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Service Delivery Model

The provider will need to develop a service delivery model detailing the approach to:

  • Identifying eligible settings/children (if applicable) - consider: 

    • How will the provider get the required information about settings from the local authority education and public health teams? 

    • How will settings be contacted? And when? Sending out a joint letter, to settings, from the Director of Public Health and provider may be more influential than a letter from the provider alone. 

    • How will refusal of settings be handled? 

    • How will the supplies be sourced and delivered? 


  • Identifying any locally existing supervised toothbrushing programmes or oral health promotion initiatives   


  • Delivering the service 

    • Consider if any activities will be outsourced and if so, how will this be managed, and if that service delivery meets the requirements of the service spec. 


  • How will the consent process of participants be managed, including refusal? 


  • Will an oral health champion be appointed in each setting? 


  • How will staff training in settings be delivered and assessed? This may be determined by the commissioners, but if not, the provider needs to consider what is more appropriate - delivering training in-person or online? Assess how well you think the training will be cascaded down to other staff members and how often it may need to be delivered. 


  • Age range of children - what additional considerations may need to be made for settings with younger children (2-year-olds)? 


  • How will they: 

    • ​encourage parental supervised toothbrushing at home including providing information on the importance of the continuance of toothbrushing over holidays?

    • use the supervised toothbrushing programmes as an opportunity to identify, address and promote the health of children more generally (Making Every Contact Count) 


  • How will they make the club available to children with special educational needs and/or disabilities?

    • Considerations include tailored training, availability of more support, types of toothbrushes and toothpaste. 


  • How will access to a dental professional for advice, if needed, be provided? 


  • How will on-going support be provided and maintained to settings?  

  • Decisions about the different configurations of toothbrushing (see below for more details) to use for example dry or wet brushing and the choice of toothbrush rack (toothbrush holder) system​​​

    • For example, one company may provide a toothbrush rack system where the brushes are the same colour as the racks, that have spaces with names and pictures on the racks and names and pictures on their brushes. Whereas another company has multicoloured brushes and no space to write names on the toothbrush racks.

Different models of supervised toothbrushing programme delivery

It is important to emphasise that the aim of supervised toothbrushing is daily toothbrushing. Discuss with the settings the different models of delivering the toothbrushing club to enable them to decide what works best for them to achieve this.
For example, consider the following:  





Dry or wet method brushing




The number of children with special needs. What implications might this have? Particularly if they need additional supervision.




The staff-to-child ratio and the implications of the method chosen




Where will the children brush? Will the children be sat on the carpet to brush, or sat at a table?




The age range of the children. What implications might this have?




When will the children brush? How compatible is the time chosen with their daily schedule?

Further considerations:

  • Are the resources shown on the website free to use and can I share the link to this website with others?
    Please share the website with others who would find it useful. The included resources are free to use. Please download and adapt for your setting while acknowledging the contribution of those who originally developed them.
  • Does this website provide any free toothbrushing supplies or staff training?
    No, these are supplied by supervised toothbrushing programmes. For interested settings (schools and nurseries), please contact your local authority early years teams or oral health promotion team for further information.
  • Do you have information for parents translated in other languages?
    Yes, the parents’ page has useful resources about children’s oral health. These include resources translated into different languages.
  • When should children brush their teeth at nursery or school?
    As part of a toothbrushing club, children should brush their teeth on a daily basis. The time of day will be decided by nursery or schools to fit in with the timetable and minimise disruption. It is critical that taking part in a toothbrushing clubs is in addition to children brushing their teeth at home. Parents and families should continue to brush their child’s teeth twice a day with fluoride toothpaste. The timing should be last thing at night and at one other point in the day. An important tip for parents to make sure toothbrushing is as effective as possible is to encourage children not to rinse with water after brushing, but just to spit out if needed. Rinsing with water after brushing washes the fluoride in the toothpaste away.
  • How does the supervised toothbrushing session work?
    Each session should take approximately 10 minutes. The children brush their teeth for 2 minutes under staff supervision. After brushing, they will be asked to spit out any excess toothpaste from their mouth into a paper towel.
  • How are children with Special Educational Needs and/or Disabilities (SEND) supported?
    Supervised toothbrushing programmes for children with SEND require tailored staff training and more support. For example, there are fluoride toothpastes available that are flavourless and do not foam which are useful for children with sensory sensitivities.
  • Are supervised toothbrushing programmes recommended for younger children (2 years old and under)?
    Supervised toothbrushing programmes are not usually run with child under the age of two years. Children of 2 years of age or younger need an adult to support them with toothbrushing. This is beyond the remit of nursery or school supervised toothbrushing programmes.
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