England’s supervised toothbrushing schemes expand

Dental Tribune International

Tue. 12. May 2026

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SHEFFIELD, England: Supervised toothbrushing programmes for young children are expanding rapidly across England, according to a new study, and the researchers say that the schemes could play a major role in reducing oral health inequalities. The study also examined how and why implementation succeeds or falters and warns that long-term success will depend on stable funding, workforce support and stronger partnerships between local authorities, public health teams, schools and nurseries.

The researchers undertook a national survey of local authorities and found a sharp rise in the number running supervised toothbrushing programmes, which involve children brushing daily with fluoride toothpaste under staff supervision in nurseries, schools and other early years settings. The researchers said that participation has more than doubled since 2022, reflecting growing recognition of the programmes as a cost-effective way to prevent caries. However, they also found that provision remained uneven across the country despite the recent growth.

Most local authorities running schemes targeted children in deprived communities, where caries rates are highest. Some programmes operated in mainstream nurseries and primary schools, while others also included childminders and schools for those with special educational needs and disabilities.

To explore barriers and facilitators to implementation in order to inform policy, the study also involved interviews with commissioners and providers from four areas operating schemes at different scales. From these, the researchers identified two major barriers to expansion: uncertain funding and difficulties engaging early years settings. Many interviewees said that short-term financial support discouraged organisations from investing time and staff in schemes without guarantees of long-term funding. They also highlighted workforce pressures and the logistics of distributing toothbrushes and toothpaste at scale as challenges.

Schools and nurseries were sometimes reluctant to participate because of competing priorities and concerns that toothbrushing fell outside their educational role. According to the study, the settings most in need of support were often the most difficult to engage.

The research found that relationship building was critical to successful delivery. Partnerships between public health teams, schools, health visitors and community organisations helped improve uptake and overcome resistance. It also demonstrated that sharing knowledge between areas, including practical advice and examples of successful schemes, is essential. The study also pointed to ways to strengthen implementation, including targeted communication, trusted local intermediaries and senior leadership support to improve engagement.

Last year, the education and health departments announced funding to support local authorities in scaling up supervised toothbrushing programmes in the most deprived areas of England. The researchers said that the government’s planned expansion of these schemes offered an opportunity to improve children’s oral health nationally, but warned that one-off investment alone would not be enough to ensure sustainable delivery because programmes would also need sustained support for local partnerships, workforce capacity and shared learning.

The study, titled “Supervised toothbrushing programmes in England: A national survey and multi-site case study”, was published online on 1 May 2026 in the British Dental Journal.