Screen Times and SmartPhones for Children – Best Practices – IC061

Teaser:
What is the right age for a smartphone?

Yeah. We would say that smartphones with full internet connectivity and everything involved and social media, it’s-

This smartphone usage has become almost the norm for every teenager across the country. And of course what a smartphone does is allow people 24 hours to access to the internet, to social media, to all the unfettered things that we need to, they can see. If you think about whole child health, and that’s how we should be approaching health for our children.

Obesity’s gone up. There’s huge linkages between the seditary behavior of being on screens, but not just the seditary behavior. Because actually if you are sitting on social media or you’re sitting on gaming, you are targeted by fast food manufacturers in a way, way more than you would be on TV. You could have a big argument about the quality of what children are doing on screens when they’re 15, 16.

Or they learning to make music. Are they revising and doing things, but for a two, three, 4-year-old, there are no benefits of being exposed. 

Jaz’s Introduction:
What a time to be alive as a parent. Back when I was a kid, I would go and play football for hours. My parents, they kind of knew where I was, but there was no way to reach me. And the other thing I remember is that when I was a kid, I wanna go to cinema. And then so you agree with your friends that, look, I’m gonna see you at 11:00 AM, at the cinema on Saturday. And there was none of this like texting and WhatsApp and Snapchat and that kind of stuff, and you would just show up at 11:00 AM on Saturday, and that’s a simple life that we lived.

But now with smart phones and social media, I really worry for our children, which is why I brought some experts on to discuss phone use in children and best practices for screen time and smartphones. And so you are thinking Jaz, what has this got to do with dentistry? Well, we have an active role to play as healthcare professionals.

Early smartphone usage and social media is absolutely detrimental to the health of our children. And as healthcare professionals, we have a duty to know about this and to spread the good word. And many of you, like me, are parents, and we need to hear this stuff. We need training.

We need guidance, and that’s exactly what we bring you today. You’re gonna love our guest, Arabella and Laura. But I wanna say thank you to Protrusive community member, Lydia, Dr. Lydia Roulston. It’s been so nice to chat to you on the app, give each other book recommendations, and you are part of this very organization that’s helping schools and communities to realize the dangers of having smartphones in young hands.

Dental Pearl:
I’m so grateful that you’re part of our nice and geeky community. Now, this is an Interference Cast, which is like the nonclinical arm of the podcast, and I usually reserve my Protrusive Pearls for the actual PDP episodes. And as many of you know, I actually struggle when it comes time. I freeze up when it comes time to give a pearl, ’cause I’ve given like 300 in the past.

I’m kind of running out of nuggets. Like obviously there’s an endless amount of dental nuggets and gems out there, but to suddenly pull one out can be a bit tricky. But you know what? I’ve got one from the heart. So even though it’s an icy, I still want to give a pearl. And it’s like from the heart as a parent. In the book, I think it was Seven Habits of Highly Effective People by Stephen Covey.

It talks about being value centered and not being like a profession centered, like your entire world shouldn’t be about being a dentist. Your number plate shouldn’t be dentist. You shouldn’t introduce yourself to, hey, I’m Jaz, I’m a dentist. Like, your identity should not be your profession. The world also shouldn’t revolve around your spouse, nor should your world revolve around your children.

Your world should revolve around your values. And how I’m linking it even more to this theme of parenthood is that, I have a 6-year-old and we go through all the tantrums and behavior issues that all parents do. It’s very normal. And I love talking about being a parent to my patients. I learn a lot from my patients.

I do have an elderly patient base, and so I do get to benefit from their wisdom. And one thing I’ve come to conclude over time is that if you want to do something for your children, don’t do it for them. For example, if you’re making career sacrifices, make sure you are clear that you’re not doing it for them.

Or if you are not going to the gym because you can’t fit in because everything you’re doing, you’re prioritizing your children and you’re doing it for them, then I’m gonna suggest you’re doing it for the wrong reasons. Don’t do it for them, do it for yourself. Whatever you want to do for your children, do it because you want to do it.

Because when the messy times come in, any family dynamic and they start answering back and you have an argument and it gets be heated, you don’t wanna be like, oh, that little s*** can’t believe how much I sacrifice for my son or daughter, and that kind of stuff. You don’t wanna feel like that. They don’t owe you anything.

Any sacrifice you do, anything you do, do it because you wanted to do it. Not for them. I hope that made sense. It just came from the heart, was totally unscripted, spontaneous, and for those on Protrusive Guidance particularly, I wanna know what you felt about that. Anyway, hope you enjoy the main interview. I catch you in the outro.

Main Episode:
Laura and Arabella, welcome to the Protrusive Dental Podcast. I’m so, as a father of two boys, i’m so excited. I read books like Anxious Generation and I follow so much, and I wanna thank Lydia for connecting us. There’s so much I wanna speak to you about, but before we get into the meat and potatoes of this, I’d like some introductions.

Okay. Start with you, Laura. Laura, tell us about yourself, you in healthcare, but also you and your vested interest in this really important public health concern. 

[Laura]
Well, good morning, and thank you so much for inviting us on to speak about this very important topic. It’s become a passion of mine over the last 18 months and is starting to take over my life a little bit.

So how have I got to that point? So essentially, I’m a mother of three boys also in the boy world. The eldest is just turned 11, so we’ll be going into year six in, going into year seven, sorry, in September. I knew from the minute he was born that this was gonna be one of our biggest parenting challenges and I think I’ve been proved right that this is absolutely where we’re at.

And then alongside that, professionally, I trained and worked as a GP. And then three years ago I stopped being a GP and had realized I’ve got an interest in child and adolescent mental health, and that’s where I work now. I now work as a specialty doctor in child and adolescent mental health, and obviously I see the issues that phones, how they affect young people on a daily basis now. 

[Jaz]
You are in the trenches, Laura, you are in the app, so you are the first person to see the negative connotations of this manifest. 

[Laura]
I think in the trenches is a very good phrase. I’m absolutely in the thick of it, and yes, I’m seeing the children that are struggling the most with their mental health in this day and age. 

