks to several CP classes at the Léo Orville elementary school in Créteil (Val-de-Marne, 90,700 inhabitants). From her bag, she takes Oscar, a large set of dentures, along with her green toothbrush. The children are captivated. Especially since with their school teacher, they have already revised and are proud to show the dental surgeon that they know the names of the different teeth.
As the 40 minutes of his intervention progress, Dr. Reyad tells the children his secrets: do not wet your toothbrush before brushing your teeth, put only a very small amount of toothpaste on it, and rub five times the sides, then make three small circles on the tooth of the six year olds, the most fragile. “Tonight, you will go home with a new toothbrush, informs the dental surgeon. And above all, don’t forget to tell your parents that you have to brush your teeth well, and make an appointment with the dentist. »
To convince them of the importance of good brushing, she does not hesitate to show them a poster with the smiles of children with decayed teeth. “Now that you’ve seen this photo, you still don’t want to be part of the ‘cavity-free’ club,” she asks a child who has been half-convinced until now.
A departmental program and city policy
The oral health prevention program was established in the 1990s in the Val-de-Marne department. “The city of Créteil has decided to enter into an agreement with the department to offer this service to children in priority neighborhoods for city policy (QPPV), explains Sylvie Brault, Health Prevention Manager, within the Communal Center for Social Action (CCAS ) from Creteil. They display multiple health problems including oral problems. However, teeth are a social marker. »
Originally, the program is funded for all class levels, from kindergarten to CM2. “Then gradually, the department decided to concentrate its financial aid on the classes concerned by the M’T dents program of the Health Insurance, which we value through our actions”, adds the manager.
From now on, the department only finances the program for the large kindergarten section, CP and CE1. And the city, which wanted to maintain this prevention action in all other classes, finances it via the Prevention and Health Promotion (PPS) program of the Regional Health Agency and City Policy funding within the framework city health workshops. These are freelancers and students at the end of their studies in dentistry, who provide the interventions.
A decisive preventive action
“These preventive actions are essential,” says Dr. Reyad, after finishing his morning class round. For three years, it has been carrying out this type of action in Créteil, and for 30 years in other towns. “I enjoy giving advice to children,” she says. Public health is fundamental. With this type of primary prevention sessions, the child becomes an actor of his health. »
Depending on the age, she adapts her speech and the themes covered: the name of the teeth, their role, good brushing, the course of the visit to the dentist, sports and oral health, the teeth of animals. Faced with the disparities she observes in the classes, she feels frustrated, “especially since some dentists sometimes refuse to take care of the children”, she denounces. But from one year to another, she observes the acquisition of children’s knowledge thanks to the programs.
Moreover, in CM2, a ten-question evaluation quiz is asked of the children (five questions on nutrition and five questions on oral health), and the three classes that come out on top win a gift basket, fruits, as well as a diploma. “They are generally very proud to win, as is their teacher, and all the more so since it is an elected official who gives them their diploma”, concludes Sylvie Brault, specifying that the city also deploys screening programs within Medico-educational institutes (IME) and for certain QPV schools.
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