Oral health

National Supervised Toothbrushing Programme

Hertfordshire has joined the Government’s Oral Health Initiative

Hertfordshire has received government funding to take the Supervised Toothbrushing Programme into its second year.

Gov.UK: Supervised toothbrushing for children to prevent tooth decay

If your school has been identified as eligible, we hope you will consider joining this important initiative. It has been carefully researched to ensure it meets government guidance in the EYFS and PSHE to provide the opportunities to participate.

www.supervisedtoothbrushing.com

Update at a glance

• Launch Date: October 2025
• Target Group: Children aged 3–5 in nurseries and primary school reception classes
• Purpose: Improve oral health, reduce health inequalities, and support motor skill development
• Support Provided: Free training, toothbrushes, toothpaste, racks, and home packs
• Delivery Partners: Hertfordshire Community NHS Trust Dental Team
• Hygiene: Equipment and guidance provided to prevent cross-infection
• Eligibility: Schools/settings in IMD 1–3 areas or part of NHS ‘Core20PLUS5’ cohort

Programme overview

The programme aims to:

• Encourage positive oral health behaviours
• Reduce health inequalities across the county
• Support fine motor skill development in young children

Participating schools will receive:

• Free training and advice
• Free equipment: toothbrushes, toothpaste, and toothbrush racks
• Packs and educational fact sheets for each child to take home

Who is it for?

The programme targets children aged 3 to 5 years in early years settings, including nurseries and Reception classes in primary schools, specifically in areas with the greatest health needs.

Hertfordshire joined the scheme in October 2025, in partnership with the Hertfordshire Community NHS Trust Dental Team.

Why oral health matters

Did you know . . .

Tooth decay is the most common oral disease affecting children in England yet it’s largely preventable.

• 22.4% of 5-year-olds and 10.7% of 3-year-olds have tooth decay (Oral Health Surveys 2020 & 2024)
• In Hertfordshire, nearly 17% of 5-year-olds have visible tooth decay
• Between 2021–2024, 280 children under 5 were admitted to hospital for tooth decay treatment

Tooth decay can impact:

• Sleep, eating, speaking, and socialising
• School attendance and performance

Local efforts already underway

Hertfordshire is already supporting oral health through its Healthy Mouths Programme aimed at vulnerable under-5s and delivered through Family Centres and Public Health Nursing.

How the programme works

The Department of Health and Social Care’s programme is being funded for the second year in IMD 1–3 areas. Hertfordshire includes the under 5 population listed in NHS Core20PLUS5 strategy.

Each class will receive:

• Toothbrushes for each child, toothpaste, and racks for storing brushes
• A home pack for each child
• Training for staff from the dental team
• Regular Keeping in Touch sessions

Children will brush their teeth daily under supervision. This complements—not replaces—brushing at home.

How schools can approach the activity

Dry toothbrushing:

• No water or sink needed
• Children spit into tissues or paper towels
• Area must be easy to clean

Wet toothbrushing:

• Brushing at a designated sink
• Children spit into the sink under supervision

Cross-infection prevention:

• Toothbrushes stored in hygienic racks
• Strict hygiene protocols followed

Get involved

With your support, we can improve oral health awareness and overall wellbeing for future generations, instilling good habits into children early on.

Want more info or to speak with settings already participating?
Let us know—we’ll connect you!
Email hct.hertsdentaloh@nhs.net

Oral health and the EYFS framework

Oral health is an important part of every child’s wellbeing. It impacts on the ability for children to eat and sleep, to socialise with confidence and to concentrate at school. However, many children experience problems with their oral health.

Tooth decay affects around a quarter of five-year olds in England and it is also the leading cause of hospital admissions for five to nine-year-olds by some distance. Many children who go to hospital because of tooth decay need to have teeth removed under general anaesthetic. 

This is despite the fact that tooth decay is almost entirely preventable.

The EYFS framework states that early years providers must promote good oral health. A new and updated set of children’s oral health ‘Top Tips for Teeth’ resources are now available to support dental professionals, health care professionals and those working in Early Years settings to encourage parents and carers teach children good oral health. 

The resources aim to raise awareness and provide instruction for good oral hygiene in children aged 0-3, 3+ and pregnant women, and address the impact of poor dental health. Parents and carers can also find new content with tips and advice on the Start for Life website.

A range of free downloadable and orderable resources, that can be used in dental practices, hospitals, Family Hubs, children’s centres and other Early Years settings, are available to partners on the campaign resource centre, including:

• Social media toolkit
• Posters (including empty belly version for partners to add local service information)
• Digital screens
• ‘Top tips for teeth’ leaflets
• Editorial copy

Top tips for teeth leaflets

Referral pathway

The Oral Health Alliance has published its agreed referral pathway as a guide. It is very important children are able to access the pathway when in Reception year. Permanent or ”grown-up” teeth can start to appear when children are age 5-7. The first permanent molars come through at the back of the mouth and no baby teeth are lost to allow it to appear. This means parents are often unaware that their child has permanent molars and they can get missed when teeth are being brushed. These teeth are really prone to decay and often have to be extracted.

Access to the pathway would give parents the information and support they need to prevent this happening.

Information from the Family Support Service

The Emerging Needs teams of Hertfordshire’s Family Support Service offer the oral health pathway for children who have been identified by Public Health Nursing, their GP or dentist, their school or Early Years Provider. Referrals can be made via the referral portal and will be picked up by one of the Emerging Needs team, who will make contact with the family; *please note that consent from the family must be obtained before making the referral.

The team will work with the family along one of three pathways that best meets their needs:

Working together, the Hertfordshire Family Centre Services (this includes the Public Health Nursing Service) and Hertfordshire County Council are improving the oral health of vulnerable under 5’s, preventing tooth decay, improving oral hygiene and promoting healthy eating.

Hertfordshire Healthy Mouths programme distributes oral health packs (a toothbrush, toothpaste, timer, oral health leaflet) to vulnerable families with children under 5. We do this through Health Visitors at one and two year development reviews and key contact networks and case lists. Oral health packs are also now being distributed to foodbanks and those in temporary accommodation.

The Family Support Service also has resources that Early Years providers can borrow and dental packs as part of the Healthy Mouths project. An Oral Health presentation is also available for EY providers to share with staff teams as a refresher of key messages. Please contact us on 0300 123 7572 for further information.

This presentation has been kindly shared by OneYMCA Family Support Service, for your use in staff oral health training.