[Jaz]
The tip of the iceberg. But there’s so much that we don’t see that’s brewing, and that’s like the whole clinical iceberg model, which we’ll talk about, I guess. Thank you so much for that. Arabella. Tell us about yourself. 

[Arabella]
Well, I’m joining in the mother of boys. So I have teenage boys. I have, a slightly higher end of Laura. So I have 19 and 15, so I’ve kind of seen it change and seen it develop. My background’s quite different, so I started life as a business and marketing strategist. So I worked in very big corporations and so I understand how we get people into these things and how they want to do this. But I retrained and did a masters in psychology and then got involved in campaigning for children.

And got into the screens area because parents post pandemic were particularly worried around screens. And in 2022, started working with an organization called Safe Screens, who were one of the first organizations calling for regulatory changes around screens. And then when we started working and talking with Dr. Becky Foljambe, who set up Health Professionals for Safer Screens.

We sort of jumped on Becky and went, who? She’s a GP. And we went, why are you the only health professional here? Why is no one else talking about this? And Becky put out a little tweet. This was all mid 2020 oh, early 2024, little tweet and said any other health professionals out there within 24 hours, she had 30 health professionals she’d never met before.

And that’s how we met Laura and connected to this growing, growing group of health professionals from every single type. We obviously have dentists, we have pediatricians, we have psychiatrists, we have psychologists, lots of speech and language therapists, occupational therapists, mental health nurses, you name it, we’ve got them.

And I work as policy director for health professionals. And our role is about really trying to get the message across that this is a public health emergency and that it needs treated like that. And that this is a problem from 0 to 18. We are volunteers and we’re a volunteer organization, and we are helping to create resources and guidance and working with Westminster and policy makers to try and make those shifts.

[Jaz]
I got into space from being recommended some from books from my within my dental community and some dentists who are members of your, and supporters of your organizations and the book Anxious Generation. It starts off with anyone who hasn’t heard of it. It gives this wonderful analogy at the beginning, like, imagine we were gonna send our children to space and they were gonna live there.

Yeah. And then, what kind of discussions would we be having? And then so essentially it drew this comparison of giving someone a device and how it changes their brain. And there’s so many unknown unknowns. Why are we agreeing to allow the manufacturers and marketers of devices to, and apps that go with it to be able to access our children’s minds?

There is. So it’s a huge problem. You described it as an emergency, and I absolutely agree, but we need to have some structure in this debate. I want to start with the scale of the problem, right? So I think one thing that I think every, I think probably 90% of people listening or watching this right now would’ve seen adolescents on Netflix, which I think, done a great job of really putting this for a while in the forefront of everyone’s minds.

Everyone was talking about this. I just wanna throw that in there and get your opinions on adolescents as a show. But Laura, what is the scale of the problem that we’re facing? 

[Laura]
I think to answer this question, we have to look at the statistics in terms, well, I think first off, we need to look at the, there’s some different nuances within different arguments. So screen time argument, the amount of screen time that children are spending is different to whether they should be on social media, which is a different argument to whether they have a smartphone. And they’re really important differentiations in what we’re talking about. So in terms of the scale of the problem.

Essentially, if we’re looking at smartphone usage, we now know that I think it’s 27% of five to seven year olds now own their own device, their own smartphone to do that. And by the time they’re 11 to 15, it’s over 96% I think. So, this smartphone usage has become almost the norm for every teenager across the country.

And of course, what a smartphone does is allow people 24 hours to access to the internet, to social media, to all the unfettered things that we need to, they can see. And that’s where the arguments sort of merge. But then in screen time, if you add in the fact that we’ve got, they use PCs at school most for a long time of the day.

They then come home and play on gaming devices or sit on the smartphones to scroll. They’re then asked to do their homework on a computer again. So before you know it, we now know that children are spending almost 4, 5 hours a day on a screen device outside of school so that turns into about I think one of the statistics is 35 hours a week.

That’s the equivalent of a full-time job. So the scale of this when you’re talking about screens and how much time children are looking at a screen is huge. It’s really big. 

[Jaz]
Laura, when I was growing up, I watched a lot of tv, like my parents were actually very pro tv. They let me watch as much as I wanted to and I look back and I really regret that. I wish I read more, all those things, but I am where I am and it is what it is. And that’s the tools that they had at their disposal. I didn’t have access to clubs growing up. Personally, I didn’t have access to those kind of privileges, but I consumed a lot of tv, so I’m very mindful with my own children for that.

Arabella, anything that you want to add to the stats? Because really thing, the next thing I wanna ask after this is. Okay. Which is worse? Is it? Are we really, is the public health worry? Is it the social media use? Is it the phone? Or is it just any screen time, including what they’re doing at school? Yeah, so please, Arabella. 

[Arabella]
Well, I think I’d add to what Laura was saying is that we frame this as a whole child health problem. So often this debate, as Laura says, can get caught up in tiny pieces so it can get caught up in, does this cause a mental health problem for a 16-year-old, or does this cause X for this?

And all of those are valid questions, but actually we need to look at it in the round. So if you think about. Whole child health and that’s how we should be approaching health for our children. We know from all the research and there is oodles and oodles of evidence out there. We know that myopia has gone up to sort of 34% of the population from 20%, sort of 15, 20 years.

[Jaz]
Well, what is myopia for those who are not familiar. 

[Arabella]
It’s shortsightedness. So shortsightedness and we know that it’s about outdoor time that makes the difference on it. Obesity’s gone up. There’s huge linkages between the seditary behavior of being on screens, but not just the seditary behavior because actually if you are sitting on social media or you’re sitting on gaming, you are targeted by fast food manufacturers in a way, way more than you would be on tv.

We’ve got lots of legislation around tv. But you don’t have that on gaming. So we know that not only are you sitting there watching it, but you are also getting the messages that these are good things, things to eat. So there’s all these subliminal things that people don’t necessarily pick up. Then you’ve obviously got all the anxiety, you’ve got the suicidal, indentation, all these things that Laura’s dealing with on a daily basis.

You’ve got the comparisons, then you’ve got the societal issues, which was picked up in adolescence. You’ve got the numbers of children who are radicalized and ended up in extremism. So 20% of arrests last year for counter-terrorism were under X. 10 years ago, that was 2%. And the Met Police are absolutely clear that that is a direct link to social media.

So there’s lots of things within this debate that often get ignored because we are concentrating on one exceptionally important area, which is the mental health of 16 year olds. But actually we need to think about it in the round, and that is why we don’t think it’s dramatic to call this a public health emergency.

[Jaz]
Laura, with the kind of child who ends up needing your services and needing your care. If there was an avatar, would you say it’s what the Anxious Generation book recommended, which was suggested, which is 14-year-old girl who is almost suicidal. And that is tragic, you know, but would you say that is an accurate representation of the kind of children who need mental health services as as a child? Is that the kind of demographic that you’re seeing the most? 

[Laura]
At what, 14-year-old girls? 

[Jaz]
Hmm. 

[Laura]
There’s a lot of 14-year-old girls. I don’t know if that’s the most, I wouldn’t know the statistics on what app. I think it’s across the board, to be honest, of all teenagers. And obviously I’m seeing the real tip of problems and there’s lots of children that I see that, you know, with awful backgrounds and really traumatic experiences in the mix.

Very, very difficult, hard times. And the smartphone is, I think, I’m trying to think of the number of children I’ve seen, in terms of who’s been affected by a smartphone. There’s a few. Definitely, we absolutely, without a doubt seeing children that are only in cams because they’ve had been bullied on side on WhatsApp.

And the bullying has got so extensive that they’ve then tried to take their life. And I can say that with my, I have dealt with that child in my clinic. So there are a handful of children in there in the services that are directly impacted purely by social media, by their anxiety levels, that their depression, their mood is all affected by what they’re seeing on social media.

But then there’s a huge majority of children in camps that the smartphone is not the cause, but then a child will become depressed, but then they spend their time scroll through on social media to think they make themselves feel better. But it’s then ends up in this vicious cycle, you get the dopamine hit, but then you end up in dopamine deficit and then it just have this absolute slump afterwards that whilst they think they’ve made themselves feel better, it’s made them feel 10 times worse because all they’ve done is compare themselves to other people in their perfect lives without any backstory to that.

So I think, I don’t know the numbers. I would love to get that research in terms of what’s the impact on our campus children. But I can absolutely say there are a handful of children that have, are there purely because of the phone use and social media use, but then everyone’s there that’s not got a direct impact. It’s making their symptoms worse, I would say. 

[Arabella]
And if I just add to Laura’s point, which is really valid, so Laura’s saying we don’t have the figures of exactly that point. And the reason we don’t have those figures is because we are not asking the question. So it’s only a lot of enlightened doctors like Laura or speech and language therapists who are actually screened for the question. It’s not commonplace to have a child coming in with self-harm and ask them about their online experience. 

[Jaz]
Wow. I mean, I would’ve thought it would be one of the first questions. 

[Arabella]
It’s not, and this is one of the things that we want, we want to change in public health policy, and we’ve created a GP screening tool. So we are trying to roll that out, which has those questions, but it’s not standard, particularly if you’ve got a 10 minute slot to ask these questions. It’s not standard that you are asking those questions. It’s not standard that if you’ve got a 5-year-old who’s nonverbal coming in as a speech and language issue, and speech and language is a massive problem, it’s not a standard question to ask how much time they spend on screens.

And how much linkage, and that’s part of the change we need to get within the health profession because we can’t measure this question because we are not asking this question. 

[Jaz]
Very valid point. Now, Arabella, from your perspective, something that Laura touched on earlier is that we’re actually dealing with, there’s so much to talk about because we’re dealing with multi-facets.

So there’s screen time, i.e., how much time someone might spent in front of tell your computer, which is one thing. Then at what age they get introduced a phone, right? Which is their own personal device. And then the apps that are on the phone are a completely separate problem, but they all encompass in this theme.

What do you think, Arabella, which of these, if we go with the Pareto principle, right? 80% of the problems come from 20% of its usage. What is the most worrisome aspect of screen use that we need to focus on perhaps as part of the emergency? 

[Arabella]
I would say, I think we probably all came to this conversation because of older children, because of the adolescents, because of the awareness, because it’s very dramatic. I think the vast majority of our members are now more worried about early years and in early years, early years the problem is very much about how much time they’re spending on. You can have a big argument about the quality of what children are doing on screens when they’re 15, 16. Are they learning to make music?

Are they revising and doing things? But for a two, three, 4-year-old, there are no benefits of being on screens. Even the so-called educational apps are not beneficial. They’re not researched. But as Laura talks about, they send the gamification of education. So you’ll constantly have a dopamine hit, which means that by the time you’re meant to be sitting in school and paying attention, you can’t do this because you are used to having buzz, buzz, buzz, buzz for every single thing that you do.

So if we had to be really simplistic. It’s very hard to be, because this is stunningly complex. We have to address the issue in early years because if you’ve had your child sitting on a screen from day one, by the time they get to eight or nine and they want a smartphone, which is the ubiquity in their pocket, it’s really hard to explain to them why they can’t have it when everything they’ve seen is is on phones.

As a country, we give no guidance to parents on phones or screen times or screens for little ones there is pretty much unique across the world with nothing there. So we don’t have anything in the Little Red Book. We have nothing in Start for Life. We have absolutely no guidance at all on how much time your kids should be on screens.

So much so that we’ve actually, I’m gonna try and show, but you can see us on our website, and this has been taken by quite a few NHS. We’ve created guidance working with the World Health Organization, guidance with other pediatric associations, with academics, which gives recommendations because we can’t expect parents to know the best thing to do with their children if we never tell them.

Or health professionals haven’t had any guidance on this. So yeah. If I was being simplistic, I would say we need to focus on early years and we need to focus on that clear message. ’cause then we have half a chance of protecting our children as they get older. 

[Jaz]
And Laura, would you agree with that? 

[Laura]
Absolutely. Yeah. And I think the issues and the challenges change as the age ranges change and you go up and that’s again, makes part of the argument very complicated. And there’s two very different clear messages as well.

The message at the beginning of trying to delay a smartphone for as long as possible, I think we’ll probably talk about age and letting a bit, is a different, very different argument to those children that are already in the world of having a smartphone and on social media. And they’re very different messages that need to be dealt with in a very different way.

But I think in terms of how we start to turn this, the new norm where everyone gets a smartphone, certainly by year seven it would seem to start turning that around. We need to focus on the younger years to do that. 

[Jaz]
Well said. I think part of the issue is this generation of parents, myself and my wife included. And that when I was a kid I could just, when I was eight, nine, I would just be in the street and I would come back three hours later. My mom wouldn’t know where I was. And everyone was okay with not knowing where someone was for a while. And now we get anxiety about not being able to see, or not being able to track even with GPS something.

So we are partly to blame as a culture of parents. And so this very, very difficult, I mean, one thing, slight digressing, but I think is very relevant. I saw on my facebook ads recently. A watch targeted for children that allows you to call your parents, which I like the idea of. ‘Cause all you can do on this watch is call and receive a call.

That’s it. Okay. And I mean, I like the idea of that as a way to have that sort of inner safety, that my child’s okay and I can reach them at any point without giving a fully fledged device. So I guess that naturally leads into your thoughts on this kind of approach, but then naturally leads into, well, what is the right age for a smartphone?

[Arabella]
Yeah. We would say that smartphones with full internet connectivity and everything involved and social media, it’s 16 and that’s very much about adolescent brain and it’s about the connection of really developmental tools in there, but also about the stuff you have going on at school and life and the distraction techniques with it to give you the space.

But the good news is that. Manufacturers are starting to recognize this problem. As you mentioned, there’s the watch one, but there’s also HMD Fusion are bringing out a phone in which isn’t as, doesn’t have total internet. It still has some connectivity, but has more protective on it. And I actually went to a launch yesterday, a pre-launch of a phone from a company called Sage, which is producing an iPhone, which has its own unique operating system so no children can get through it, and there’s nothing you can do on it and take all these information off so you have the positives that you need.

You have your wallet, you have your GPS, you could have certain apps on there that you need to go in. Parents can find you, you can make calls, but it’s not distracting. And we need to get to a world where we are offering parents and children a solution that makes tech work for them. And that’s why we are thinking it’s a very much a regulatory framework that can move this.

‘Cause everything shifts so fast. So, if we’re seeing ads now for sunglasses, which have all the AI in. And have everything in there. I mean, can you imagine how confusing that’s going to be for a teenage brain in relating to reality if actually you are not really seeing reality and you are talking to people through your glasses.

It sounds fun, but it’s really quite complex when you’ve got so much going on in our heads and Laura obviously sees the impact of these phones on kids every day and what she’s doing and the children that are coming in. 

[Jaz]
Would you say Australia’s the front runner here and being proactive in this? I recall recently they made it to age 16 to have, I think it was social media, to have age 16. Is that correct? 

[Arabella]
Yeah, they’ve, so what’s great about Australia is they’re actually grasping this as an issue and making it very clear and they’ve put the manufacturers, the software companies on the back foot for making them deliver age verification and showing you have to prove a way of doing it, and there are ways to do it.

However, you get into a question of what social media. So for example, they have taken YouTube out, but YouTube, from three years old, 90% of UK children are using YouTube. YouTube has fast moving, fast loads of fast moving things in it, and it’s actually one of the key ways that children see pornography.

They see violence, they see all these things which they’re not choosing to see, and it’s coming through. They’ve also taken WhatsApp out, and again, WhatsApp is another way for cyber, but massive problem for cyber bullying, grooming all these other areas. So you do get into a problem of what you define as social media.

But actually at least they are doing something. And they are recognizing it’s a problem. So that has to be a positive. 

[Jaz]
Laura, any comments on this theme? 

[Laura]
Yeah, I think I’ll just go back to something you said about a couple of things. So one was about Jonathan Haidt touched on this, doesn’t he? That we’ve moved from a play-based childhood to a phone-based childhood. And that that’s happened whilst all the devices have come up and become more in enticing to turn the child inside. At the same time, all the parents have been made to feel really anxious about not watching their children.

And there’s less eyes on the street. There’s more women at work. There’s many people looking out the houses, checking it, Tommy next door’s. Okay. And he thinks that that’s, he describes that as that phenomena where everything’s come together. And of course, the media is also to blame.

It’s not the parents to blame that we’re feeling so anxious as parents, but it’s absolutely part of the solution in that we need to empower parents and we need to free them really, because there’s some arguments against tracking in terms, I’m not saying whether what’s right or wrong, every parent has to make this decision on their own, within their own base, their own element of safety and their own confines of their own feelings.

But there are arguments in terms of if your child knows you’re always being tracked, the fact doesn’t develop their confidence in the same way. It doesn’t develop their problem solving skills in the same way they know what are you actually telling them if you are tracking them the whole time that this world’s unsafe, that they, that they’re not safe there to go out and about.

So there are some and also do you trust them? Are you saying that you don’t trust your child if you have got constant tracking device on them? So there’s some, I think we’ve got a long way to go before people feel safe to not track their child. And I think that’s one of the biggest problems about the devices.

And I think it’s one of the big pools that parents have of buying their child a smartphone because it has the tracking ability on it. But when you do think about it, there are some other arguments. There is another side to the argument whether we should be tracking all the time. And it is sad that children have not got that freedom as much, and as parents, don’t feel we can give it to them.

[Jaz]
If you were to have a overnight this power to do anything you could. And starting with the age, I know Arabella you said age 16, is the time you should even consider having a smartphone. Laura, would that be your number as well in terms of age based on what you’re seeing?

[Laura]
Yeah, definitely. 

