The first survey, published in the British Dental Journal, was undertaken in Spring 2022 to explore the provision of supervised toothbrushing programmes in nurseries and schools across England. The second survey, undertaken in Winter 2024 and also published in the British Dental Journal, examined the changes since the first survey, and summarised key barriers and facilitators to the implementation of these programmes. A third survey is currently underway.

Data from our surveys along with other variables (such as area-based deprivation, prevalence of tooth decay in children, number of hospital admissions for tooth extraction, dental access, rurality and early-years education) has been mapped to show how the geographic spread of supervised toothbrushing has changed over time and reflects the distribution of these variables.

Interviews have been conducted with policymakers, oral health providers, early years setting staff, parents and children involved in running supervised toothbrushing programmes. We have interviewed 159 of these participants to explore in-depth the barriers and facilitators to implementing supervised toothbrushing programmes. This work was published in Community Dentistry and Oral Epidemiology.

This toolkit has been co-designed with stakeholders at all levels of implementation. We have reviewed and reflected on what resources were already available, their quality and developed resources to fill the gaps identified. The content of the toolkit was pilot tested in a small number of sites and is updated as new guidance and resources become available.

Through qualitative interviews in four areas of England we are developing a series of case studies to capture experiences of the implementation of supervised toothbrushing programmes and offer insight into the factors which affect their delivery.