Jo Dawson reports on her dedicated efforts to have dried fruit removed from the free fruit snack selection at primary schools.

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I'm a mum and a dental nurse. I was concerned that my young children were being given dried fruit as snacks at school. I was told it was only six times a year and not to worry. When my eldest moved up to Key Stage 2 (KS2) I realised that the school snack policy was allowing older pupils to bring in dried fruit as a snack every day of the year.

I contacted the head teacher, who felt unable to change the policy for KS1 pupils, as it would be hypocritical when giving out the dried fruit through the government-funded School Fruit and Vegetable Scheme (SFVS). The school could not afford to buy fresh fruit or vegetables for all Key Stage 1 (KS1) pupils six days a year.

A summer of email tennis with the helpdesk at SFVS proved fruitless. So I decided to head to the top.

Matt Hancock, the Secretary of State for Health and Social Care, was scheduled to speak at an NHS conference in September 2019 so I got a ticket and off I went, armed with boxes of raisins. Due to proroguing in Downing Street he never made it, but I made the most of the opportunity and got to speak directly with Duncan Selbie, then Chief Executive of Public Health England (PHE), and Simon Stevens, Chief Executive of the NHS. In October I went to the BDIA Dental Showcase to see Chief Dental Officer Sara Hurley, and also spoke to people on the stands. The team at the British Society of Paediatric Dentistry (BSPD) were welcoming and offered support when I joined. They published a press release about Raisin Awareness. I also got publicity in various dental publications including BDJ Team (https://go.nature.com/2O3i4fT), Dentistry Online, Dental Review, Dental Nursing and GDPUK, totalling over 15,000 views.

I felt determined to effect a change and raise awareness about frequency of sugars and dried fruit sticking to teeth - getting non-dental people to understand what makes a tooth friendly snack

Following my lobbying in Manchester, Duncan Selbie set up a meeting for me with Sandra White and Jenny Godson at Public Health England. In the meantime, I'd met my MP who wrote a letter to the Department of Health and Social Care (DHSC). By the time I got a reply COVID-19 had hit; Matt Hancock was a bit busy, but Jo Churchill kindly gave a response. Basically, SFVS, PHE, the Office of the Chief Dental Officer (OCDO) and DHSC all concluded that even though this is not in line with broader Government & PHE advice - which recommends that dried fruit should be consumed with a meal to reduce risk of tooth decay - the policy could not be changed for logistical reasons (delivery).

As a direct result of my campaign, a newsletter to schools was issued by SFVS including details about the cariogenic risk of dried fruit snacks, but I don't think that it reached the parents (in a nationwide survey of SFVS parents, out of 30 respondents, only one had received this information from school). I felt determined to effect a change and raise awareness about frequency of sugars and dried fruit sticking to teeth - getting non-dental people to understand what makes a tooth friendly snack.

My MP suggested I try and get more dental associations on board. To date, I have gained support from the British Dental Association (BDA) and the Oral Health Foundation.

I decided: if this can't be changed from the top down, let's try from the ground up.

Phase 1

Raisin swap in one primary school, funded by Devonshire House Dental Practice, Cambridge.

One hundred and eighty KS1 pupils are now getting tooth-friendly fresh vegetables instead of raisins and sultanas on those six days of the year.

A bonus environmental effect of this change is that there is less plastic packaging and none blowing around the playground.

Devonshire House Dental Practice commented: 'I would definitely recommend other practices to get involved. Our social media posts have received lots of engagements, likes and shares. It's good for children, good for staff and promotes wellbeing. We are all proud of [Jo Dawson's] passion and are happy to support her in her campaign'.

The whole school snack policy has also been changed to prevent dried fruit being eaten as a break time snack. Pupils were informed and an email was sent out to parents explaining the change in policy and reasoning. One hundred and eighty-nine KS2 children are now only eating fresh fruit and vegetable snacks in the school grounds.

This is great news for 369 pupils but there is more to be done. Many children take chocolate, cereal bars and dried fruit to school for snacks (my online survey recorded 50% of parents who supply snacks to KS2 kids included these).

Recent developments

Things have obviously slowed down during the COVID-19 pandemic, but since then I gained a place on an Oral Health Promotion Project course. It was intensive but brilliant. It shone a light on best practice examples of oral health promotion and I realised that I have the potential to make an even greater impact on children's oral health.

It was suggested to me that I should enter the BSPD Outstanding Innovation Award as the prize is the opportunity to speak at the BSPD conference and so gain more publicity for the campaign. Although I didn't win, my entry was well received.

The judges said: 'Jo has amazing tenacity and her campaigning is linked not just to reducing dental caries but obesity too. Undeterred when she could not change the policy of the School Fruit and Vegetable Scheme, she set about making a difference at local level'.

The next phase of my Raisin Campaign is to expand on phase 1 and get more dental practices and more schools involved.

For details of how your practice can join in, look out for more information in the April issue of BDJ Team.