Encouraging conversations about kid-friendly realistic eating strategies in the dental setting

Introduction Childhood obesity remains one of the greatest health challenges faced by the United Kingdom. With shared risk factors, obesity and dental caries are often associated.Aims A quality improvement project (QIP) was conducted at a London dental hospital to: 1) improve recording of children's body mass index (BMI) prior to listing for dental general anaesthetic (DGA); 2) create a referral pathway for children causing weight-based concern; and 3) improve clinician confidence with weight-based conversations.Methods Gold standards were created considering age and medical/behavioural complexities in this two-cycle QIP. The intervention involved smart template creation and teaching by a consultant paediatrician. A childhood obesity pathway was developed to appropriately signpost and refer to weight-based services. A mnemonic (CARES: create, assess, rapport, engage/explore/educate, signpost) was created to support dental professionals with discussions.Results In Cycle 1, BMI was recorded in 12 patients (37.5%) and centile only in seven patients (21.9%) (mean BMI = 20.0 [range: 14.5-50.7]; mean centile = 70^th [range: 1-99]). In Cycle 2, BMI was recorded in 20 patients (74.1%) and centile only in one patient (3.7%) (mean BMI = 17.1 [range: 14.6-21.1]; mean centile = 57^th [range: 6-95]).Conclusion This QIP demonstrated clinicians were not routinely recording BMI prior to DGA listing. The creation of a smart template, childhood obesity pathway and mnemonic aided clinician engagement in conversations about weight.