Information for Early Years Settings

A quarter of five-year-old children in England have tooth decay, increasing to 50% in deprived areas. Tooth decay causes pain and suffering with wider impacts on child development, attendance at early years settings and school readiness.

Daily supervised toothbrushing with a fluoride toothpaste in early years settings (nurseries, childminders and schools) is effective at reducing tooth decay, especially in children at greatest risk and is cost effective too. Due to it’s consequences for children’s education, dental health is included in the Early Years Foundation Stage guidance and the government has invested £11 million in 20025/26 to expand supervised toothbrushing to 600,000 children aged 3- 5 years old living in deprived areas.

Early-years settings include nurseries, schools and childminders. For those running a supervised toothbrushing programme, responsibilities include supervision of the toothbrushing scheme, managing consent forms, delivering daily brushing in line with guidelines, maintaining infection control, checking and caring for equipment, and liaising with the provider for ongoing training needs.

01
Consult your local programme provider to decide the best model for your setting.

Consider:
The age range of the children.
Staff-to-child ratios at various times of the day.
Whether any children have additional needs requiring extra support.

Choose a consistent location suited to your setting:
Will children brush while seated on the carpet or at a table?
Ensure the location supports good hygiene and easy supervision.

Select a time that fits your daily routine. Options include:
After registration while children are seated on the carpet.
As a break during learning activities.
After lunch, to help children settle for the afternoon.
02
The setting lead or oral health champion must:
Ensure all staff involved in the scheme are trained. Training should be given by your provider. If you have not been offered training please contact your provider.
Make sure staff read and follow the quality and infection prevention control procedures.

Ensure:
New staff are trained by the provider or via cascade training by the setting lead/oral health champion.
Staff who feel unsure receive additional training to build their confidence in:
Delivering oral health messages.
Supervising the toothbrushing effectively.
03
Supervised toothbrushing is most effective at preventing tooth decay if children brush with a fluoride toothpaste every day they attend your setting.

Detailed instructions on the steps involved in supervised toothbrushing can be found in the government toolkit.

Supervised Toothbrushing - Government Toolkit

Guidance on prevention and infection control must be strictly adhered to for the safety of the children as per the guidance. On an annual basis the provider will visit your setting to see how the programme is going and provide support if needed (Quality assurance). However, remember if you have any problems or questions at any time contact your provider who are happy to help.