Toothbrushing programme to improve children’s oral health

Kimberley EYC

7 years ago

Toothbrushing programme encourages children to take care of their teeth

A programme to improve children’s oral health,a joint initiative between 4Children – now part of Action for Children – and Public Health England (PHE), was released in April. The initiative was piloted in 68 nurseries and with 20 childminders across the country. The Smiles4Children programme explored the best ways of getting children under five to brush their teeth during the nursery day. It also looked at how to involve parents and develop partnerships with dental surgeries.

The toothbrushing programme was designed to support awareness of oral health in 2, 3 and 4 year olds, aiming to achieve a generation free from tooth decay. According to PHE figures, more than a quarter of five year olds are suffering from tooth decay.The pilots, which ran in nurseries operated by Bright Horizons and Toad Hall Nursery Group, and in childminder settings that are members of the Leap Ahead childminder agency, looked at introducing tooth brushing sessions into settings as part of a daily routine activity. This included considering the best time to do it, whether singing songs helped to make tooth brushing fun, and practical ways of storing children’s tooth brushes.

As part of the programme, participating settings attended two days of training talking them through techniques and ‘implementation’ ideas. Most nurseries nominated a ‘programme champion’ to support the practitioners through the programme rollout and act as a point of contact for parents.

Prior to the programme, 27 per cent of both parents and practitioners were unaware of the suggested amount of time for toothbrushing; while 67 per cent didn’t know that you should not rinse your mouth after brushing.

A feasibility study revealed that as a result of the programme, children who took part are less reluctant to brush their teeth at home. Also, the number of parents either attending or planning to attend a dentist with their child has increased significantly.

Both practitioners and parents learnt a great deal through the programme, including tooth paste portions and length of time children should be brushing. According to guidelines, children from birth to three should use a ‘smear’ of toothpaste, while three to six year olds should used a ‘pea sized’ amount.

Early years settings also learnt how to safely store children’s toothbrushes and found creative ways of storing, cleaning and labelling toothbrushes to reduce the risk of cross-infection. Nursery managers and practitioners were very positive about the experience, stating that the introduction of daily toothbrushing was not seen as an additional burden, either financially or practically. 42% of settings found it ‘very easy’ to incorporate brushing into their daily routine.

The annual costs of delivering the supervised toothbrushing programme in the study were £204.06 per year or £4.09 per child. These costs only included purchasing tooth brushes and toothpaste, paper towels and for printing the information booklet. This is based on a full daycare setting with 50 children operating 51 weeks per year. Staff costs are not indicated as there is only a small additional impact on staff time as toothbrushing can be incorporated into daily routines.

Following publication of the feasibility study, Public Health England has published a toolkit to support supervised toothbrushing programme in early years settings and schools.