[Jaz]
And what other, let’s say we had this perfect society where you two were coming together to set the rules. Can we just spend a few minutes on what would these rules look like? And these are like ideals based on the best available research that you are aware of.

And based on you in the trenches, Laura, and all the work that you’ve done, Arabella, what would be the perfect standard? The perfect world? Arabella? 

[Arabella]
Well, you’d start with no screens before five. And that doesn’t include tv, actually. What’s interesting is we’ve known for 20 odd years that having background tv noise or radio is not good for speech and language in young children, but actually shared TV from brilliant sources like public service tv, such as Bit CBBs, where you are sitting together at, it has a narrative, it has a beginning, it has a middle, it has an end, and it has a discussion point and is defined.

Fast moving, boom, boom, boom. Not great, but no screens before five and then really intentional your use within education. Why are you using this piece? What’s its value? Where’s it’s adding to it and we are not saying that there isn’t value in tech, there absolutely is value in tech, but really thinking about it.

So it’s not a standardized piece. And we are not gamifying education. We are hearing awful things about children who get to school and they can’t sit up on a rug because they’ve lost their core strength because as babies, they’ve literally just sat on a screen all day. And they’ve been sat on a corner, on the side.

And this came from a fantastic piece of annual research by Kindred Squared called School Readiness. And they look at children, it’s got worse and worse and worse. So that’s the first thing I’d start. Really intentional work. Work in schools. Separating the thought process behind what’s the ed tech that makes frees up teachers times to teach versus just putting children in front of it. And then Laura, do you want to pick up on teenagers and what you do around them? 

[Laura]
Yeah. If I had a magic wand, I think Snapchat wouldn’t have been invented. That has to be one of the biggest cause of some horrific problems. 

[Jaz]
And YouTube shorts. 

[Laura]
Yeah. 

[Jaz]
Like the shorts are absolute so like, dopamine heavy. Short, short, short. I hate that. 

[Laura]
Yeah. Because they’re just so easy to watch and the before you know it hours have passed by and it’s killing our concentration skills and it’s addictive. I think WhatsApp, I would never also have invented. And I mean that’s the bane of all of our lives. It’s certainly the bane of my life.

It’s the only thing I have my screen, it’s what takes up most of my screen time. ‘Cause I’m running four people’s lives on it. And for these poor children that are having to navigate the nuances of WhatsApp in terms of, they make a mistake at school and before you know it, they’re just cut out of a group.

That’s it. They’re banned, they’ve been taken out and the impact of that on your self-esteem. You don’t even know what you’ve done wrong. No one’s able to communicate or work out these friendship issues in person. You’re just barred from the group and that’s it taken out. So I would absolutely get rid of WhatsApp, but the positive thing I would do and change if I had a magic wand is improve community.

And that’s where argument gets so much bigger because that’s what people are missing, I believe, and that’s what they’re trying to find on social media and through the phones, is that feeling of community. And we don’t have shore start centers, we don’t have community centers, don’t have youth hub clubs, anything like we had.

And that’s what that gap is filling, and that’s for me would be where my magic wand would lie. We need to give the children something else. We need to make real life better than the on life version. 

[Jaz]
Thank you. Now we are speaking to dentists. Mostly it was dentists who listened to this podcast. So I mean, I could say, what advice would you give to parents from their lens, but I think I can give them the websites for the organizations to represent and they can get some really good guidance for themselves as parents. Not only just healthcare professionals, but as dental professionals.

What do you think, what kind of message do you wanna give to the dentists and dental therapists and dental nurses listening out there for how to change anything about our practice or the way we take a history. Or the advice that we give to help this problem. Help this, help- 

[Arabella]
I think, Jaz, you make a really good point because one of the big things we see is about body comparison and it’s about body dysmorphia. And as a teenager, you are meant to be comparing yourself to people. That’s kind of what you do. But your world would’ve been 20 people in your class. And we all remember what it was like and you felt awful. But suddenly you’re comparing yourself to thousands and thousands of people.

But also you are getting really dodgy advice from people who are self-professed experts in this area across, across social media. Quite a famous thing, which particularly talks about children’s teeth or teeth. You can fall down your own teeth, so just file them. It’s really easy. That’s a big trend that went around social media. 

[Jaz]
Yes, I remember. 

[Arabella]
Which is quite terrifying. 

[Jaz]
Also, mewing and like chewing hard things to drop your jawline, that kinda stuff. Yeah. 

[Arabella]
All that kind of stuff. And so I do think some of it will be about actually having the conversation with a child who comes in and isn’t wearing their brace properly because they think they can achieve it through mewing to ask, where did you get this information from? Why do you think this is pointing ’em in the right direction of trusted sources?

I mean, one really clear way we are seeing it at the moment is around pregnancies and hormonal contraception. I know this isn’t dentistry, but it’s the same kind of problem. So there’s a lot on online about hormones, hormonal contraceptives or coils or things like that are dangerous and they’re gonna give you cancer and they’re gonna give you all these different things and you shouldn’t do it.

We’ve now got the biggest increase in teenage pregnancies that we’ve had in a very, very, very long time. And you talk to our GPs and they will tell you the number of people who, or teenage girls who, young women who come in and go, I want to have X, Y, Z, but they don’t, they refuse to take HRT. They’re having spent a lot of time trying to understand where did you get this information?

How did you do this? Not HRT, sorry, contraceptives, which is a massive problem and that’s very similar to the kind of health advice I imagine. You get people who turn up, who’ve bleached their teeth in very odd ways or they’ve try doing different things. 

[Jaz]
Oil pulling for a while. This was 10 years ago. There’s a huge trend where huge cavities in the mouth that have a structural loss way beyond remineralization, but they were hopeful that magically, ’cause this is what they’re seeing on social media and that kind of stuff, magically animations of teeth with big holes magically growing back.

And they believe it and they actually believe that this just, they’ll spend half an hour swishing coconut oil in their mouth. But they won’t spend the 15 minutes in total per day doing the correct oral hygiene routine and that kinda stuff. So yeah, we see this misinformation disinformation all the time.

