Supervised toothbrushing toolkit to tackle tooth decay in children 

A new toolkit to increase supervised toothbrushing for younger children aims to address health equalities caused by tooth decay. 

Researchers from the University of Sheffield, University of Leeds and Bradford Improvement Academy, have developed free online resources for NHS organisations, local government,  schools, nurseries and parents, as part of the BRUSH project  to better support existing and new toothbrushing programmes.

A quarter of five-year-olds in England have tooth decay, this can rise up to 50 per cent in deprived areas of the country. The burden of tooth decay is significant, causing pain, as well as affecting what children eat, their speech, sleep, quality of life and attendance at nursery or school.

Treatment of decay is the most common reason why young children are admitted to hospital (33,000 each year), costing the NHS over £50 million annually. 

Co-lead of the study, Professor Zoe Marshman, Professor in Dental Public Health at the University of Sheffield, said: “One of the key ways to prevent tooth decay is toothbrushing with a fluoride toothpaste. Toothbrushing programmes in nurseries and early years at school are really important to complement toothbrushing at home. 

“We already know supervised toothbrushing programmes for young children are effective in reducing tooth decay, and easy for nurseries/schools to run. However, the uptake and maintenance of these programmes has been fragmented. 

“The new toolkit will make it easier for new toothbrushing programmes to be set up, meaning more children will be able to benefit from the programmes so less children suffer from tooth decay and its consequences.”

The BRUSH project was funded and supported by the NIHR Applied Research Collaboration South West Peninsula (PenARC) and conducted by researchers from the University of Sheffield and University of Leeds. The researchers worked with NIHR Applied Research Collaboration Yorkshire and Humber to understand how best to implement and evaluate supervised toothbrushing programmes.

Kristian Hudson, Implementation Specialist at the Improvement Academy, NIHR Applied Research Collaboration Yorkshire and Humber said: "Supervised toothbrushing programs will only have an impact if they are successfully implemented and sustained. We were therefore very careful in making sure our approach to the research used robust implementation science methods to discover what the key barriers and facilitators to implementation were. We asked many stakeholders about this including commissioners, trainers, headteachers, parents, and children. It's been great to help the team with this and our findings will mean the toolkit is even more useful".

Co-lead of the BRUSH study, Dr Kara Gray-Burrows Lecturer in Behavioural Science & Complex Intervention Methodology at the University of Leeds, said: “We know that there’s good practice and excellent resources out there, so our project was about bringing together all that’s already good and seeing what gaps there were.

“The toolkit is a central one-stop-shop sharing best practice and containing new materials we have developed to give organisations setting up these programmes, nurseries, schools, parents and children the relevant information and resources easily.”

Talking about the toothbrushing club at Tinsley Meadows Primary Academy in Sheffield, David Yates (Nursery Teacher ), said: "At first I did think, we’re going to do toothbrushing now and we’ve got 60 children, what if it is chaos and they’re all brushing each other’s hair or things like that! But they are really good at it, seem to enjoy and engage with it.”

For more information about the BRUSH study or to download the free resources please visit: