Reimagining dental care services

Final Project  - MA Service Design 

(Royal College of Art),

Partners: Kolibree, ZS Pod Marjankou, Dental Care Houses Prague
 Service Design   Public Health   
 Digital Platforms  

The Overview

Tooth decay becomes one of the major global health challenge

In the 40s, WHO re-defined health as not the absence of disease, but the presence of physical, mental and social wellbeing. The problem is, that health care systems around the world are not flexible to adopt this change of paradigm. Dental care systems are not an exception.

Unhealthy mouth can dramatically impact our physical, psychological well-being, and happiness, but it is not inevitable. Majority of dentists agree, that the most effective is health promotion and education. The point is to start teaching kids and then family. Dental health depends on the educational level of the parents and the way the dentist have to influence them to be better.

Eventhough, we know this, tooth decay becomes one ot the major global health challenge. According to WHO, 60 - 90% of schollchildren worldwide have dental cavities, about 30% of people aged 65 - 74 have no natural teeth, and nearly 100% af adults have dental cavities.

WHO has formulated specific targets on dental caries among children to be achieved by 2020. The target was to reduce dental caries severity among children aged 12 years to no more than 1.5 DMFT ( Decayed, Missing and Filled Teeth index). However, most of central and eastern European countries haven't reached this target. 

This project aims to answer why these countries were not succesfull in reaching this target, than to define the key painponts of dental care system in the central Eropean countries on the policy level. Than to explore leverage points which might be influenced in order to improve dental health among youth by testing several service propositions with parents, kids, teachers and dentists.

The Research

Why the central and eastern European countries are less succesfull in reaching the target?

The research consists of an online questionnaire, 14 interviews with key stakeholders such as dentists, dental professionals, school teachers and parents. Than, I organised two design workshops with one group of pre-school children and one group of school-children in order to better understand their relationship to health education.

Research Questions

1) Why the central and eastern European countries are less effective in the dental helth prevention?

2) What motivates parents and kids to keep better dental health? 

1. Parents are less motivated and consistent

We as individuals are responsible for our health and health of our kids. All is about learning the right habits.

Nevertheles, we have to overcome inconsistency.

Business around products and services of dental hygiene is not recognise as something important for people and they do not invest in those.

These families who are motivated, will obviously em-
brace technology advanced treatment or technology

for prevention. Whereas, those who are not motivat-
ed won’t understand anyway what it is for.

2. Czech patients do not visit dental checkups regularly

From the interviews with parents I found out, that they are motivated to visit regular checkups, but they forget very often to book it. Than it takes even three years to visit another checkup. 

From the interviews with dentists I know, that these families which visit cheskups regularly have significantly better oral health. The same underlines research.

But, from the statistis I know, that czech patients do not visit regular dental checkups. In 2017, only 3,5 % of patients visited checkup twice, and 37% of patients visited checkups once.

From the interviews and online questionnaire I found out that parents do not bealieve in the quality of dental prevention programs at schools and kindergartens. Parents claim, that there is not enough programs available out there.

Concerning school teachers, they say the same. 

“I’m really not sure if our school do some preventive programs. It’s not important, because these programs are useless.” MgA. Sladka told me in the interview.

From the expert interview with Dr. Samuel Elhadad from the University Maryland in Baltymore I know, that the dental decay is easy to avoid. It is all about education. The same argument have WHO nad FDI.

From the primary research, I found out that the advantage of these countries which have less problems with dental health (UK, Germany, Switzerland,..) is for example that the school dental service was not thrown overboard. But, in the central Europen countries, the introduction of organised prevention such as school-based dental health education has been mostly abolished in the early nineties.

3. Organised prevention such as school prevention programs were throwen overboard in these countries

4. Dentist do not have time to focus too much on prevention


Dentistry is business and dentist are not 

rewarded for healing patients but for 

amount of treatments. Dentist do not have enough motivation to focus too much on prevention.

Dentistry is business and dentist are not 

rewarded for healing patients but for 

amount of treatments. Dentist do not have enough motivation to focus too much on prevention.

What motivates parents and kids to keep their teeth healthy?

The Goal: to avoid tooth decay as much as possible

toothbrushing at least twice daily with a fluoride toothpaste

avoiding sugar intake

Tom is 6 years old boy living with his family in Prague, the Czech Republic


Learning new habbits when it is a duty


Exploring new thinks in an engaging way


Dental visits

Feeling responsibility

regular dental visits / twice yearly

Kristýna is Tom's mother. She is 33 year old. Married to husband Tom.


She had dental health issues when she was young.Thou, her bad experinces with dentist is the reason to avoid the same problems regarding Tom.

Lack of time / she does not remeber when to go to other checkup. Also, she does not have time to check Tom is he toothbrush regularly. Tom should be old enough to take responsibity.

Does not trust to school, government and even their dentist. Only her and Tom is reponsible for their own health.


Kristýna was motivated to visit checkups regularly over the first three years of Tom.


Get discount when need for drilling

Dental visits

Beying healthy

The Conclusion and Problem Statement

While the dental care system in Baltic countries is fragmented, there is an increasing need for a holistic approach to solve the problem. But it seems less important issue for national policy makers. Thus there is need to find a way how to motivate parents to be ivolved more. Maybe the way is through produst of dental aesthetis and fashion and lifestly ervices and products.

No signals of some big systematic reforms or systematic change in dental health care policy. The dental health care system  is designed in order to help people when a disease occurs. No enough focus on prevention.

How might we connect parents, schools and dentist in an engaging way in order to improve the dental health of both kids and parents?



The platform enables a holistic approach to kids’ dental hygiene, connecting between home, school and clinics, thus connecting isolated  interventions to kids’ oral hygiene.

Connect all the stakeholders through gamification, one storry or a game which keep kids attention.

Prototyping the rewarding system for children - design the experience before product

The hypothesis one:

Kids will be motivated to practive toothbrushing when they will be rewarded by some kind of score, which than can use as weapons to attack other kids in a social network which practice toothbrushing less. They will confront each other. They will get points after visiting checkup, at school, and at home.


Exploring gain creators:

What motivates children / the workshop = easy to motivate, hard to keep attantion in the long preriod.

What motivates parents / rewarding system / insurance, rewards, opening new levels of education, social network and sharing pi.


The first iteration: new hypothesis