[Arabella]
Yes. And I think you have an incredibly important role in when children come into you and have, or young people asking where they got this information from and really trying to explain to them why it’s not safe, why it’s not helpful, which is what a lot of our GPs are now doing and questioning when people come in, particularly with oral contraceptive questions.

[Jaz]
I think the other role we have, and Laura, beyond you after this, because the other role we have as dentists is that a good, a decent percentage of population, I wish it would be higher still as a public health objective, but a decent population of our decent percentage of our population come to the dentist routinely.

Whereas the GP is a bit like as and when you need, and it may be a different GP, whereas hopefully you get a relationship. It’s relationship building with our patients, which is another adult who can guide you. Yes, our remit is oral health, but the key word there is health.

So, Laura, the reason I’m asking you here is, you see those in distress. You see, like I said, the very tip of the iceberg. We as dentists can help you in the lower down in the iceberg. In the preventive role. We are also in the front line of healthcare where we can, we want to focus on prevention. We give them advice about their sugar intake, which is very important for us to do.

But are we crossing any boundaries if we start saying about, asking parents about screen time, like, maybe not, I think maybe we should be helping with this problem. Well, what do you think a dentist should be doing? 

[Laura]
Well, I’ve see spoken to lots of children now and there’s children I see that are difficult to engage. They don’t want to be there. They don’t want to talk, they don’t want to talk to you. But as soon as you start asking about their world of social media. They come alive. For me, this has been a real turning point for me, a learning point and a point of acceptance that this is their lives.

And once you start inquiring about their online life, they will start to tell you about it. And often you’ll find, they’ve got, they don’t just have one account. They have 3, 4, 5 TikTok accounts. That will all have a different purpose to them. That will then , there’s a reason they’ve got each different account.

And until you start asking these questions, you won’t find this information out. So I think as all health professionals, we’ve got a responsibility to check in with that child. And you know, if we’re struggling to engage with one, that’s probably your way in, is to find out what their online life is like. And that’s not in a judgmental way, that’s not in a checking in way, that’s trying to, this is how we now have to engage with our young people. 

[Jaz]
Well it’s building rapport as well, isn’t it? 

[Laura]
Absolutely. Yeah. And when you start asking those questions is when you start hearing anything scary or things that aren’t right, or then you can start giving you alleyways about asking where they get their information from and where, who they trust in their life, who are their trusted adults, who’s in charge of, who can help you with taking control of your healthcare?

And I don’t think there’s any, I think you’ve got, I think as health professionals, the more of us that understand this message that we have to keep asking and that we come back with, well, did you know the recommendations are no more than a couple of hours a day for your screen time. But as you get older, after that young age, the more of us that can put that message forward, then it’s just gonna be the more they hear it and at some point you’d hope they start listening as do the parents.

Just planting that seed in terms of there is more you could do than just be looking at this screen all day, every day. Do you know what the damages could be doing? So I think it’s about opportunistic chat and finding a way in with the teenagers and the young people because they’re become, they’ve got a real risk of just becoming more and more cut off from us as humans from those generations above that still know the balance is really important. 

[Jaz]
Excellent. And I think the word that was screaming in my head there was safeguarding. Right? We, as dentists, we have a safeguarding policy. We have a safeguarding lead in our practice. We have a separate one for adults.

We have a separate policy for children. And I think that as dentists we should probably revisit our safeguarding policy and consider does this actually, are we just there reactive? Like when we see an obvious, real tip of the iceberg kind of stuff, or as proper safeguarding, can we probe a bit further and see if we can help, well assist in these children getting the right help they need.

So that was the thought coming to my mind. I see you, nodding there, Arabella, anything you wanna add about the safeguarding aspect in healthcare? 

[Arabella]
Well, I think this is a safeguarding issue. And actually you said at the very beginning we had a conversation around, would these exist if we were creating them Now these products? Without any safeguarding in? And we’re in a mad world where we have all these restrictions and regulations around things.

If you have a teddy bear where the eye comes off. It gets recalled into child safety. Yet we have these products where we know, and the coroners have linked children’s deaths to these products, and yet they’re on the market. And we are having to prove that they’re not safe with ridiculous amounts of causal information, whereas actually it should be the other way round.

These shouldn’t be on the market until they’re proven safe. And as health professionals, the core of what you guys do is not just safeguarding, it’s also precautionary principle. Why we shouldn’t, we have more than enough evidence from not only the academic research, but from your day-to-day experiences.

You talk to our emergency health consultants, they are having all these kids, not just the mental health issues coming in, but teenage girls who’s been asphyxiated because of the sexual violence that they’ve seen on screens and they’ve seen on, I mean, these are really scary things that are happening.

And yet, if it was a drug, it would be banned tomorrow without a doubt. But because it’s tech and because we confuse and conflate benefits and harms, we are not looking at it in that right way. But yes, this is at the bottom line, as you’ve put it, this is a safeguarding issue. This is real genuine harms and you have the most extreme of obviously, suicides, but also the kids that Laura is seeing.

But we shouldn’t forget that all these little things are impacting how our children relate and their long-term health. So one thing that’d be wonderful is because, as you say, dentists have a relationship with families from day one. Very young. It would be wonderful if you had some of our leaflets around guidance just sitting there.

[Jaz]
I was just gonna say that. I was just gonna say that. ‘Cause we have, we were leaflet heavy, we leaflet rich. Even just sending ’em an email sometimes with the correct video of brushing technique, but to be able to distribute your stuff. The volunteer work you do is amazing. We can slowly help and I’ll say any petitions we can sign, I’d love to put them for our colleagues and then for them to spread it amongst the parents because I think all wonderful, as parents, we are concerned.

We are in it together. I hope to think, and the vast majority of us want to get, we need guidance. I think we. Now we don’t know what’s the best way to handle this unprecedented, uncharted territory, if you like. And we need guidance. We need help. And what you guys do is you Protrusive Guidance, you give us some advice, some recommendations. So I think if we can distribute that, not only through the safeguarding and children, but actually to parents that come in who also want to help their child. 

[Arabella]
Yeah, I mean, all parents want the best and it’s very confusing, the information that’s given at the moment. It’s very confusing, this idea of I have to help my child get ahead, which is totally true, but being able to swipe on a smartphone isn’t the same as being able to code or being able to understand how AI works or those, and that’s the critical thinking.

And we seem to have conflated these two things and I think it’s very hard as parents, as I said, I’ve got a four year gap between my teenagers who are late teens. The difference between those two year groups at school and their experiences in just four years is mind blowing, and that’s how fast it’s moving.

It’s really hard for my experience of being a parent when my kids were four or five, fundamentally different. Fundamentally different, and that’s what we have to get our heads around. 

[Jaz]
I’m gonna ask you some personal question, and you may decline this, and that’s okay, right? Do your children have Snapchat?

[Arabella]
Yes. Because it was too late by the time that I realized the issue. 

[Jaz]
It was almost grandfathered in, right? Because everyone just had it. And before we see what hits us, they’re all in that. It’s a bit like the kids, they pick up YouTube and now suddenly Australia takes it away like, well, we’ve had this since age four, right? It’s a bit like that. 

[Arabella]
And Laura made a really good point early on that actually we have to look at these in different lights. We have an opportunity to protect our children who are younger by not bringing it in and how we manage those children who’ve already got these things. And in my teenager’s lives, Snapchat is the way they communicate with each other, where they organize it.

If I took him out on Snapchat at this point, he’d be no longer in the playground. And that’s why this is a collective action problem, why it’s easier to bring it in in gradually as a possibility. Some schools bring it in. Year seven and they gradually do it. But this is absolutely a collective action problem and we need to start early so that it’s just not even a consideration when currency journals get to 11. 

[Jaz]
Laura, what advice would you give to dentists who are parents, and they’re worried about their children’s social media use and maybe their kids are on Snapchat and they know about, as you said, one of the apps that we would ban if you had a perfect world will be, will be Snapchat.

What advice can we give to those children who are already using that social media and then also separately, before they get onto those apps? The whole thing about delaying it as much as possible, but then the whole thing about I’m the only kid in the class that doesn’t have this, that’s a different thing. So that’s not part B, but part A, what advice for those already using those kinda apps?

[Laura]
I think my advice would be to educate yourself because power is knowledge and the more knowledge you have about this, the more powerful you feel as a parent. And this is an incredibly difficult thing for a parent to deal with.

And you have to be forearmed to do that. I’m an absolute dinosaur. My children would call me. I am so strict and I know that I’m gonna be challenged in September. My real challenges are coming in September. None of them have a phone. We took the iPad away from them. I try to keep them off YouTube as much as I can.

They’ve got a switch, which they’re not really interested in because they’ve only got Mario Kart. I’m at the very opposite end, and I know I am about to have a very big challenge ahead of me, and I am just holding off as long as I possibly can. But the only reason I can do it is because I have absorbed myself in this stuff for 18 months and I see the effects and I feel so strongly.

I have that I’m able to say no. And whilst it’s me putting my head above the parapet, it’s very difficult for me then to make my son put his head above the parapet, who’s quite a different character to me. So my middle son is standing there with a placard of, don’t ever use a phone that’s why these are individual choices that you have.

You know your child, you have to work with that child. And you have to find compromises. So I think my first tip would be to educate. I think my second tip would be we need to empower parents. At the end of the day, you can say no, and you can also, whilst once those children who have already got a phone, they’re already in Snapchat, that is their communication tool.

It’s almost impossible to take it away completely at that point, but you can restrict it. One of my very good friends who’s a GP. She’s got four children, her eldest two have got phones. At 15 and 13, she made her eldest daughter who was on Snapchat all the time and once, once my friend got involved in this campaign, she reduced her Snapchat usage to three minutes a day.

She said, that is it, that’s all you’re allowed for three minutes. So she can go on, check it and come off and she’s done that. You can do it, but you have to be empowered. You have to know why you are doing it and that you are doing it for the better good of your child to do that. 

[Jaz]
These are tough family dynamics. I mean, these are some of the toughest things we face as parents. 

[Laura]
Absolutely the toughest thing we face, and I knew that was gonna be the case from, as I said, the minute my first child was born. It’s not a position any of us want to be in. It’s not a position any of us should be in, and it’s a horrible, horrible topic because you don’t want to be judgmental and try to run these campaigns and not be judgmental.

It’s very, very difficult not being judgemental. We are not blaming any parent. This is at the norms that have become normal and no parent wants their child to be left out. And that’s fundamentally the bottom line. You don’t want them to not be communicating with their friends, but we have to encourage this in a safe way.

And I think the other thing we can do as parents is reduce their screen time, but got to be proactive and put in other stuff as best as you can. And that doesn’t necessarily mean spending money or going to all the clubs. You just ask your child, ask your friend. Ask your child to invite a friend to your house.

Encourage real life person play dates. Encourage them to go to the park together without a phone. And when you have play dates at your house, be brave and say, put your phone in here, guys. And the more you make a stand and do that, the braver you feel the more empowered you become to do it. But it’s really, really scary. It’s a very, very scary move at the beginning, but it does feed on it. You do become more empowered the more you do it. 

[Jaz]
I just wanna add that, sorry, Arabella go for it. 

[Arabella]
I was just gonna, and building on where Laura’s coming from. She’s absolutely right because all the research shows that if you work together as a family to create a digital plan and you have guidance in, it’s much more supportive for children, but also adults working.

We actually have created family digital plan plans for different age groups, and they’re really simple tools where you sit down as a family, obviously not when they’re very little, but actually very importantly, sit down as a couple. And any other carers to talk about where do you have things, what’s important?

What’s there? So yes, they might have things, but don’t have them in the morning. So the first hour of the day. First hour before bedtime. Never ever, ever have them in the bedroom overnight. Any type of devices. Don’t have them at meal times. You might decide that you don’t have them in the car on the way to school because you listen to a podcast or you talk to each other, or you do different things.

