There is a “postcode lottery” of supervised toothbrushing for children in England, leading dentists have said as a new study revealed wide variation in provision across the country.
Labour pledged in its manifesto to “introduce a supervised toothbrushing scheme for three to five-year-olds, targeting the areas of highest need”.
But the British Dental Association said that the Government is yet to deliver on its promise.
A town where children are 3x more likely to undergo a tooth extraction compared to the regional average has launched a supervised brushing programme.
— BDA (@TheBDA) January 20, 2025
It’s a tried and tested policy.
We’ve heard promises.
But we need to see national leadership in Englandhttps://t.co/kTEXMXoULh pic.twitter.com/XDrAhuCZXx
Supervised toothbrushing is already available for some children across England, with national programmes in place in Wales and Scotland.
These programmes are typically delivered in schools or nurseries, with children encouraged to brush their teeth with a fluoride toothpaste.
And a new review, published in the British Dental Journal, reveals variation of existing schemes in England.
Current schemes, which are run or commissioned by local authorities, appear to target areas of deprivation or where the prevalence of dental disease is highest.
But the use of the schemes varies hugely – from just 70 children receiving support in one local authority while more than 10,000 have been helped in another.
Four in 10 areas have not implemented a supervised toothbrushing programme at all.
The paper highlights key barriers to the programmes that are in place, including funding, logistics and a lack of engagement.
“Dental caries in children in England remains a major public health problem,” the authors wrote.
We need more than the current postcode lottery of provision
“STPs (supervised toothbrushing programmes) have been shown to reduce both the prevalence of dental caries and inequalities, while also being cost-effective, particularly when targeted to areas of deprivation.”
The researchers said there is “robust evidence demonstrating the positive impact of these programmes”.
They conclude: “In 2024 there was wide variation in the provision of STPs between LAs (local authorities).
“The results suggest there is room for both future growth in the number of new programmes but also in the size of existing programmes; although, significant barriers were identified.
“Funding was cited as a key barrier… highlighting that without a sustainable, ideally recurrent, funding mechanism, it is not possible for some areas to implement a STP.”
Commenting on the findings, Eddie Crouch, chairman of the British Dental Association, said: “The Government has made the right call on supervised toothbrushing, but it needs to put its money where its mouth is.
Five year olds in the most deprived parts of England are nearly three times as likely to have tooth decay as those in the least deprived areas – supervised tooth brushing schemes can help tackle this, as our new position statement highlights: https://t.co/JmHyXqdE8O pic.twitter.com/7En7HmRRUF
— The Faculty of Dental Surgery (@FDS_RCS) August 15, 2019
“Ministers have a chance to save children pain and our NHS a fortune, but only if they are willing to invest.
“We need more than the current postcode lottery of provision. Austerity-fuelled hyper-targeting will not achieve the change our children deserve.”
A Department of Health and Social Care spokesperson said: “NHS dentistry is broken, too many children are growing up with tooth decay and not enough has been done to help children keep their teeth healthy.
“We will fix this, introducing supervised toothbrushing in early years settings and putting prevention at the heart of our plan to rebuild dentistry.”
