Leeds (UK). Nearly a quarter of five-year-old children in England have tooth decay. This ratio is even higher in deprived areas of the country. And it’s not just one problematic tooth – children with decay have an average of three or four teeth affected. It is the most common reason for which young children aged five to ten years are admitted to hospital. When Labor leader Keir Starmer announced the party’s intention to expand toothbrushing programs in nurseries and schools, he faced criticism for planning to take this responsibility away from parents and place further burden on schools. But for younger children, supervised toothbrushing already happens.
It has been rolled out to deprived areas of Scotland and Wales and is being piloted in some areas of England. It is effective in reducing tooth decay, especially for children from deprived areas. This doesn’t mean brushing teeth at home, but it does reinforce good oral health practices. As experts in dental health, we know well the impact poor oral health has on the lives of children and families. We are leading a project to improve toothbrushing programs in nurseries and schools in England, and have recently developed an online toolkit to help schools, nurseries and parents, as well as the NHS and local government.
Painful – and preventable
Tooth decay causes pain and suffering. It affects children’s daily lives, including their eating habits, their speech and their self-esteem. This prevents them from doing things they enjoy and can disrupt sleep. And tooth decay impacts school readiness and attendance. Due to toothache, children have to take leave from school and go for dental treatment. While going to hospital to have a tooth extracted under general anesthetic minimizes the impact of caries on children’s lives, the event can be distressing for children and their parents. And the consequences of poor oral health in childhood last a lifetime. Children who have decay in their primary teeth are four times more likely to develop decay in their adult teeth. In England, treating tuberculosis in children and adolescents is expected to cost the NHS more than £50 million in the financial year 2021–22. For young children, toothbrushing with fluoride toothpaste in schools and nurseries is one way to deal with this problem.
included in the curriculum
Supervised toothbrushing involves children brushing their teeth as a group during the day, supervised by nursery and preschool staff or teaching assistants. This usually takes five to ten minutes. In Scotland, the ChildSmile toothbrushing program is offered to all children aged three and four in nursery and some younger nursery children, as well as some older school children. Research analyzing the program has found that it is effective in reducing tooth decay, especially in children at greatest risk, such as those living in areas of social deprivation. However, in England, toothbrushing programs are currently somewhat less common. Furthermore, oral health is already part of children’s education in nurseries and schools in England. This topic is covered in statutory guidance for primary and secondary schools. Similarly, promoting oral health is included in the statutory framework for early years settings such as nurseries. Running a supervised toothbrushing plan is one way to meet children’s oral health needs in their early years. Supervised toothbrushing in nurseries and schools does not replace toothbrushing at home. It serves as a supplement to home toothbrushing to help young children learn and practice good oral hygiene.
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