But you can decide that as a family. What’s important, but also incredibly important is we as adults need to actually show our children what? Because children copy us. 

[Jaz]
Perfect. This is exactly what I was gonna say. It was that we need to be role models for our children. 

[Arabella]
Yeah, we absolutely do. And it’s really hard because we couldn’t live without our phones partly because of work, but partly, as Laura said, you are managing all your children. So I spend half my time looking on spawn to find where their matches are meant to be or doing my order or whatever. And one of the things you should be doing with younger children is you should be narrating what you are doing.

So when you pick up your phone, you go, mom’s just looking up when your football matches. Or Mom’s just doing so they can understand because otherwise it just looks like you are always on your phone and they probably think you’re on TikTok. Because that’s what they’d be doing. So as adults- 

[Jaz]
Well one of the reasons I got a smartwatch is just because the odd notification, I can just see it ’cause not emergencies, doesn’t need me and put it away and they’re just, rather than picking up the phone one, that was my main driver for getting a smartwatch is so I can eliminate having the phone in my hand.

‘Cause my son’s watching me, so I’m very mindful of that. I think it’s a great point. Another point, I love the idea of a digital plan. So we have a rule that in the car we don’t do any screens in the car. We can listen to songs. We take turns being the youngest in the middle, and then, and my wife and I, we all have turns about, okay, what’s your song?

I am trying to put on a Punjabi song. So I’m trying to teach them a mother tongue and stuff. So, that’s great. Unfortunately, we need a better digital plan at home, right? And hours meaning more boundaries there. And I love that. A great thing, a great reel I saw recently was Jordan Peterson, the guy who wrote the 12 Rules for Life.

He said that you need to run your family like you’d run a small business. You need to actually be purposeful and therefore you need to call in the meeting. Okay guys, we’re having meetings, we’re doing meeting notes, like family meetings and actually making plans and being purposeful. So that’s how you run your family. I love that. And what you said about making a digital plan just weaves in so well into that. 

[Laura]
Yeah. And they’re small actions that don’t feel as scary for a parent to stand up and say to your child, hey, we’re gonna introduce some small rules and we are all gonna do it. It’s part of the parents as well.

So things like when you come in, your phone goes in this box for the first hour of the, a first hour after you come home from school, so that you talk to me. And you all do that. You all put some people at the box at the bottom of the stairs where all the phones go in before they go up to bed at night.

So you need to do that as well. And obviously, you’re an adult and you’ve got parents that might be, you’ve got your elderly parents that you’re worried about, you have to bear those sort of things in mind. But as a general rule, those are small changes that you can do.

The other, the last thing I would say is on this is that, the really, really important part of this is that we are getting so much evidence that the young people themselves want this to change. And this is, they can see that they know that they are spending too much time, that these phones are addictive and taking over their brain.

So that also really helps empower a parent and the teachers to know that the young people themselves are really wanting change in this field. They know they’re spending too much time on their phones and social media. 

[Jaz]
Totally. Amazing. Any last points? ‘Cause I’ve really enjoyed this chat. I think some great action tips in there. Great ideas, and I think people can take action and at the very least, if everyone just download some of your guidance and put your websites, and I’ll put everything in the show notes. What are the best websites to go on to learn more just so I can all, I’ll put it in the show notes, obviously, but just so I can hear it from you, Laura.

[Laura]
So, obviously, as a health professional, it’s got to be the health professionals for saferscreens.org. As a parent, I cannot recommend the smartphone Free Chartered campaign. High enough. It’s fundamentally changed my life on so many levels. The aim of it is to find other parents that feel the same as you, that you want to hold off together, delaying giving your child a smartphone, and it builds communities in your area, and you can get as little involved or as much involved as you want in that campaign. And I honestly can’t recommend it high more. 

[Jaz]
Amazing. Arabella? 

[Arabella]
Those are the key places as well. And if you do follow social media, then please do follow the health professional social media. Sites because we try to do bite-size ideas and easy swaps for parents to try and bring people in and link and raise awareness.

But we also really importantly, need to raise our voices. Politicians do respond to parents and they respond to health professionals. And if you are talking to your MP and you’re concerned about this, write to them. Tell them about examples that you are seeing in your clinics if you are having kids coming in.

Your example about the coconut oil, I mean, that’s a brilliant anecdote because it shows the real, so things like that, that you can communicate and communicate to your royal colleges, because actually every royal college should have a clear policy on social media. It should have a clear policy on smartphones and digital, and most of them don’t at the moment.

So the more that you can raise it up, your professional organizations and say, this is something that you are concerned about from a safeguarding, it brings that message that all professionals, all health professionals, but also the police are worried about it. Education is worried about it. All these different people, that everyone is worried about it, that will drive change. It will shift things. 

[Jaz]
Well, Laura, Arabella, thank you so much both your time. More power to you. Please keep fighting a good fight. Us as the dental professionals, we will support you. I’m gonna make sure that I plug this everywhere in the community, in our apps and in our channels to get more, more followers for you, more distribution, more political action, wherever we can do to help the future of our world, which is our children. So thank you so much. 

[Arabella]
Thank you. 

[Laura]
Thank you. 

Jaz’s Outro:
Well, there we have it guys. Thank you so much for listening. All the way to the end. Any links and organizations that we promise, we will put in the show notes. If you can help and support these organizations, it will make the world a better place. So please do so.

If you’d like to get some CPD or CE, that’d be great. If you’re on Protrusive Guidance and you’re paying subscriber, please scroll down, answer the quiz, get 80%, and we will send you that certificate. Our members easily rack up 50 hours of CPD or CE every year easily. There’s a bank of over 450 hours of CPD on the platform with at least 50 new hours created every year.

Head over to www.protrusive.app to join the nicest and geekiest community of dentists in the world. As ever, love to Team Protrusive. Thank you so much for everything you do, and in this episode, love to all the parents out there. The struggle is real. I’ll catch you same time, same place next week. Bye for now.