Health reporter, BBC News

School and nursery staff in the most deprived areas of England will be asked to supervise young children while they brush their teeth, under a national toothbrushing programme.
Schemes are already running in some schools – but now dedicated central funding will reach the poorest areas where children are most at risk of tooth decay, the government says.
Dental experts said the move would “save children from pain and the NHS a fortune”.
But the National Association of Head Teachers (NAHT) union said caution was needed to avoid shifting “what is ultimately a parental responsibility on to the burden on schools”.
National supervised toothbrushing programmes have been running in Scotland since 2006 and Wales since 2009.
And in Northern Ireland, some nursery staff have been supervising toothbrushing since 2016, in a funded programme targeting the poorest 20% of areas.
Teachers and other staff demonstrate and help, without directly brushing the children’s teeth, at some point during the school day.
Tooth decay
The idea, according to experts, is not to replace toothbrushing at home but to help build skills, good habits and confidence.
But in England, provision is patchy, partly because of logistical problems but also a lack of staff and dedicated funding.
About one out of every four five-year-olds in England has had tooth decay – and in poorer areas, it is one in three.
Tooth decay is the most common reason five-to-nine-year-olds in England are admitted to hospital.
And in many areas, access to an NHS dentist has become increasingly difficult.
‘Lifelong impact’
Health Minister Stephen Kinnock said focusing on prevention would help give children the best start in life.
“It is shocking that a third of five-year-olds in the most deprived areas have experience of tooth decay – something we know can have a lifelong impact on their health,” he said.
“It’s why we’re delivering supervised toothbrushing to young children and families who are most in need of support, as part of our wider plans to revive the oral health of the nation.”
The government says it is also working to reform the dental contract, so dentists take on more NHS work.
From April, local authorities will be given £11m funding and asked to identify schools and nurseries most in need.
The aim is to reach about 600,000 three-to-five-year-olds a year.
For every £1 spent on the scheme, £3 in treatment costs will be avoided – adding up to more than £34m over the next five years, the government says.
Some children will use the 23 million toothbrushes and toothpastes donated by Colgate to the programme.
The British Dental Association welcomed the move but said more needed to be done to tackle food marketing and labelling.
Eddie Crouch, who chairs the association, said: “Supervised toothbrushing is tried and tested policy that will save children from pain and our NHS a fortune.
“The only concern is why it’s taken a century to get here.”
‘Parental responsibility’
Paul Whiteman, of the NAHT, agreed there was a crisis in children’s dental health and the government was right to prioritise it.
“However, we cannot keep loading increasing expectations on schools,” he said.
“Nor can we keep looking to schools to fix all of society’s ills.
“Most people would see toothbrushing as a basic part of parenting and we must be careful not to shift what is ultimately a parental responsibility on to the shoulders of schools.”
Mr Whiteman urged the government to find other ways to support parents and focus on “rebuilding NHS dentistry”.
Dr Katie Dalrymple, lecturer in nutritional sciences, at King’s College London, said the initiative would have a positive impact – but to truly protect children, the focus must be on reducing exposure to high-sugar foods and drinks.
The government is also expanding water fluoridation across north-east England, following a public consultation.
How to brush young children’s teeth
- You can start brushing as soon as teeth come through
- Use fluoride toothpaste – a pea-sized amount for three-to-six-year-olds
- Making a game of it or brushing your teeth at the same time can help
- Spit out toothpaste after but do not rinse with water, which can wash away the fluoride
- Help children brush their teeth until they are confident and doing it well, around the age of seven
Source: NHS